Tag: Illness

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Chronic Disease Medical

Day 1698 and Capitalize On My Pain

We often talk about solving “pain points” when doing product development and market fit work for startups. We have popular metaphors in this vein. Start a company that sells painkillers not vitamins is so ubiquitous a piece of advice I can’t even locate its original source.

I’ve been thinking a lot about how much I personally apply this motto to the pain I’ve experienced in my own life. I’ve had personal pain points (travel and miniatures cosmetics sounded small but the market proved itself out) and now I am working on a medical spa concept as a side project in our barn in Montana.

The two growth areas in America, and soon I imagine the world, is artificial intelligence and healthcare for aging populations. I’ve been particularly interested in complex chronic diseases and the holistic approach required to treat them as I myself suffer from one.

If I experience a problem my instinct is to solve it for everyone. So I figure if the data coming from Jackson Hole is to be believed I should find a way to integrate what I know well (technology and complex disease management) and use that experience help our elders age with less pain. Literally painkillers perhaps in some cases.

I found this listicle in some dreck of an SEO bot optimized website so apologies to any original bloggers but it’s a decent list of how to think through why we like this metaphor. Skip if you just want my human written personal content. I’m just experimenting with including extra content from AI for my own recording keeping.

The Reality Test: Do users actively seek solutions, or do you need to educate them?


• The Money Test: Does budget appear instantly, or do they “need to think about it”?


• The Urgency Test: Do they want it this month, or is it “maybe next quarter”?


• The Solution Test: Are they actively looking for alternatives?


• The Decision Test: Do deals close in 1-2 calls?


• The Value Test: Can they quantify the cost of the problem?


• The Team Test: Does the whole team being sold on it want it?

Categories
Medical

Day 1697 and Gut Brain Axis Misery Meets Peptide Season

It would seem I found an antibiotic that disagrees with me. As the tail end of my soft tissue recovery from my abscess surgery and deep tissue infection appears in sight I had a setback with an additional antibiotic.

Cephalexin was one of the top choices on the pathology report from the hospital and recommended as a first line treatment by the surgeon, several artificial intelligence differential diagnostic secondary checks and my primary care doctor.

They did not prescribe it first and I found out why yesterday when I felt as if I’d hurt a shoulder ligament doing, of all things, tai chi. I was despondent over it (ironically another side effect). The gut-brain axis gets weird when you kill off bad microflora.

So yeah not the antibiotic for me. As it turns out we recently learned it’s associated with tendon rupture. Not quite as bad as the other more infamous Cipro. Which ironically I was on with no issues. But Cephalexin has got some risks to tendons and ligaments too.

Being on an immune suppressant (an IL-17 called Bimzelx) for ankylosing spondylitis and psoriatic arthritis has improved a number of biomarkers but also made me susceptible to skin infections. Like the kind that require slicing. Not fun.

Now in the wake of the deep tissue infection, we had a systemic MSSA problem. It was entirely rational to nuke that thing from orbit. Any resurgence needs maximum force to prevent chances for regrowth. You simply have to to be very watchful for side effects in all things now.

I feel like I’m in some awful healthcare version of pimp my ride. Pimp my diagnosis?

“So I heard you had side effects so I gave you a side effect for that side effect.“

And so I’ve been sent down the peptide rabbit hole to see if that might help with tissue healing. My shoulder is probably fine as I stopped quite quickly but a reminder that I need to be watchful of what I’m taking and experiment carefully.

Naturally I’m already considering my risk profile carefully but as it’s peptide season in Silicon Valley (who isn’t on at least a micro dose of a next generation GLP-1 agonist or some new fangled GIP.

Why not add some more to the mix? Strong tissues and lean mass being protective against many a problem. Behold a little Grok breakdown of what I was recommended.

