Tag: Doctors

Categories
Chronic Disease Internet Culture Reading

Day 1772 and No Signal

The volume of communication we receive digitally has risen to deafening levels. I’m shocked we aren’t all in a civilizational stupor muttering “mawp” like the cartoon secret agent Archer.

As we attempt to balance the barotrauma of the increasing volume of dings, pings, tings and Slack bings trying to reorient our attention towards them, the temptation is level the pressure explosively. Shut up!

The noise is bearing down on us relentlessly. Just when we think the pressure might equalized and we have adjusted to the din, a new chime will force a recalibration.

MAWP!

Our phones become dysbaric monsters. The ambient pressure disorder that is leveling your attention span to the cacophony of alerts and aggravated existential noise leaves us deaf, dumb and disoriented.

Different people cope with this in different ways. Many of my friends have committed email bankruptcy including me. Some people make big claims of having screen free homes. Others go to physical therapy or osteopathic craniosacral specialists for cervicalgia. Isn’t it nice to know your text neck is killing you even if the tinnitus and vertigo doesn’t get you first.

This is all to say that my Signal Mobile application inexplicably stopped working this morning and the silence is causing me some degree of anxiety. If I were a woman with fewer scruples I’d consider it disabling.

Alarmingly, because I’ve been forced to mute virtually every other channel of communication to avoid the noise, this means it’s been largely impossible to get work done.

Hopefully I find a solution soon. I rebooted my phone, cleared my cache and updated to the new iOS. Nothing works. I’m afraid that I’ll be losing the one channel that actually functions for me.

If not, you may very well not hear from me again. Twitter direct messages still work. If you are looking for me check the nearest ear, nose and throat specialist. If I can’t fix my ankylosis in my thoracic maybe I can improve my posture in the meantime. The worst case scenario will be installing WhatsApp but I’ve not given in to that nightmare scenario just yet. I’m running silent in my attention submarine but I’ll have to resurface at some point.

MAWP!

Categories
Biohacking Chronic Disease Medical

Day 1768 and Maybe A Corner Is Being Turned or Maybe I Should Turn Back

I feel as if I lost almost all of October to combating a medical hard left turn from what was supposed to be a pretty simple procedure requiring no downtime and little healing.

I feel like I got quite a scare and yet you’d think I’d be used to it, as this is all downstream of the interleukin-17 inhibitor that I changed onto at the beginning of the year for my autoimmune condition.

Every single quarter, and in some cases every other month this year, I have had some bizarre skin infection resulting from otherwise pretty benign situations. An infected gland in my eye (twice!) an abscess that turned into a deep tissue infection, and a tiny incision that allowed in a subcutaneous infection all rocked my world.

As much as I am thrilled to see all of my inflammatory numbers rolling in to baseline normal, I just don’t know if I can sustain having a health crisis this frequently for a medication that is supposedly working. It’s working at an extremely high cost to my sanity and body.

And you might say, “Well, the numbers don’t lie.” And I’d agree. But there are many other factors I have to consider, not the least of which is that healthcare access in America is so bad that I have managed two of the four crisis points with medical tourism abroad.

I am going to give my IL-17 inhibitor a full year as dosing on and off biologics is no easy matter and the compounding effects are quite real. But I do very much wonder if in order to go forward I must turn back.

Categories
Biohacking Media

Day 1766 and Thursday Styles Theory Strikes Again: Testosterone for Women Edition

One of my long standing theories, and a personal coinages, is the Thursday Styles Problem. It’s a theory of knowing directionally what is coming, but never being quite sure of when.

The New York Times publishes its “styles” section on Thursdays and Sundays. If you work in media, public relations or culture, you are aware of the general trends that will emerge on Thursday ahead of time. If you know “what everyone knows everyone knows” ahead of time, there is a lot of money to be made.

Predicting the trends sounds easy when I put it this way, but the timing of it requires quite a bit of foresight, and considerable planning.

The trend piece is researched and reported over months. It requires the editor to be familiar enough with the trend to approve the writer taking time & resources. That means other upstream media has to have covered the topic in the niche which requires its own planning and coverage.

And while hype cycles have shortened, culture still takes time. And really important cultural trends may even require years to be relevant enough to be Thursday Styles worthy.

And can you afford to wait for the cycle to run? Breaking news happens and a piece gets pushed. A hotter trend might push the piece for weeks or months. If your business can’t survive the long game of becoming a Thursday Styles trend, being first hardly matters. Being right doesn’t matter as much as being right on time.

