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Biohacking Chronic Disease Medical

Day 343 and You Don’t Have to Feel This Way

Modernity is tough on our bodies. We sit hunched over glowing screens for hours and we call that necessary. We rationalize ignoring our meat sacks as logical. Cartesian logic like “I think therefor I am” is a convenient an excuse for disembodied living. Except eventually it will catch up to you. Maybe not for a while but it will. Maybe you’ve noticed feeling shittier recently.

I’ll tell you how it starts. You feel sluggish. So you stimulate your system. Maybe you drink more coffee and eat more sugar. Then you notice you don’t sleep as well. That makes you even more tired. So you stop moving as much as you did before. You don’t track any of this so it’s hard to notice till the effects compound. Then you notice aches and pains and you think well maybe it is just getting older. Maybe you start to have a back problem and friends tell you they have the same problem.

It’s the slow downward spiral of misery and it’s probably happening to you. It happened to me fast and hard but the path is the same. We accept feeling badly. We accept that deterioration is a fact of life because we’ve got to work and take care of the kids (if you are lucky enough to afford a family). We just accept lower standards of living because we get worn down.

It just doesn’t have to be like that. This shitty quality of life doesn’t have to be the new normal. Fuck the doctors who can’t diagnose you. It’s systemic. You’d be lucky to find one things so broken because it’s a place to start. Most people are justly subtly broken. But it’s not reached the acute stage where our medical system finally kicks in. Doesn’t mean what you feel isn’t real.

The shitty part is next. You’ve got to do the work. You’ve got to change your life. No doctor or health practitioner is coming to save you. They an give you a piece of the puzzle but you’ve got to assemble it. If you commit to getting well it’s going to cost you willpower. Because the path out is hard work. It’s nutrition, sleep, lifting heavy things, going outside everyday, taking supplements and vitamins, meditation and mindfulness. Frankly it’s a lot. I spend a third of my day on it so I can live what’s left well. But I no longer feel subtly shitty all the damn time.

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Biohacking Medical

Day 341 and Drugs are Good M’Kay

I am a prolific consumer of supplements and vitamins. I maintain a spreadsheet to keep track of all my inputs. I take a bunch of exotic stuff so it’s easiest to check for interactions and assess impact if I maintain strict consistency.

I’ve seen remarkable benefits to the entire mess but it’s taken over a year of dedication to see the compounding effects. Taking vitamins isn’t quite like taking a pharmaceutical that way. But I suppose everything is dependent on dose. And yet I tend to apply a completely different moral valence to my supplements then my pharmaceuticals.

When I was a teenager it felt like the war on drugs had mostly devolved into scar tactics. After school specials, assemblies with terrifying speakers, and the general media landscape showing “this is your brain on drugs” probably gave me an unnecessarily limited view of how to approach drugs. Recreational drugs were bad but I also knew that pain medications were deadly. It didn’t help I had a family member who was an opioid addict.

The running gag on South Park with Mr. Mackey telling the kids that drugs are bad mmm kay logged into my subconscious. And not in a sun skeptical way. I appear to have taken it at face value.

South Park’s Mr Mackey says drugs are bad…mkay?

Except drugs are neither bad or good. I wouldn’t dream of considering my various supplements and vitamins as making me bad or weak. Those keep me healthy and function. I also take prescription medications. Those also keep me healthy and functional. It’s the same thing. I don’t take them for kicks or to get high.

But the idea I absorbed from childhood that I’m supposed to regard things like pain killers with intense skepticism continues to hinder my progress. I was warned by the orthopedist I may need to up the anti-inflammatories I take for my spine as my ligament injury heals. But I am still reluctant to take the prescribed dose. Despite being under the supervision of two doctors.

I’ve got to learn to let go of this attitude. Drugs are good mmmkay? Tinkering and tweaking and looking for improvements are great. No one deserves to be in pain. It’s not morally better no matter what religious nonsense we may have absorbed. Sure pain is a terrific teacher. But it’s perfectly alright to chose to forgo it. We can chose to grow without inflicting any more pain on ourselves than necessary.

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Medical

Day 337 and Good News

On Wednesday afternoon I had an accident. My husband heard a snap and I was on the ground. I fucked up my ankle. X-rays and urgent care visits ensued and we begged our way into an orthopedist to assess the damage and get an MRI and ultrasound. The initial shock was wearing off.

The mobility aids dropped off by my concierge doctor had me feeling much more optimistic that whatever the diagnosis I could manage. A walker could easily get me to the bathroom on my own power. A shower chair was arriving from Amazon so I could finally wash up with something other than wet wipes. We’d also acquired an infrared sauna, a number of supplements to supplements to support ligament recovery, and some cold compression devices. I’m hoping it get an electro-stim device as well.

The orthopedist we’d begged our way into first thing this morning had good news for us. I’d torn two ligaments but it was pretty run of the mill. For once I didn’t have an exciting diagnosis. It was boring and simple. It wouldn’t require any surgery. It would be two weeks of keeping all weight off my ankle and then a slow introduction to physical therapy. If all goes well I’ll regain mobility in a month.

I’ll be wearing a boot and using a walker for a while but we can slowly introduce weight bearing activities at physical therapy within a few weeks. Maybe by Christmas I’ll be able to get myself up and down stairs. Since I don’t want to miss our Christmas tree being upstairs for the entire season.

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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.

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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.