GHK-Cu (Copper Peptide)

GHK-Cu is a naturally occurring tripeptide (glycyl-L-histidyl-L-lysine) that binds to copper ions, forming a complex that plays a role in tissue repair and regeneration. Its mechanism in tendon healing involves several key processes:

  • Collagen and Extracellular Matrix Synthesis: GHK-Cu directly acts on fibroblasts (cells responsible for producing connective tissue) by increasing the production of mRNA and proteins for collagen (types I and III), elastin, proteoglycans, glycosaminoglycans, and decorin. This enhances the structural integrity of tendons during repair. Sources Sources
  • Angiogenesis and Nerve Outgrowth: It stimulates the growth of blood vessels (angiogenesis) and nerves, improving nutrient delivery and innervation to the healing site, which accelerates wound contraction and tissue remodeling. Sources
  • Anti-Inflammatory and Antioxidant Effects: GHK-Cu blocks the release of tissue-damaging free iron from ferritin channels, reducing oxidative stress and lipid peroxidation after injury. It also modulates inflammation to create a favorable environment for healing. Sources Sources
  • Systemic Effects: When administered, it can enhance healing systemically, even if injected away from the injury site, by regulating copper-dependent enzymes involved in cell growth and repair.

Research, primarily from animal models and in vitro studies, suggests these actions lead to faster tendon recovery, but human clinical trials are limited, and it’s not FDA-approved for therapeutic use.

TB-500 (Thymosin Beta-4 Fragment)

TB-500 is a synthetic peptide derived from thymosin beta-4, a protein involved in actin regulation. It primarily aids tendon healing by promoting cellular mobility and regeneration:

  • Actin Upregulation and Cell Migration: TB-500 binds to actin, a key protein in cell structure, enhancing cell migration (chemotaxis) and proliferation. This allows fibroblasts and other repair cells to quickly move to the injury site, accelerating tissue repair. Sources
  • Angiogenesis: It stimulates the formation of new blood vessels, improving blood flow and oxygen delivery to damaged tendons, which supports faster healing.
  • Anti-Inflammatory and Antifibrotic Properties: TB-500 modulates inflammation by reducing pro-inflammatory cytokines and preventing excessive fibrosis (scar tissue formation), creating a balanced healing environment.
  • Tissue Regeneration: In animal studies, it promotes overall wound healing and tissue regeneration, though evidence for tendon-specific effects in humans is anecdotal and lacks robust clinical data.

TB-500’s effects are mostly observed in preclinical research, with potential for muscle, tendon, and ligament repair, but it’s not approved for human use and carries risks.

BPC-157 (Body Protective Compound-157)

BPC-157 is a synthetic pentadecapeptide derived from a gastric protein, known for its protective and regenerative effects on various tissues, including tendons:

  • Fibroblast Activation and Migration: It promotes the outgrowth, survival, and migration of tendon fibroblasts under stress, enhancing cell proliferation and tendon explant growth in vitro.
  • Growth Hormone Receptor Upregulation: BPC-157 dose-dependently increases the expression of growth hormone receptors in tendon fibroblasts at both mRNA and protein levels, facilitating anabolic processes for tissue repair. 19 14
  • Angiogenesis via VEGFR2 Pathway: It activates vascular endothelial growth factor receptor 2 (VEGFR2), leading to the VEGFR2-Akt-eNOS signaling pathway, which promotes new blood vessel formation and improves nutrient supply to healing tendons. 22
  • FAK-Paxillin Pathway and Anti-Inflammatory Effects: BPC-157 activates focal adhesion kinase (FAK) and paxillin, proteins that regulate cell adhesion and motility, while also exerting protective effects against inflammation and organ damage. 24 25 20
  • Overall Tissue Protection: It accelerates post-injury healing in muscles, tendons, and ligaments, restoring function similar to uninjured tissue in animal models. 27 26

Extensive animal studies support BPC-157’s role in tendon and ligament recovery, but human evidence is limited to anecdotal reports, and it’s not FDA-approved, with potential unknown side effects.

Categories
Emotional Work

Day 1696 and Unk-Unks

Older millennials from families that watched the news may remember the infamous Donald Rumsfeld quote about unknown unknowns.

I’ll include the full quote from the Secretary of Defense about the lack of evidence for weapons of mass destruction in Iraq.

Reports that say that something hasn’t happened are always interesting to me, because as we know, there are known knowns; there are things we know we know. We also know there are known unknowns; that is to say we know there are some things we do not know. But there are also unknown unknowns—the ones we don’t know we don’t know. And if one looks throughout the history of our country and other free countries, it is the latter category that tends to be the difficult ones. Donald Rumsfeld

Much hay was made over how ridiculous this sounded at the time. It was the title of an Errol Morris documentary. Naturally the origins of this phrase are more complicated than a soundbite from a politician.