There is an art to this. Publicists play long games. They seed articles with a long arc in mind. Prediction markets place bets on the likelihood of something occurring, but with many actors you can’t really control when and how a thing happens.

It’s hard enough that Alex Danco believes it to be its own cultural movement and a force akin to past movements like modernism. Predicting the future is now an active part of living in the present for everyone.

So naturally when something I am doing happens within a month or so of me doing a thing, I tend to feel smug. When Albania was on the front page of the styles section while Alex and I were vacationing there, I gloated. I’d been hip to the forgotten European country for years.

Today I got a push notification about women taking testosterone. It had the full ugly animations of a thirty minute reporting on a full blown phenomenon.

Frustratingly it is very light on specifics as to what constitutes a “high dose”, while framing the piece almost entirely around the wonders women experience from taking a higher dose of testosterone than what might be considered average. 5mg a day is roughly average, and the procedure I did lasts 4-6 months, so I am starting at an average dose after having been on a 3mg a day cream without getting an improvement in my bloodwork.

We’re started me with 10mg of estradiol (range 6-25mg with 8-10mg being most common), and 75mg of testosterone (range 50-150mg with the most common being 75-100). Day 1754

I have been very open about my dosing, my own bloodwork, and what went into why I chose to do it. Which, I’m glad, as the New York Times sure isn’t telling. Being very honest and open about details seems important as I have the privilege to experiment and I want others to benefit from that.

Because of minor complications, I’ve been attempting to be entirely transparent with those as well. The treatment itself is not dangerous and is tolerated very well, but I have had unusually high incidences of skin infections due to the IL-17 inhibitor I take for my chronic inflammatory condition, which led to a longer recovery than I’d have preferred.

Now that this is a full blown trend I promise to report back as I heal and as my blood work begins to show results. Until then, if you want to know what other trends I think will hit big and want to get ahead of the pack, remember I am just a message away. And I keep a shopping blog as well so you can buy what I buy before it shows up with a rave in the New York Times.

Categories
Biohacking Chronic Disease

Day 1764 and Not so Easy In and But Out of the Woods

It has been sixteen days since I confidently decided to insert testosterone pellets by tiny incision into my left buttocks. I was felt certain we’d checked all the appropriate risk factors and my tolerance threshold was met.

I felt I was making pretty decent progress on healing over five days as I had not only the benefits of HBOT but also read light therapy. I was pretty darn pleased and felt well.

And then it seemed I took a turn six days further on. Perhaps some trauma from the lidocaine and epinephrine induced enough of altered window of immunity that some bacterial weaseled its way in the wound and viola a subcutaneous infection called cellulitis.

I was put on two different antibiotics and we figured it would clear quickly. That was incorrect And it has been a slow healing process

Barely improving day by day. And I had somehow made the decision the night before the procedure that I would just waltz into a new beauty shopping blog as the holiday season warmed up. So that was perhaps bad luck on my part. And has slowed me down on something I was doing for some joy so I hope I didn’t let anyone down. I am muddling through.

Today I got an ultrasound on the wound after a fever spike and did a number of blood tests to see where my white blood cells and inflammatory markers were at.

The local hospital was having computer troubles which meant trouble scheduling an ultrasound but we managed to find another imagining clinic this morning.

Back at the hospital for bloods (they do walk ins for blood draws) they still appeared to be having issues with computers. “Your insurance isn’t recognized” was the verdict thirty minutes after using it at other lab. That made for a chuckle but we got it done.

The results are already in and we seem to be looking at healthy epithelial tissues and my CRP and Sed Rates were not elevated. Of course, half the reason I am worried is I take an immune suppressant for chronic autoimmune inflammatory condition.

It seems to manifest frequently as skin infections. My old drug wasn’t nearly as effective but it also didn’t have side effects. S

Hopefully slowly and with lots of protein and rest I’ll be healed and can spend my time on work and my pet beauty blog.

And tomorrow I’ll cross my 30th HBOT treatment mark so maybe it can make progress on building me up instead of dealing with a flesh wound. Which is actually just damned good luck on our part.

Categories
Biohacking

Day 1755 and Slow Healer

I am on a TMI roll this week so you will have to excuse this old blogger. If my n-of-1 experiments help even one woman struggling with her health, it’s worth it to me to embarrass myself in public by sharing the real details.

I’ve come consider this blog not just a personal experiment in daily writing, but my contributions to training the artificial intelligences of our future. I shall write women’s health into the Akashic records, even if I have to write every single day. Oh wait

Today I am moderately concerned about mg pace of healing and if I have contributed negative to it by increasing my strain modestly.

