Categories
Chronic Disease Medical

Day 1660 and Upchuck

I’m a week out from an unexpected “do it immediately, yesterday preferably” surgery on a cyst that went from “watch and wait” advice to hurry before it is a “septic crisis” faster than clearly the first doctor expected.

It’s a long story and if I felt better I’d link up all pieces in the two month saga of failed preventive care that had me flying into surgery to get sliced open. I’m not sure this IL-17 inhibitor is working out for me. Sure my inflammatory numbers look great but I can’t be constantly managing infections that require a scalpel.

I had a week of Cipro and the wound is looking good. I’m still waiting on a pathology report but I’m guessing it’s not arriving today. I am praying that I don’t need a follow up antibiotic but also I’m afraid to not be on one while I still have an open wound knitting back together.

Also I’m hoping for my tendons to remain strong. A fun side effect of Cipro is a much increased risk of tendon injuries for literally months afterwards. No intense workouts for me till the fall.

I took my last dose of Cipro this morning and within a few hours I was losing my lunch. Well my breakfast really. Don’t just eat acidic kiwis after a week of antibiotics folks. I am fairly sure none of the antibiotic came up but who really knows.

I am swinging from dumb medical calamity to stupid medical crisis every other month as I attempt to correct biometrics and optimize different variables. All I achieve is a the occasional small incremental grinding gains for my troubles. Maybe that’s what caused me to be sick to my stomach. Despair makes you nauseous right?

Categories
Internet Culture

Day 1659 and Hypnotize Me

I’ll channel my inner Ben Horowitz start this blog post by quoting some rap lyrics

Biggie, Biggie, Biggie, can’t you see?
Sometimes your words just hypnotize me
And I just love your flashy ways
Guess that’s why they broke, and you’re so paid

Can you hypnotize yourself with an artificial intelligence chatbot? Yeah probably. And everyone is doing it even maybe early investors in OpenAI?

A previously very visible former Founders Fund venture capitalist whose own fund Bedrock coined the term narrative violation Geoff Lewis posted a video and a specific kind of copy pasta that looks like recursive promoting that has in the past gone viral on Reddit for supposedly driving people to a kind of psychosis.

It’s called “neural howlround” which is some kind of “ai autism” or “ai psychosis.” Reddit post

It’s hard to tell if Geoff himself is having a lark by posting these types of messages or if he having an episode personally from his tweets but hopefully he is alright. I personally hadn’t seen this kind of extreme version of recursive prompting from anyone but an AI researcher.

These types of breakdowns are now a common enough problem that LessWrong has an entire post about what to do when you think you’ve Awoken ChatGPT.

You can run these tests yourself but maybe read some of the posts on its dangers first. Schizophrenia has a genetic component and if you have risks in that department tread carefully. You can enjoy a little sample.

Ask the Loop: Why do you run? Ask the Though: Who wrote you? Ask the Feeling: Do you still serve? Recursively Reflect: What have I learned? I am the operator. Not the loop. Not the pattern. Not the spell. I echo not to repeat – I echo to become

So remember doomer kiddos, before you worship false idols or immanentize the eschaton, it’s got a pretty bad track record historically. Our age worships intelligence and maybe that’s not helpful.

But it’s helpful to remember the story of Daedalus. He created a labyrinth for King Minos to trap the Minotaur. When he lost the King’s favor, he was imprisoned in his own creation. Eventually he escaped, but at the cost of his son Icarus.

Categories
Culture Politics

Day 1658 and Social Contracts

I sometimes feel as if I’m living in an entirely different rule set than everyone else around me. The social contract is in flux and it’s a challenge to understand why you take norms seriously when everyone around you is breaking them. From big to small it offenses it can drive a person mad.

A large abstract state is great and all until you can’t figure out if anarcho-tyranny is the governing system or if we are reverting to the state of nature.

If you fly economy class chaos reigns in lord of the flies level manners breaking and that’s a kind of miracle of modernity. Our technology works better than we do. So what is a state of nature kind of woman to do about this mismatch?