“Unk-Unks” was a term regularly used by defense contractors. Wikipedia sources it back to 1969 in a Fortune article about Lockheed. “For Lockheed, Everything’s Coming Up Unk-Unks“

I find it to be a pretty useful framework. I have to imagine the Lockheed folks are irked that their clever coinage has come to be associated decades later with Rumsfeld and the Neo-conservative boondoggle of the war on terror.

I feel as if I’m in a persistent state of unknown unknowns these days. It’s not a new feeling either. I know what I don’t know and how vast a space is contained therein.

I know precious little and find that I know less as I get older (maturity being a helpful tutor in that manner). Which admittedly sucks.

Being uncertain of what I don’t know is just the natural state of being. Yet I’m regularly trying to add more to the small set of known knowns in my life. I hate not knowing how to have less pain and poor health in my life.

The experimentation I do on my body is part of my attempts to shave off a few more of unk-unks by trying to add more knowledge. And I just wish I could feel even a little bit physically better. But that seems to be in the unknown unknowns these days.

Categories
Biohacking Chronic Disease Medical

Day 1694 and Every Last Bacteria

It’s been a strange summer. It has been 41 days since I had surgery to drain an abscess that has become a deep tissue infection.

American medicine failed me but Istanbul has excellent medical if you are motivated enough to travel to fix intractable problems. And I most surely am motivated.

Add in the daily guidance of consumer grade LLMs taking input from myself and my family doctor and I managed a pretty miraculous recovery. Yes the bots are friendly but my physician agrees. It’s a very successful clinical outcome.

That’s Perplexity if you are curious. I like their mobile application and model choice options. Though pity any poor hacker who gets in as they are going to see some gnarly pictures if they make that bad decision.

Alas I am noticing the folliculitis troubles flaring again just as I’ve begun a fitness recovery protocol. Which you will notice in the image if you read the above image closely.

Alas progress is never a straight line. The flare up is bad enough I’ve opted to start another round of antibiotics (my fifth in this process) so any remaining bugs of the MSSA varietal cannot manage any retrenchment.

I’m showering with the scrub up washes surgeons use, I’m swabbing my nasal cavities with muciprin, and I’ll do a Cephalexin course.

Having fully passed through the onboarding loading dose regimen of Bimzelx with significant side effects, I need to see if it stabilizes. All this suffering will be for nothing if I give up now. But I must get to a place where I’m not constantly fighting infection and it can maintain lower inflammatory biomarkers. How this goes is anyone’s guess.

Categories
Chronic Disease Medical

Day 1692 and Your Wellness Isn’t A Demonstration of Moral Integrity

I am enjoying the adaptive training program prompt managed by an artificial intelligence which I’ve amended around my chronic health conditions as well as my considerable slate of biometrics.

I’ve been using it for a week now as I needed a recovery plan for the fitness losses that came with a month of bed rest recovery after my surgery in July.

Not to suggest I was in terrific shape before the surgery as it discovered a deep tissue infection that went so deep and so rogue I’d likely been suffering from it for sometime despite my attempts at preventative care.

It’s upsetting seeing your resting heart rate go from mid 80s to mid 60s. Realizing your high resting heart rate isn’t because you are a lazy fattybombalatty who doesn’t do enough cardio (real thing a physical therapist has said to me) but because you have a chronic deep tissue antibiotic resistant bacterial infection. Ain’t chronic disease a trip?

Anyways, I’m healing and trying not to overdo things in the process as I’m a bit stupid when it comes to wellness. More is always better has been my mental orientation for much of my life and it’s a hard habit to kick.

Workaholics Anonymous needs a subgroup for those of us who can find ways to over do literally everything. And I do mean everything. I did a stretching and mobility routine last night that had my heart rate at 150BPM doing seated spinal twists. Did I stop? Nope. I finished the 30 minute program. My adaptive training programs response?

Complete rest – no negotiations

And who am I to negotiate with an AI who has no emotions involved in the process of putting together a recovery training regimen. It’s not going to moralize at me.

Categories
Biohacking Chronic Disease Medical

Day 1688 and Deciding What To Outsource to Artificial Intelligence for Health and Wellness

One of my Twitter mutuals recently published an artificial intelligence prompt for making an adaptive fitness coach which works inside any of the major large models.

