Tag: Health

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Chronic Disease Emotional Work

Day 330 and Vitamin Not Pill

I was reading a fellow investor’s thesis page and noticed one lens they use for investing is whether a product is a “vitamin or a pill” with the insinuation that pills are inherently better investments than vitamins, as one is a nice to have for a business and the other is a must have. Now I can’t speak to this as an investment thesis, though I largely agree, but I do disagree on a wellness basis.

Preventative medicine is just as necessary as interventional medicine. In some cases more so, as getting ahead of a disease’s inflection point should be the humane way we handle our medical needs. We are just often too focused on short term impacts to see the value of solutions that build over time. Think of it as the quarterly reports of healthcare. Why build for the future when the market judges by each 10K?

The nature of panic may make us inclined to spend heavily on something that has become acute. But that does not make it inherently more effective or worthwhile. It’s just the immediately necessary. It just means we need higher minimum effective doses to see a result.

What we often ignore is compounding effects of wellness interventions are far superior to the mitigation of a pharmaceutical over time. Most of us would prefer to not require the costly (both biologically and financially) medicines that keep us together. This is not to say that I am not deeply grateful for all the drugs I take. But rather that I have seen incredible value in what we deem “lifestyle interventions” and other “nice to have” vitamin style supplements and protocols.

And while it takes much longer to see their effects, the compounding positive effects often wildly outperform anything that might be dubbed a pill. The trouble probably boils down to switching costs and time to pay off. Which is why an investor would prefer a pill to a vitamin. But just because something has a longer lifecycle doesn’t make it inherently less sticky. Or less effective. Or crucially any less profitable. The only way we ever see the deeply positive effects of habitual practice and dedication is to do the work. That work is boring, repetitive and low payoff. Until, most times years in the making, you see how putting your future self over your present self is what is giving you the future you always dreamed would be yours.

Categories
Internet Culture Politics

Day 326 and The Long Now

A culture lacking optimism is a culture without a future. Even before the pandemic, American youth had plenty of reasons to temper their optimism. Inequality, corporate dominance, rising debt particularly for school, unaffordable housing, lack of social support for family, the changing climate and the frequency of natural disasters all tend to weigh on you.

I’m a optimistic person so I always presumed I’d find a way around things. And I largely did. I got an education. I started my own company. I sold it. I found I had developed a valuable skill set. I met a man through one of my best friends and we got married. All was well in my American dream for many years.

But cracks had always been there. Little details that made me question common cultural, social and political assumptions. I discovered the limits of modern medicine with a chronic disease. I saw the disaster that financialization could wreck on families with a bankruptcy. I wasn’t naive about our systems and their inequalities.

But the knowledge that the future could be worse than today wears on you. Once you start living in a liminal state it gets worse. The pandemic made it harder for me to believe in the future because the present became a holding pattern. Ben Hunt at Epsilon Theory calls this The Long Now.

The more we put off investing in a future the more the long now stretches on. We borrow against all the things that could build us a better tomorrow. And we fall back. We put off doing things that would make our future better because it’s rational to do so. What if things get worse?

I’m tired of living in the long now. I’m investing in myself. I have been investing in my body and my health. And I’m ready to invest in a home. Not because I particularly want to own property but because I want to stop the long now and believe that my future is something I can build.

Categories
Preparedness

Day 325 and Preparedness Reading List

Since I’ve been yakking on about being a prepper recently I thought I’d take a moment to share my recommendations for thinking about a more resilient life. They range from the extremely practical to the oh shit I hope I never need this information.

Homestead & Practical Skills

Escape the City by Travis J Corcoran is literally pound for pound the best value in preparedness. It focused largely on folks who want to build up a piece of land or otherwise want to homestead. But it’s extremely practical advice on everything from planning a home to what tools and skills you will need.

Encyclopedia of Country Living by Carla Emery: an absolute classic with everything from recipes to practical how to guides. If you want to see what practical skills might be for you this is a great start.

Back to Basics edited by Abigail Gehring: it’s not as comprehensive as Carla’s encyclopedia but it’s a bit more accessible if you want to think about gardening, food preservation and the like.

Land book by Neil Shelton: a very specific little book on how to evaluate and buy rural properties for families.

