When you live with a chronic illness a certain element of unpredictability is always there. As I’m settle into having a case that is under control (what I wouldn’t give for a term like remission but autoimmune doesn’t get terms like that) I find my body is more reliable. More days are good days and bad days can be papered over with drugs. And as an autoimmune case stabilizes you can take more risks to push through bad days without promoting a systems cascade. That means you can take more risks on a good day and have a positive outcome.
Today was a good day. It might sound strange but this was the first noticeable day where I worked a straight workday in over 18 months. I started off before 9am and didn’t wrap until 5:30. I barely broke for lunch. It’s not that I haven’t worked during my sabbatical and recovery months, but typically I try to keep a pattern of rest between work blocks. I doubt anyone feels great at 4pm but in particular I notice all my symptoms are at their worst in the later afternoon. Frankly people are onto something with siestas.
I’m honestly thrilled to have had an extended good day. I didn’t notice any major pain spikes at any point in the day. I can usually tell if I overdo it and need to rest. Sometimes it’s just a pain spike that forces me to lay down. That wasn’t the case today and even more excitingly I don’t think I dipped into any reserves to have a full day. I suspect I’ll feel fine tomorrow.
It’s honestly not that different from using up too much HP or lives in a video game. Sometimes you gotta do it but it’s expensive. And sometimes you go up against a boss and are like oh “huh” guess I’m stronger than I thought. Today I discovered I’ve actually built back up my HP. And I’ve still got all that old XP from years of grinding. It felt like I had misjudged the difficulty of a level I hadn’t played in ages. I was so sure I was going to get beat. But I sailed right though. And I’ve still got plenty of lives for whatever level I’m playing through tomorrow.
I’m feeling pretty good these days. I’ve written about my progress and my biohacking. But one area I’m not improving in is consistency. Despite meticulous record keeping and a routine I maintain assiduously, it’s almost impossible to predict when I’ll have a bad day. They appear at random!
Most days were bad days the past two or three years. The good days really stood out. I noticed them because they were rare. Now I’ve got a pretty consistent pattern of several days on and one day off. Sometimes I’ll even wrack up almost a week of good days. I used to have bad months and bad weeks. Now it’s rare for me to have more than three bad days in a row.
But I’m still regularly caught off guard by bad days. Out of the blue for no discernible reason I’m in pain, exhausted and struggling with basic function. The pain is the first symptom. Radiating out from my upper spine it pins me flat on my back in bed. About all I can manage in that state of pain is my phone over my face and the light gestures required to work a touch screen. But I don’t know why I have these bad days.
I can do everything “right” and be feeling terrific and then I’m fucked up all over again on a dime. Now I’ve got a small pharmacy I can toss at my symptoms now so I can often medicate myself back to a tolerable baseline.
The issue is what should I do once I’ve recovered? Do I rest? Build up my strength? I used to practice “active resting” where I would engage in restorative practices even when I felt well. The idea was I was building up a reserve of energy for the next crash. But was that the wrong approach?
I’m beginning to think I should take advantage of every last moment of health I have. If I feel well then screw the “active resting” I’m going to use every good minute I’ve got to pursue my goals. Active resting doesn’t seem to have any benefits I can reliably track. And it seems no more likely I’ll have a good day if I have rested then it is I will have a bad day. At best it’s marginally related to a poor night sleep but once I’ve woken up to face the day the day is cast there isn’t it?
I hate that I’m unreliable. I hate that I can’t track triggers. Doctors have seemed largely sanguine on the issue. Some days will just be bad. Sometimes your immune response will be off. But I’m feel lost and angry that I don’t know how I can live life without some degree of predictability. The only thing I can rely on is that on good days I feel good. So maybe I should just pack shit in on those days. No restorative crap. Just go hard at my goals. I’m not sure this is a good plan. It’s probably a bad one. It could just be my addiction to work talking now that my mind knows my body can handle my hard living again. At least for a few days. But if hard living doesn’t produce predictable crashes then what should my takeaway be? Fuck if I know.
I’m getting the sense that a lot more people suffer from general poor health than we let on. When I discuss my own struggles my inbox blows up with fellow suffers of autoimmune conditions. People are fatigued, in pain, mentally sluggish and often struggle with adjacent symptoms like chronic inflammation or gastrointestinal ailments.
Please know you are not alone. As it’s rarely considered socially acceptable to be sick (it’s own issue) I’m going to use my position of privilege to discuss how I’ve hacked my way from completely disabled to about 90% healthy. I’m here to share what luck, power, and wealth have given to me so others with less may succeed like I have.
Step 1: Diagnostic Baseline
It’s really hard to do anything when you are sick and trust me I hate being told well nothing is wrong so maybe just lose weight, exercise and eat healthy. Like sure you fuckers I haven’t considered yoga. Fuck all the way off. But alas it’s true that in order to navigate modern medicine you need a baseline. Go to a GP and ask for a full blood work up. A blood test is typically composed of three main tests: a complete blood count, a metabolic panel and a lipid panel. Read up on what you might see on a typical blood panel. This article is a good place to start (I am not a patient of theirs and do not endorse them for care it’s just a reference).