Having recently been saved from going septic and a gnarly deep tissue infection thanks to clever diagnostics from the commercial chatbots I am considering what else they might be able to help me along with in my day to day.

Being failed rather regularly by doctors over a decade of chronic illnesses has made me skeptical of the institutions in American medicine. But having one doctor (a dermatologist) miss a glaringly obvious differential really shook me.

Her dismissal of the details and particulars wasn’t malice, but a function of the systemic inability to put enough attention on the details of the person in front of her. Attention really was all she needed ironically.

I’m sure she didn’t set out to be that kind of doctor, I’d bet she hates that it’s all 90 second visits and Medicare coding and making money for the private equity group who owns the clinic. I feel for her. She surely wants to get back to doctoring.

No one can spot every detail and retain the complexities of every case. Especially one like mine. But a computer has a much better shot at mimicking Dr House than I do at finding a Dr House for myself. And it certainly has a better chance than someone who let the system dominate them into breezing over the details.

So I am using my mutual’s prompt to see if I can outsource a very slow and adaptive return to fitness after my month off from exercise to recover from surgery. I like what I’m seeing from all models that I’ve tried it on but I imagine I’ll have all the same “me” problems with overdoing it and pushing too hard. But who knows, maybe this aspect of wellness is better handled by machine than by me.

Categories
Biohacking Medical

Day 1686 and Immature Collegen Fibers

One of the most unsettling aspects of having a deep tissue infection surgically removed is watching the hole fill itself back in from the bottom up. It doesn’t look like normal tissue as it regrows.

When deep tissue wounds heal from the bottom up, the new dermal tissue appears white because it consists of immature collagen fibers and lacks proper vascularization during the initial stages of repair. Via Perplexity

I happen to take a collagen supplement which is looks like tiny little white balls in a capsule. Collagen is a hot aesthetic supplement for making your hair and nails grow but it benefits your fascia as well. It’s a popular supplement with biotin for overall health of one’s tissues.

I am aware of a number trends in the space to generate and promote the growth of collagen as I happen to follow the arc of Korean plastic surgery as it led to many successful cosmetic products. Collegen became popular in America through aesthetic practices and social media.

And yet with working in cosmetics and taking it as a supplement I hadn’t ever experienced a chunk of tissue growing back personally. It’s all been, well, literally cosmetics. And now it’s growing back and it’s really anything but attractive.

I am also concurrently bringing a hyperbaric chamber to Montana so we can do hyperbaric oxygen therapy protocols for ourselves and for the community. I am interested in their benefits for chronic issues but they have also proven themselves in the treatments of skincare wounds in diabetic and burn patients.

Ironic that I should have immature collagen fibers lacking vascularization at this moment and will soon have access to state of the art treatment for it but I have to heal this one the old fashioned way.

It’s my hope that we are going to improve our treatments for chronic issues in the future but in the here and now my acute issue is being handled the old fashioned way with lots of care and research and rest.

Categories
Aesthetics Travel

Day 1683 and Caftan versus Cutouts

I am doing a bit of coastal convalescence. Americans would be loathe to call a vacation anything but a euphemism. What are we French?

That said, sunlight is the best disinfectant and I’m sick of taking antibiotics after my exciting Istanbul surgery adventures after a physician was a bit cavalier about my request for preventative care given details in my case file.

So why not get a little bit of time off with the loved ones and see some sights. A spot that particularly captured my imagination has two distinct demographics with widely divergent tastes.

A resort a thousand feet above the Ionian Sea

There are a number of beautifully styled women in their prime forties and fifties with gracefully maintained skin, silk caftans and sunhats. They seem to have children and husbands and are otherwise living their best life.

And then we have the younger crowd who I’ll call the cut-outs. In an ideal world, this would be Norma Kamali technical fabrics showing off her pioneering swimwear. That would be very sexy.

But it’s mostly different ways of showing off suggestive swathes of bare skin in clingy clothing. Lots of neon colors and odd cutout areas that get close to the action (side boob is popular) but still count as being covered. It is also mostly skintight but occasionally some volume is added to let some other salacious details pop.