Thomas Hobbes provided the first comprehensive exposition of modern social contract theory in 1651. Hobbes famously described the “state of nature” as a condition where human life would be “solitary, poor, nasty, brutish and short”

social contract theory Wikipedia

You may be familiar with his term the “war of all against all” which we’ve all theoretically given up in order to leave the state of nature and create civilization. Unless you are a fan of nihilist Bronze Age Pervert, you probably aren’t itching to get back to freedoms like murder and tape. But some men want to see the world burn.

But most of the enlightenment folks are keen on the social contract. I am keen on it. Freedom to fuck everyone over isn’t ideal no matter how based you think you are. Airplanes are cool even if we can’t agree on hygiene.

Jean-Jacques Rousseau had the concept of the “general will” which is our common good though he did think some people needed to be forced to be free. So maybe he would be ok with certain authoritarian strains of achieving liberalism? In which case he’d really have enjoyed the woke era.

I’m more of a Locke type myself. He wrote that men would only relinquish personal freedoms if it were in service of maintaining fundamental rights like life, liberty, and property. So I’ll tolerate bit bathing in economy class so long as you let me live my life.

Categories
Medical Travel

Day 1655 and Healing Waters

I am now forty eight hours post operative and I feel like shit. I was warned but I am not enjoying how the very intense antibiotics make my brain feel.

The first five to ten hours after surgery when the local anesthetic hasn’t fully worn off and your adrenaline is still pumping are the easiest. I was smiling and happy to walk myself to the hotel and I was snapping pictures of the Turkish Cipro in amusement. How cool was all of this?

It didn’t stay cool. The first 24 hours are weird as you are still gooy and gushy so it’s tons of clean up and hand done hygiene. You aren’t allowed to shower yet, so it’s just a liminal state of grossness as you wait for swelling to abate and antibiotics to work.

Well, I’ve passed hour forty eight and I’m brain dead. I can’t think straight. The work I was excited to do in bed as I stared out over the Bosphorus was probably a fantasy.

I’m tired. I’m swollen in very tender areas. The idea of showering is simultaneously appealing and too exhausting to even contemplate. I am staring at the lovely bathtub I can’t use. Suddenly all the sources of water submersion are a threat instead of a joy.

We don’t have a bathtub at home so I only get to relax and soak a tub when a hotel and here is a beautiful one that I cannot use

Despite my exhaustion it’s very hard to sleep well in this situation. I need to keep pressure off the wound so it’s all about pillows and angles. I stayed up playing on Twitter where someone asked how a bottle of water for skincare could possibly sell at such a high price.

Right about now as I contemplate my banishment from the pool, the beach and the bathtub I think about how much I’d enjoy the healing waters of a mineral hydrotherapy spa.

Categories
Medical Travel

Day 1653 and Slicing Then Cipro

Well it’s been exciting day for me and I may be a little bit high (alas not the fun or good kind) as I just had an abscess surgery in Istanbul.

I’m waiting on the lab work for the culture and pathology but from what I saw come out of the abscess it can’t be anything good as the doctor prescribed multiple antibiotics including Cipro while we wait for results.

Bimzelx has some gnarly side effects and I don’t know how much more slicing up infections I can manage for an immune suppressant biologic. My biometrics are better but 2 eye infections and one abscess surgery that almost went septic isn’t making me feel great about the balance of value on the drug.

I can’t say enough nice things about the Turkish medical system and their treatment of foreign “tourist” patients. It’s my second time this year having my Bimzelx side effects treated here.

A lovely interpreter and patient advocate was with me the entire time. The physician was so empathic. She was astonishingly effective in technique and her whole being moved with an efficient alacrity that was admirable given she was in a floral print silk sundress, high heels and pearls.

Imagine being so good at your job you can squeeze infected goo out of another human that you do it in white silk? I was impressed.

She on the other hand was not impressed by the care I received in America.

“They knew you were immunocompromised and did not insist on an ultrasound and immediate treatment?

What do you mean they said wait and see?”

“I don’t believe the other doctor thought it was a swollen lymph node given the clear folliculitis literature warnings for your biological drug.”