Step 2: Pick Your Tools and Measurements
If it is possible (lots of folks suffering from chronic fatigue can’t) start on the basics. Order a tracker like a Fitbit, Oura Ring, Apple Watch or Whoop. Then pick an app that can help organize your data. I personally use Gyroscope. My tracking stack is a Whoop for strain & recovery and an Apple Watch for more generalized tracking like sleep, sleep and heart rate monitor. I use MyFitnessPal for food tracking. Strong for workout tracking. Calm for mindfulness, and Gyroscope syncs it for one dashboard. I also use an app called Welltory which uses HRV & blood pressure from monitoring it does in application as well as through syncing with Apple Watch.
An iPhone application folder with wellness apps including Gyroscope, Welltory, LifeCycle, Apple Fitness, Calm, Whoop, Endel, MyFitnessPal & Apple Health.
I also track my symptoms in a journal app called Day One as it’s the lowest friction place I can do simple logging of metrics like pain, mood and energy levels. I also use Google Sheets to keep track of my medications and supplements as I take upwards of 25 different pills and remedies a day (trust me I wish it didn’t work). While there is a lot of variance on workouts I always get hour of low impact walking (3 miles a day), ten minutes of mindfulness, and all my supplements. Like I never miss a pill. I’m happy to discuss my supplement stack with folks but here is a basic guideline of what I take that is provably good.
Step 3: Steadily Improve
Most people overdo it. You try to change a bunch of stuff all at once. Or you dive right into a big change. This is too overwhelming. And it can make you feel sicker (some folks call it a healing crisis). Just pick one metric and improve it by 10% over a week. Pick one activity you will do for 30 straight days. I said I’d write every day and here it is day 91. (Edit, I updated my stack on this post to reflect current use on day 355). The point is you can’t improve everything all at once.
Part of my success is simply telling myself I was going to run the experiment even if it was a failure. Biohacking requires that you don’t change up your variables too often or too quickly. You need to establish trend lines. The biggest mistake you can make is being “noisy” as you will never isolate the meaningful variables. And you won’t stick to it. So it’s a double fuck up. Clean reliable data matters. Don’t change too much too fast.
Step 4: Try Common Experiments
You don’t need to reinvent the wheel. Coming up with unique experiments probably won’t be necessary till you are well along your biohacking journey. My elaborate tests didn’t really start till this year after two full years of tracking. Start with common experiments others have shown to work. Fasting is a great place to start for metabolic health and fat loss. Walking makes a big difference in your resting heart rate. Being active once an hour has proven metabolic benefits. Try intermittent fasts and then if you see a benefit you can progress to 72 hour water fasts. Adding more protein to your diet is popular for a reason. Start with 20 grams at a meal and work up to a gram per ounce of your goal body weight. Eating more protein tends to shift your diet away from lower quality calories as it’s hard to eat a whole chicken breast and then eat a bunch of fried potatoes. Though I have tried. Work in supplements for whatever your bloods showed you to be borderline on. Vitamin D deficiency is common. If want to sleep deeper try magnesium at night. If you are tired B vitamins are proven. If mental acuity is your goal CoQ10, green tea and ginseng work for many people. Metformin is the top metabolic drug for a reason. If your lipid panel said you needed to lose weight or you have metabolic syndrome Metformin is your first stop. Like I said, there are a lot of proven hacks you can test out and incorporate into your life right now. Don’t be intimidated just work an experiment that has a high probability of success.
Anyone can begin biohacking with a goal, basic tools, and some patience. I’ve taken myself pretty far in the past three years. I’ve had great doctors but some of my success comes down to being willing to experiment with my body.
I’m sure there is a perfectly reasonable evolutionary explanation why humans developed a bias correlating health with moral righteousness. Jesus and lepers aside, teaching the herd that you needed to stay away from infectious individuals is what formed the “winning” population is probably a lesson some reply guy will shove down my face. Like I get it, fucking and producing offspring is what makes you Darwin fit.
It’s just a deeply stupid thing to continue when we have the scientific method at our disposal and can actually test for what causes disease. This isn’t to say that lots of behaviors we moralize around strongly can’t correlate to poor outcomes (smoking, alcohol, food) but depending on the person you’ve got countless other variables. Population level statistics are crucial for actually gaining certainty on a hypothesis and what happens “most of the time” but there are always edge cases. We shouldn’t let edge cases dissuade us from good policy that will benefit most of us. But we should always leave wiggle room and exceptions for the outliers.
I don’t even mean this grandiosely, more like if you are a heroin addict switching that to cigarettes is a better addiction substitute. Maybe you get lung cancer or heart disease but that’s still on balance the better outcome when faced with overdose. For me weed is a better drug comparatively than opioids for chronic pain. Would I be thrilled to require no drugs ever? Maybe! Or maybe that is just centuries of stories moralizing the clarity and goodness of our leaders who never once required aid or comfort on their journeys to power. Lol, sure humans love to retcon the stories of our historical victors. The only hero who didn’t try to write out the sinning part was Jesus Christ and we sure hate to be reminded of the failings of his friends and family. Mary Magdalene was such a slut amirite?
So next time someone shits on you for doing something that is unhealthy for the general population but healthy for you, I give you my full permission to tell them to shove it if they are being an asshole. Don’t like dunk people for sharing their joy at making decisions that improve their lives. But don’t expect that it has to be done to everyone’s lives.