These appear to be gaggles of girlfriends mostly. They don’t have men with them that I’ve seen, though I’ve seen a few couples where a young man has a woman dressed like this on his arm. And they are all made up in full beat makeup that would make a drag queen think “not very demure.”

When you make odd choices for travel and off the beaten path you sometimes see a hospitality culture that is both expensive enough to attract the tasteful but with enough flash that it plays on social media so the Instahoes aspire for picture. And believe me this spot is extremely Instagram friendly.

I am neither caftan Parker Posie mom nor young beautiful aspirational influencer (or OnlyFans star depending on who you ask) so I am staying out of the culture clash between richer hipster travelers and “it’s expensive so let’s show off” personas.

I am in a more wrap dress and kimono style woman when pools and beaches are involved. I am happy to enjoy the salt room and infrared sauna before a massage without styling my every single fit for the occasion. That said I did feel as if I nailed the vibe. All cotton and silk with one floral kimono for the pool. Even I need to live a little.

I got captured taking a selfie during golden hour before dinner
Categories
Aesthetics Culture Politics

Day 1679 and Avoiding the See and Be Seen of Luxury Travel as Post-Liberalism Nears

The lingering live embers of Venkatesh Rao’s charnel age have left me with deadened impression in my bodily sensorium. Tasting, breathing, and seeing the culture of now feels somewhere between spoiled and not quite ripe.

One of my minor affectations is periodizing my writing into sardonically named 6-year eras…We’re about to enter the last year of the third age of Ribbonfarm, (2019-24), and I finally have a name for it: this is the Charnel Age. December 21 Ribbonfarm

I have been known to drop an Antonio Gramsci joke from time to time. This is harder to make a joke about though. The age which was being born as Gramsci was imprisoned by the fascists from 1929-1935 surely felt as filled with morbid symptoms and putrefaction.

How it compares to our current perverse extended gerontological Fourth Turning of death and rebirth is yet to be seen.

The old world is dying, and the new world struggles to be born: now is the time of monsters

That quote is a translation of Slavoj Žižek’s which isn’t quite as pithy as the Slovenian made it sound.

La crisi consiste appunto nel fatto che il vecchio muore e il nuovo non può nascere: in questo interregno si verificano i fenomeni morbosi più svariati.”

Or for those lacking Italian skills (which as I do) here is it translated more literally.

“The crisis consists precisely in the fact that the old is dying and the new cannot be born; in this interregnum a great variety of morbid symptoms appear.”

Rao calls charnel vision “a tendency to see things from the perspective of natural processes of transience, death, and decay,” which can feel foreign to the long century of stability.

Americans enforced this order through its dollarization and the financialization . But empires change and even the longest institutional decay can be seen from far enough remove.

And so we have Swiss politicians running to Washington DC as the cosmopolitan upper classes try to enjoy an August off from the always on mania of this interregnum while also keeping an eye on matters.

As it turns out the extra mile to get to an esoteric Dolomite lake or a less well known riviera (might I recommend the Balkan coastlines to the more adventurous). If you need to find me, I won’t tell.

Categories
Medical

Day 1674 and Venturing Out

I had a very indoor July which I was not expecting. One of the joys of Montana in the summer is relatively temperate conditions until you hit the end of July and into August.

Obviously freak heat waves come when they come (a lot more than I expected these days) but generally you enjoy low humidity comfortable sixties and seventies temperatures with full sun and the occasional afternoon thunderstorm.

We enjoyed some cabin camping in June but because of my absolutely out of left field emergency surgery for a deep tissue infection I’ve been an indoor cat for the remainder of the summer.

No sweating, no swimming, no excessive movement and lots of rest. Some classes of antibiotics come with very specific warnings for sun exposure as well.

I was meant to be in bed resting and frankly work was almost impossible during some of the worst of the antibiotic transitions as the pain from systemic stress was hard. Which is atypical as I’m almost always able to work through pain.

But as I am almost finished with the last round of antibiotics and I’m seeing good progress on the wound I went outside today and even broke a little bit of a sweat.

I didn’t do anything crazy just some groceries and errands but I walked two miles in the process and I’m doing pretty well. I was feeling so optimistic I bought a sun hat. We’ve got some much needed vacation activities planned and I’d like nothing more than being outside in the shade with my family.