Yesterday I wrote “want to see something gross” about how maximalist approach to healing the incision site where we placed testosterone pellets.

I thought it was going pretty darn well and I had physical evidence with photographs to prove it. I did however have two days of poor biometrics which I had thought was a result of pushing myself physically a bit too hard while in my two days of menstruation. I

have rip-roaringly bad luteal phases (hence the exploratory hormone therapy to bring my testosterone to a normal baseline) but I have blessedly short menstruation that hits hard but doesn’t stick around. Aunt Flow knows she gets a weekend, and it ain’t a long one, before she has overstayed her welcome.

Now I’m going to show you something a lot worse than gross pictures of an incision site. I’m going to show you embarrassingly bad Whoop metrics. And now that I see them laid out I realize I probably should have asked my doctor earlier if I needed to go back on a prophylactic antibiotic just in case cellulitis was lurking. Like my god my HRV and heart rate are god awful right now.

Now they were a bit wonky this month but this is some danger Will Robinson territory. I honestly didn’t feel bad enough that I took it seriously.

I thought “eh Whoop has been sucking” for me. I thought this is just adjustment and the high heart rate is the testosterone is kicking in and my low HRV is just adjusting to finally having some energy. I feel genuinely energetic for the first time in years.

But today at a check up with another doctor they noted that I was at higher risk of developing cellulitis given my history over the summer with the abscess surgery and the panniculitus it had revealed. The side effects of the immune suppressive called Bimzelx I use as an inflammatory dampener seems to mostly manifest in skin infections. So either I’m just a slow healer and being paranoid or I’ve got to rock on with some amoxicillin to get the ill’in to stop.

Categories
Biohacking Medical Startups

Day 1753 and Vibe Coding for Your Skin Health

Many moons ago, when I was first attempting to get a diagnosis for why I was always in pain and exhausted, I got a battery of allergy tests. I did the “gold standard of allergy testing” called patch testing which is a form of pin prick testing designed to pick up responses that may be delayed.

It was an awful experience. I barely made it through the 5 day trial between the 100 allergen pin pricks and final measurements.

I remember begging the doctor for a way to measure early. I asked if I could take some Benadryl to take the edge off. Alas the only way it would be accurate and covered by my insurance is if I gutted it out.

You are not allowed to shower, sweat, be exposed to UV rays (no going outside) or take immune suppressants that might subdue your body’s response.

I was struggling to breathe, my entire body itched and ached, and I had a migraine so bad I couldn’t see for the stars & dizziness. It’s possible I wasn’t stable enough to have adequately consented to the test but I did get my final results.

Out of 100 common allergens tested it was confirmed I was extremely allergic to 10 of them with another moderate sensitivity set of twenty or so that I should merely try to avoid as opposed to my firm “no go” list.

The dermatologist gave me a sheet with 75 different chemical names and formats that I might encounter in the wild from these core allergens:

Budesonide
Ammonium Persulfate
Benzisothiazolinone
Limonene
Oleamidopropyl Dimethylamine
Formaldehyde
Lauryl Glucoside
Methylisothiazolinone
Propolis
Thimerosal

I instructed to search ingredient lists for these names any time I purchased a household product, personal care item, cosmetic or other item which might include these ingredients which ranged from nail care to vaccines.

It was honestly quite overwhelming. And some of the above ingredients are in basically everything. I dare you to avoid Limonene for a month.

So my husband and one of our best friends did what any practical minded engineer would do and they made me simple Google sheet where all 75 varietals could be checked if I plugged in the ingredients from any item.

I used it for years. I’d plug in the INCI from every brand I encountered into the sheet no matter what. I gave away a lot of products to friends.

Today it occurred to Alex that we should probably vibe code the thing into a proper web application using Replit so other people could check ingredient lists for their own allergies.

Within two hours, most of which was waiting on the kindly AIs to do their thing, we had a fully functional web application.

You can set your own allergens or click a few buttons for common allergens and “clean ingredient standards” and run a check for an all clear.

It isn’t super fancy but it doesn’t need to be. It just needed to keep your data safe, be easy to log into so you can securely check and access your personal list and generally functional enough to change and set allergens. We’ve put it on our own little domain just to see how much this will cost to run (and we’ve set up alerts so it doesn’t go bonkers) but we figured this should be accessible and simple.

And while there are other options on the market, most are bloated, overly paranoid and designed for scaring California moms rather than quickly helping people with clear preferences for avoidance and actual tested allergies. So hopefully our pain can help you breathe easier.