Emergency & Disaster Preparedness

Beginners Guide to Emergency Survival Preparedness by Jeff Kirkham and Jason Ross: these dudes write the Black Autumn series which is a weirdly racist but packed with surprisingly good detail fiction series. Their beginner guide is actually short and reasonable information on preparing for the 3-10 day emergencies.

Urban Preppers with Pets and Kids by James Mushen: exactly what it claims. I used to be an urban prepper and it’s one of the first books I read after Hurricane Sandy got me prepping. Likely the first place to start for most of you.

Philosophy

Lean Logic by David Fleming: it’s subtitle is a dictionary for the future and how to survive it. This isn’t practical so much as a deeply comprehensive look at a world that isn’t flooded with cheap oil and requires a more decentralized approach.

First Aid and Medical

The American Red Cross First Aid & Safety Handbook: pretty self explanatory. This is the text everyone uses when they get certified.

The Survival Medicine Handbook by Amy and Joseph Alton: preppers love this doctor and nurse husband and wife duo. The book is super practical and frankly you should pray you never need it. But if you are outdoorsy you appreciate that medicine looks different if a doctor isn’t on the way to help.

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

Day 318 & Boring Health

The word wellness has become so comically performative that I cannot use it with a straight face. It would require so many disclaimers and apologies and contextual additions to move it beyond the associations with wealthy white women (thanks Gwyneth) it’s not worth the bother. But it’s also equally true most people do not feel well. The feeling of being healthy eludes us.

Our health degrades more quickly than we’d imagined, as if planned obsolescence wasn’t a term for software, but rather a term that describes our bodies as we move beyond our twenties. It feels intimidating to try to staunch the flow of time.

We acquiesce to our obligations, our stresses, our weaknesses and our limits. And our health degrades further. And with each turn of the wheel it seems even more impossible that we could feel any other way. But I promise you this does not have to be your life. You can feel well. I’ve come back from the brink of chronic disease. It is possible. It’s just all extremely boring and time consuming.

It’s hard work and it’s boring and repetitive and frankly your work won’t show results for months or even years. But you are not doomed to lose your health to outside forces simply as a consequence of time, stress or overwork. I’ve written a beginner’s guide to biohacking as well as an introduction to supplements. Anyone can pick up the basics and begin to improve how they feel. Just don’t expect miracles. And yes it’s a position of privilege to pursue most of it. But there are ways.

If you look at one of my typical days I split a third of my life into some type of preventive work. Just in case anyone ever wondered why I don’t socialize much. I put most of that time into my body.

I sleep a full eight hours. I meditate. I go to therapy and group every single week. I do full body compound lifting three times a week. I do steady state cardiovascular work an hour every day. Ok that’s just a fancy way of saying I talk long walks. I take my vitamins. I eat protein and vegetables. I stretch. None of that is privileged or even interesting. It is just slow boring work that builds over time.

Categories
Biohacking

Day 314 and Circadian Psych

I’ve been off since Daylight Savings on Sunday and I’m a little grumpy about it. All of my sleep metrics have been down by about 15%, which you wouldn’t think would make a dent in your day but somehow absolutely does. I’ve always been a winter person so I tell myself I don’t mind that it’s getting dark at 5pm but the adjustment is always brutal. Clearly my body minds.

I figure this will all pass in a few days but I resent the feeling of having my body not quite understand the rhythms of the day. It’s like having mild jet lag for no discernible reason. It messes with everything. The sun sets and I think oh it must be dinner time. Except it’s only 5pm and I just ate lunch a few hours ago.

It’s been combined with a few other changes in my routine which has probably compounded the issue. I tell myself I shouldn’t let it get to me. I keep trying to slide myself back to proper regimens. I am getting up at the same time even though it’s an hour earlier. I’m going to bed at the same time. And I’m sure it will pass. But god damn am I in a fucking foul mood. Your body really does keep the score.

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

Day 310 and Short Burnouts

Is it possible to have brief periods of burnout? I’d always associated it with the years on the other side of a startup. If you’ve put in long hours for an extended period it makes sense to have a year or more of recovering from dipping into reserves for too long. But I wonder if it might be possible to have a week of burnout from a couple intense months.