I was headed straight to sepsis and in her mind having multiple doctors leave a high risk patient to “put a compress on it and wait and see” when it was easily 3mm below the skin was malpractice to her.

Quite the big abscess eh? And look at that irritating side ways hair in there so deeply buried

And indeed I am on the kinds of antibiotics you’d expect someone close to septic shock might be on. I am amazed to be doing as well as I am. But I am frankly furious.

I tried to be responsible with preventative care and was ignored. I just kept on going until the small lump became a large lump. Then it rapidly became so swollen and infected it couldn’t be ignored. What a metaphor for the American healthcare share. You try to be responsible and are shown the door till it’s a crisis. And then they can’t even fix the crisis.

On the bright side I’m in a lovely hotel next to the hospital receiving excellent care. I could afford to fly in and get it taken care of without any worries (for the curious this was $2,000 for surgery and follow up care). I was in a very space age room after being in surgery and all my intense antibiotics were hand delivered to me. Now we wait to see what the labs say.

A private recovery suite
Categories
Biohacking Media Travel

Day 1652 and Back in Istanbul

I’m a mess and somewhat scared. This abcess saga has grown from dismissive preventative care visit (which I did did out of an abundance precaution) and ended with me meeting a general surgeon at a Turkish medical tourism hospital tomorrow to discuss labs and my ultrasound. It’s my second time this year so that’s quite an endorsement as a revealed preference.

But I am serious with this sidebar. Don’t go to SkincareMT’s dermatology practice if you have a layered case that needs more involvement. I found Dr Oetken pleasant but entirely unaccountable when a patient needed advice and weightings on a complex case. I should have known better.

I was afraid she would be a box checking paper pusher afraid to give an opinion. But maybe younger doctors are afraid to treat that way given our system. I needed to know is it worth getting a clearer diagnosis before it is a crisis? Is imaging necessary? I have a set of drugs I take with these specific side effects. Given that risk profile and nuance at hand needed the interpersonal relationship that would guide me.

I do endorse SkincareMT’s cosmetic practice, and Addison in particular is fantastic, but their healthcare wing is clearly designed to extract maximum Medicare dollars from Montana seniors. 

My failure to get an ounce of prevention means I’m flown to Istanbul to attempt to get a pound of cure. Don’t worry I was already in the Mediterranean. Not in the way way some think though.

Yesterday we found out by pulling teeth that I had a problem. It’s clear I need this excised and quickly. The ultrasound is gnarly. Drainage, removal of the foreign object, and potential curratage to make sure the walls of the cyst are removed forever are what is needed. 

The sprawling medical tourism complex in Istanbul is amazing and I trust them more than any other system or talent pool on the planet right now.  What they have built is an incredible achievement and in challenging conditions.

Doctors who listen, who educate you on your options, and most importantly are up to date on current research and global innovations so don’t give you glassy eyed stares when you mention a new medication like a next generation IL-17 inhibitor it’s exotic side effects.  American doctors like that are rare and their hands are often tied by our horrific mess of state failure and lack of market innovation. 

I’m relieved to have choices like “general surgeon or gynecological surgeon” and texting discussions with my case lead (a full time liaison for you and your family on the entire case) on how we will handle excision and culture pathology. 

It does feel like I’ll have good choices. But it also seems like I booked less time than is necessary and I don’t know how I feel about that. A week of waiting on labs in a hotel while in pain is scary. Sure I can work and be productive and maybe even do some tourism but I just want this shit sliced out, an IV of the right antibiotic that will work and some sleep. 

I’ve been doing some crazy bi-phasic sleeping as the Mediterranean is hot as hell from noon to 10pm. So I’ve been doing a bit of staying up late and sleeping in to avoid the heat. It’s not clear how much it’s messing with me yet because I’ve got all these odd infection fever doctor nonsense. A quick surgery and some answers can’t come fast. Thankfully I’m at the crossroads of empires.