Some options for chemicals and irritants you can select on our app.
My own settings of allergies and sensitivities
Categories
Biohacking Emotional Work Medical

Day 1749 and Some The Worse For Wear

Every time life gets intense I wonder to myself why am I speeding into the turn? And then I look back at the last almost half decade (which is easier than I’d expected as I’ve written every day) and I feel the achingly slow pace at which we tackle the challenges of our lives.

We’ve had really big wins and really glass chewing teeth grinding bloody inch by inch progress that barely feels like a win at all.

It’s easy to focus on the bruises when they aren’t a metaphor like yesterday’s adventures in scalpel driven hormone treatment. But the the wounds that are more emotional are just as easy to spot.

Some pain has given me relief and some has been so heartbreaking it crushes me that it’s beyond my control. Bodies and borders are often beyond the control of mortals.

So I’m just rushing headlong into fun things like shopping columns and biohacking and my portfolio companies and my political engagement and hopefully we find the money and solutions to all the bottlenecks which range from family and pain to visas. And yes the bruise on my butt is literal.

Categories
Biohacking

Day 1748 and Putting Testosterone Pellets In My Butt Cheek

Intrepid biohacker that I am, when I learned that my testosterone levels were concerningly low, I began on a program to raise them.

I started with nutrition and supplementation but I already had a diet and supplement routine that was evidence based for raising testosterone levels in women.

I added in DHEA (Dehydroepiandrosterone) at 25mg. Six months of that brought me up to just about half of the lowest baseline acceptable. I was NOT getting adequate results.

My physician prescribed me a cream from a compound pharmacy which unfortunately didn’t agree with my skin. So we were going to get creative.

I had read a blog post from Cate Hall (whose husband Sasha Chapin had helped me on another entirely different vector of my life) on how testosterone pellets changed her life.

She had had teeny tiny testosterone pellets placed into her subcutaneous fat and had remarkable results in terms of energy and focus. This and that happened, and the summer was a mess, but today was the day I finally followed in her footsteps.

Vials of compounded testosterone

We’re started me with 10mg of estradiol (range 6-25mg with 8-10mg being most common), and 75mg of testosterone (range 50-150mg with the most common being 75-100).

We’ll aim for labs at 4-6 weeks after insertion which would represent peak levels. We will repeat dosing at 3-6 month intervals. We will check levels at 4 months or so, or earlier if I feel the effects waning.

Do be warned that within a paragraph or so, there will be images of needles, scalpels, and some blood. So feel free to not scroll down further.

Part of the difficulty with dosing this stuff is that the pellet doses are wonky and frequently out of stock – estradiol comes in 6mg and 10mg increments so 8mg is impossible.

Naturally, we’ve made surprisingly little progress when it comes to women’s health, particularly as it relates to hormones.

Prepared and ready to go

But as I am happy to be a guinea pig and my luteal phase is a mess of migraines and misery I figured I had little to lose and much to gain. I was the first patient my doctor has done the procedure on so if anyone in Bozeman is interested, you can confidently give it a go with him as I’ve survived it.

These cool tubes don’t actually go inside too far but sort of shoot the pellet into the incisions

I was given a local numbing agent with epinephrine. I needed a surprising amount of it but I was a bit nervous. Once I was just able to feel pressure and no pain it was time to make a small incision with a scalpel and in popped the tiny bit of hormone on the left butt cheek.

No big deal at all.

But if you don’t want to see it going in don’t scroll.

Just giving you space to turn back.

A tiny incision in my goose bumped bum with the little pellets easily tucked in

I am all bandaged up and still riding the cortisone of it all but I feel alright. I’ll be adding in progesterone orally to temper the estrogen as that’s another matter. I’m excited to report back on it as if I have even a fraction of Cate’s experience with it I’ll be quite happy. Also it’s about $70 a month so not cheap but not at all expensive for something that could potentially mitigate some long term issues I’ve struggled with for years.

Categories
Community Politics

Day 1736 and Putting Good Things Back Into The System

I had a few appointments in town today including two doctor appointments. I like to have my husband with me when the medical system is involved just in case I need a backup or level headed second opinion.

Afterwards we were able to catch a late lunch (nearly happy hour) at one of Bozeman’s trendy no seed oil spots. It being an odd hour for dining we could hear the conversations at the bar as the place was mostly empty.

A virgin Huckleberry margarita

There were two couples, one Boomer pair and the other geriatric millennials, who as it turned out both celebrating their anniversaries this weekend. The out of town Boomers had come for a Yellowstone and Tetons visit while the younger couple turned out to be local farmers in the valley and were excited to learn the tourists had something in common with them.