I wrapped a few big projects last week. It was easier than anticipated and I felt a real sense of joy and accomplishment. But then this week I was a bit of a mess. I had several days of terrible sleep. Then I burned my hand making breakfast. Fun fact blisters are a form of burn, which finally made sense once I experienced a real burn as it’s healing looked exactly like a blister you get from a hiking boot. I’m feeling a sense of overwhelm with the drumbeat of preventative care and appointments that comes from 20 months off from things like dentists. I just felt like I got nothing done that was important to me this week. It was one thing after another. And it seems like others are feeling the stress as well.

Maybe it’s alright to have a week of feeling unproductive. I was very on for all of September and October and then I wrapped some stuff so it’s possibly normal to feel like all focus and willpower has gone out the window. But the temptation to force a fix on it is quite strong.

I’ve got a habit of turning everything into an opportunity for self improvement. I’ve been concerned about my capacity for using self control as a way to abuse myself. It’s been a running theme that I find myself concerned about the work that goes into keeping myself productive and healthy. So maybe it’s just par for the course. But I’m already worried about next week as I’ve got 4 fucking doctors appointment including one that involves a long drive. Maybe there is never a world where productivity is easy to come by and I should let go of the worry. The days are short but the years are long. And progress compounds over time.

Categories
Biohacking

Day 307 and Cortisol

I had a couple nights of bad sleep. Because I’m the sort of dork who tracks, well, everything, I knew I had a crash coming my way. Naturally I took to Twitter to meet my biohacking needs and asked for tips on how to lower the stress hormone cortisol. And wow people must be stressed as hell as I got hundreds of responses.

Cortisol pumping constantly is what happens when you are in fight or flight stress mode. Being in a parasympathetic state is good sometimes because you can’t be stressed all the time. It will kill you.

Using a tracking app called Welltory that incorporates manual HRV readings and my Apple Watch this is what I looked like this morning. The red and choppy fluids are supposed to signify that I’m not doing well and losing energy.

So I started taking as many pieces of advice on the thread.

  • Meditated
  • Went outside for sun
  • Took extra vitamin C
  • Took ashwagandha
  • Sang to reset my cranial vagus nerve into parasympathetic
  • Used a Theragun to massage everything
  • Went for a walk in the woods
  • Took a cold shower
  • And then said fuck it and took a benzo because it’s not all holistic

All that effort seems to have paid off because a few hours later Welltory was telling me maybe I could use a little more stress in my life. I’d like to think it was the meditating and herbs but sometimes also pharmaceuticals.

Categories
Biohacking

Day 303 and App Pressure

I refused to give in to peer pressure as a kid. I was way too much of a handful to ever let anyone else tell me what to do. Sadly this led to being constantly on the shit end of the girls in my classes because I didn’t like to play their games. I was terrible at respecting authority, and this included any kind of peer power structure.

Thankfully we moved every two years so I never had the suffer the consequences of being headstrong. Probably why I was so eager to thumb my nose at power. I didn’t think it was going to last for very long. So I never had to solve for it.

It turns out I should have learned to cope with peer pressure when I was younger. Instead of reflexively being against all kinds of authority, I should have learned when to accept (and when not) the input of people and systems who have power over me.

Why? Because now I don’t know when to say no. As an adult I am extremely susceptible to pressure from my applications. I opted into letting them have power over me and I have no idea how to say no to them. I’ve got a problem with application pressure because I didn’t learn how to deal with it as a kid. Ooops!

As part of my quest to regain my health I have become an avid biohacker. I track tons of metrics. I wear both an Apple Watch and a Whoop. I’ve use half a dozen different applications daily. But what I didn’t appreciate until recently is that the nudging state of my wellness apps is functionally just peer pressure.

My “Health” folder on my iPhone

And I give in to it every damn time. Welltory says I need to be active 10 hours today? I better go walk around the house. Apple Watch trends say I have fewer active minutes? Fuck I must be lazy. Gyroscope is reminding me I didn’t meditate? Oh no I am not zen enough! My applications are bullies and because I opted into it I feel like I’m a failure if I don’t say yes to everything. I guess it turns out you cannot escape life lessons.