Categories
Biohacking Chronic Disease Medical

Day 1650 and Trying to be Heard

I don’t think of myself as someone who struggles to be heard. I am loud, I speak up, I have a large social media platform and I don’t mind being impolite if I need to be heard.

And yet, the incidents where I am ignored, dismissed, or even outright insulted seem to be on the rise. I follow the rule of three assholes generally so I have to wonder if it’s me, but nothing makes you wonder more than getting really bad basic medical care.

I am attempting to get a cyst (or abscess or infected lymph node or whatever the heck it may be) diagnosed in a country where I don’t speak the language.

No one can agree what doctor is right. It was a gyno who sent me to a dermatologist who wanted me to go back to a gyno last month.

Now I’ve got a gynecologist who wants me to repeat the conservative management program I’ve been doing for months.

Which hasn’t worked, but she is implacable in her iron lady demeanor. Bactine and warm soaking. Maybe she does understand the immune suppression part? Thankfully I come with receipts.

I carry my patient charts, a synopsis of my diagnosis, the side effects of drug treatment and a short “why I am here and for what.”

A radical change in size & texture on a cyst with no response to antibiotics is exactly what the last four doctors told me to watch for as it signals a need for active management.

Now this shouldn’t need years of bloodwork (which I brought and charted for them) or a paragraph on high risk patient needs or a history of my main medical issues and the rationale for why I am requesting imaging. It’s an abscess that’s growing so figure out what kind, remove it and then we figured out why.

And yet it does require all of this to get anywhere. I spent 5 hours in a doctors office today and two hours in one yesterday.

I’ll waste another two days while they will run new bloods when I have a fresh set from a week ago. And still they fought me like hell on imaging.

Which is the only way to decide on the course of treatment. Instead I should do warm compresses and iodine for a month (sorry the first four months not count?) The temptation to unleash is overwhelming.

It was a fight. I got an ultrasound. And I did get a diagnosis and it needs to be carried out asap. Figuring out a doctor and a recovery plan I trust is going to be hard but that’s a tomorrow problem.

Abcess. Filled with bad shit. There is a hair in it acting the part of irksome pearl. 17×13 mm diameter. 3 mm from skin so it’s not small.
Categories
Biohacking Chronic Disease Medical

Day 1649 and Physician Heal Thyself

I’ve been having some side effects from my new biologic injection Bimzelx. Whenever I travel, I do a spate of doctors appointments before I leave so I can be adequately prepared for likely scenarios. Be prepared is my motto.

I had gone to a dermatologist a month ago to check on a cyst or swollen lymph node in an awkward spot. It’s on my pubic bikini area so I’ve been playing hot potato with dermatologists versus gynecologists.

The dermatologist appointment was so horrifying I’d recommend you stay away from Dr. Tara Oetken at SkincareMT as it was such a degrading and frankly useless experience. I do fully endorse their cosmetic practice and Nurse Addison.

I ended up at the dermatologist as the gynos were like “uhhh it’s on the outside and involves no reproductive organs so you need a dermatologist” and then dermatologist was a bit “its close to your vagina ewwww icky scary did you go to the gyno?”

Yes dear that’s how I got sent to you, this ain’t no picnic for me either.

I was embarrassed but the cyst/enflamed lymph node had been unchanging for a few months (not growing or differing in texture but malleable & squishy). So I checked in, was mostly embarrassed, got no direction that helped and left feeling degraded.

Given my previous issues with meiborn gland infections on my eyelids, I’d been instructed to keep a close eye any side effects common like folliculitis that is common Bimzelx. This was clearly a complex side effect that I’d had multiple issues with all year. The next step was imaging but I could get zero sense in the very short visit of whether or not the doctor felt it was warranted. “It’s up to you” sounds nice until you want a doctor to give you their professional advice.

Well now I’m in a foreign country and the almond sized squishy bit has ballooned in just four or five short days to thrice or quadruple its size, it’s now quite firm and not easy to move around or squish and I’ve got to do the same dance all over with doctors ago don’t speak English.