The Boomers had also run a farm in Florida but retired and sold it as it is apparently nigh impossible to grow oranges for juice in Florida anymore. The conversation had turned to everyone’s frustrations with the tariffs and the pressures it put on their work.

No one could remain competitive as cost inputs kept going up. Finding labor for smaller farms was getting more expensive and harder to secure. And land developers increasingly competed to acquire land piece by piece from older larger family farms who struggled to compete. We were full on eavesdropping at this point.

The husband in the young farmer pair was dressed just like Alex. He could have been Alex for how closely their styles matched. When he left for the bathroom, his wife said to the older couple how hard it has been recently.

Land he’d worked for years on a lease had just recently been sold to developers at an enormous markup. They understood the demand for housing but how could anyone continue to farm and make a living?

Between tariffs, labor costs and ravenous unmet demand for housing that could only be financed by large scale real estate developers the era of the family farm felt over. Only the big dogs could afford the costs and regulatory overhead.

We were finishing up our meal as we nodded along. Alex said to me “ok I know we don’t do this very often but I think we should pick up the meal for the younger couple.” Being on the verge of tearing up myself I couldn’t have agreed more.

I waved over the waitress and asked if this was possible. She seemed a little surprised “the whole meal?!” But it wasn’t a crazy amount. It was about $100. We sneakily paid our tab and theirs as quickly as we could. We didn’t want to make a thing of it. We just wanted to make their day a little better.

We got up and said to both couples that we couldn’t help overhearing it was both their anniversary weekends coming up and we wanted to wish them many more happy years together.

We thanked them both for keeping America fed and tried to casually saunter out before anyone noticed what we’d done. Hopefully this added a little cheer to their day. In a system as big and opaque and impersonal as America it can feel like there is nothing any of us can do.

So when you can do something even if it’s a small thing like picking up a meal we should do so. America is an idea but we are also a people and we stick together even if our elites make stupid decisions.

Categories
Biohacking Medical

Day 1723 and Hormonal Rollercoaster Rides

We spent a long time at the doctor’s yesterday as Alex and I gutted it out with our excellent physician (with AI assists) through a myriad of different tests. We were attempting to figure out why he keeps getting respiratory infections and why I’m such a tasty treat to skin bacteria.

In truth, my basic inflammatory biometrics have improved so much on the new IL-17a inhibitor Bimzelx that it’s probably worth the hassle of occasionally having to slice open a random effected gland or abscess once a quarter. It’s just a shocking amount of work to do whack mole with pathology reports.

What I don’t seem to be able to improve is my low testosterone and the flavors of migraine headache that come with the roller coaster of my luteal phase. Which is presumably a clue and we are following it.

Astonishingly my lady hormones are in tip top shape. Though the “you should have no trouble getting pregnant if we can get off the medicines that stabilize you” remarks remains a heads trip. Yes I asked.

It is not a head trip that makes one’s husband enthusiastic about the prospect. Which is fair, as we have no family support, no backup plans for me regressing physically, and the family that does support us can’t get to America. So one can see why a CEO husband with sick investor wife who would have to give up work, plus potentially messed up baby, isn’t super appealing. Anyways! TFR is a fun topic.

I started with basic supplements in the precursor category like DHEA and STRO about a year ago when my testosterone came in at a 2 nanograms per deciliter (ng/dL) when it should be somewhere between 9 to 55 nanograms per deciliter (ng/dL). For context, adult men typically have levels in the 240–950 ng/dL.

The one sticky widget is that my testosterone remains stubbornly low. You wouldn’t think such a raging “see you next Tuesday” such as myself would be overburdened with the feminine hormones and lacking in ball buster hormones but I am.

I managed to eke it up to 5 with supplements and nutrition but it really didn’t match my otherwise excellent hormonal profile. Having ruined my chances at a healthy immune system when we tried the first half of IVF, I’ve spent some time working on and with my natural cycles.

Good information for all humans

I loathe being in my luteal phase but when I’m in my follicular phase I get 90% of my work done. We had presumed it was the rapid decline in estrogen and progesterone but maybe my floor rate testosterone was more of the issue.

For the past 8 weeks I’ve been using a testosterone cream that clicks up your dose and you rub it between your thighs. I know it’s gross. So I was curious to see where I might land. And praise the Lord I am now at 15 ng/dL. From 2 to 5 to 15 is some excellent progress but still below where we’d like me to hit. So we are going to run another test and try out the tiny pellets they slice into your skin. Since I’m already used to scalpels and antibiotics I figure why not?