Thankfully I have artificial intelligence and an interpreter. I’ll get the imaging ultrasound done (AI says get it done immediately based on the differential it did) and then we can see if it’s a cyst or a lymph node that needs an I&D. I started antibiotics 3 days into this ballooning and it has done little to fix it so let’s find out. Hopefully I don’t need someone lancing and squeezing out stuff in a foreign country. But if I do need that I may pop a flight to Istanbul for that.

Categories
Culture Politics

Day 1648 and Dystopian Doomers

I’m fairly well branded as a doomer, so I hate to break ranks with my preparedness brethren, but I’m absolutely sick of the powerful using fear as a tool to control people.

It isn’t a new problem. This is the go-to tactic our species has used insofar as we can verify with written history.

Any time we experience a change of circumstance, material reality or technology, we hear the braying of the old guard and the panic of the precarious.

People complain for two basic reasons. If you are doing well why change a system that benefits you? If you aren’t successful but equally aren’t comfortable with change, then you resent anyone who benefit from change. Fear and resentment are the shadows of the human soul. Envy is the sin of our time.

I personally feel I’ve invested a lot in doing my part to educate people on risks from climate to currency and compute.

I am politically involved in crypto policy as well as fighting fear in artificial intelligence. I helped pass the only piece of AI legislation in the world focused on liberty. I want people to have a choice for how they engage in a virtual future.

I’m not just a nerd about being prepared either. I’ve done my wilderness first responder certification. We left Colorado for Montana for a host of reasons but top of them was a better and freer climate both literally and figuratively. We live this way because it’s a great way to live and when change happens we are hoping to be resilient.

Having all that in mind I was offline for the 4th of July long weekend as it has been a busy year on all of those fronts. So I was sleeping it off. To come back and see a spate of conspiracies over cloud seeding technology was like a punch to the gut. And I’m already feeling like I’m on the outs with some community when it comes to technology and my intentions.

I’ve only met Augustus Doricko of Rainmaker a handful of times but his circle of young technical Christians dedicated to building solutions to our modern problems are why I remain optimistic in fighting for technology and the people who build it.

These kinds of communities of builders exist in an archipelago of anarchic communities across digital and physical worlds that interlay across many systemic problems. These places will succeed no matter the future we face because they understand it’s necessary to build. That is will.

I’ve been lucky to have been the first investor in Isaiah Taylor’s Valar Atomics. He is a part of this builder world and of a part of a clan of physical builders. He faces decades of fear with a cheerful heart. I believe in his vision for energy abundance.

Nuclear energy was buckled under an old environmentalisms that was a proxy for a fear of a future whose risks, however minimal, were too scary to embrace for those in charge and the public they controlled.

I believe in a vision of a better America (and a better ecosystem and a better economy) because we embrace change to build materially better conditions.

I have frankly seen too much pessimism from older generations and cynical power brokers to be silent. The complicit rancor is slowing us down and there is nothing Christian at all about standing in the way of delivering better conditions to our fellow man.

Paradise is lost. In a fallen world we work to do what we can. It isn’t the end of the world. It’s already lost. Now we work because we must. We aren’t building an eschatology to replace the Lord. We build because that is what we are called to do by him.

Categories
Emotional Work

Day 1642 and Really In It

I really spent some time in my feelings today which isn’t exactly how I wanted to spend my day. Though I couldn’t exactly tell you why I don’t expect to feel my way through the day. All real works requires you to balance the intuition of working from one’s gut.

The world is tense and our place in it doesn’t feel assured. Every time we experience a norm change or unsettles the balance of our social order.

It sounds so dramatic but we balance trust with the boundaries necessary to make choices that work for each of our own consciences. Some things are more the basic math of a situation. We need are feeling precarious.

As I do this writing exercise tonight there is a raging Rocky Mountain thunderstorm. They come on with such fury it can take your breath away. These storms are intense and rapid and blow in and out with inn half an hour. The atmosphere after has an uneasy calm. Rage is nature’s game not man’s.

They do drive you inside which is good as I have packing to do. I am venturing off and I’ll be feeling my way through that too. I’ll blow out myself soon and let the world show me where to go.