Tag: Illness

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Medical Preparedness

Day 354 and Covid

The worst has happened. After nearly two years of being ambiently aware of Covid as a risk in the world I have tested positive. I honestly didn’t think I had it. I feel a little bit sick. I briefly ran a fever. I mostly felt the malaise from the inflammation. Little did I know that the game had changed with Omicron. That was all Covid.

I think we are in the middle of public communication crisis. The new symptoms for Covid are not severe coughing but the sniffles. And the vaccine doesn’t give you neutralizing immunity. It sure does help reduce the severity of the infection if the mildness of my symptoms are any indication. I worked several days before I realized the extent of the illness. And in no way had we reduced our daily caution. The only time I spent indoors with other people was when I had to go to urgent care for a torn ligament in my ankle.

I’ve got to be honest. This is going to happen to you. It’s happening fast and you probably didn’t see it coming. From when Omicron first got identified to me getting ill was less than two weeks. We have a rapid test shortage which means only those with flexibility and money will know if they are sick.

It’s going to be a very ugly month. Not because anyone is going to get extremely sick. But rather a lot of us are going to be a little bit sick. Let’s be gentle with each other when it happens. We are all going to be really miserable together.

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Chronic Disease Medical

Day 352 and How To Be Sick

Everyone I know seems to be sick right now. My husband is sick. My media friends are sick. My finance friends are sick. My random internet friends are sick. No one is in bad shape but everyone is miserable. If Omicron is as transmissible as it seems you’ve got a good shot at getting sick in the next month or two even if you are fully vaccinated. Don’t panic. I’ve a ton of experience being sick so let me give you some advice on how to get through the misery in one piece. Being sick is an opportunity. You’ve got this.

Drink lots of water: basic but crucial. Down a full glass of water every few hours. Set a timer. Being hydrated is key to your body flushing out gnarly stuff.

Stay in bed: your body has diverted all your energy to your immune system to fight off invaders. You are going to be tired. Don’t try to overcome it with stimulants like coffee. That’s just going to make it worse. Accept that you won’t be as focused or as energetic. The less you try to push through it the faster you get better. Cancel everything. If you want to get back to normal the fastest path to that is letting yourself heal.

Intake lots of nutrients: your body needs all the help it can get. Now is not the time to restrict calories. Eat vegetables and high quality protein. Eat healthy fats. Take a multivitamin. Consider taking Vitamin C and Zinc. Drink broth as it keeps you hydrated and gives you nutrients. Here are some ideas from the Cleveland Clinic.

Take care of yourself: tempting as it may be to order junk food, binge watch tv and doom scroll social media, you need to build up your vitality and constitution. This is what had worked for me. Being in bed tightens up your muscles so do a basic stretching routine for ten minutes twice a day. Don’t overstimulate your autonomic nervous system. Go out in the sun and keep your circadian rhythm normal. Meditate even if it’s only a few minutes. Do deep breathing. Take a hot shower even if you can’t stand up for too long. Brush your teeth and your hair. Talk to to your family and let them know how love them. If you have the strength do something artistic or creative. You must maintain your humanity. That means finding rhythms that build you up.

Accept Help: being sick robs you of many of the building blocks of modern identity. If you have built your self acceptance on concepts like hard work and being productive, it’s going to make you feel shitty when you are in bed and can’t do anything. Being sick is a reminder that self acceptance is the key to happiness. You are more than what you do or produce. You are a human being worthy of love simply because you exist. At your weakest and your sickest you are as worthy as at your best. Be ready to accept help from others so you can accept yourself. Be ready to be cared for by others. You do not owe anyone anything. Your existence is enough.

Chances are you are used to feeling healthy. Being sick is going to rock your reality. But you will overcome it. Cultivating empathy for yourself is the best path for doing so. Don’t judge yourself. Care for yourself as if you were your own child. Without judgement. Good luck!

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Biohacking Finance Internet Culture Medical Startups

Day 350 and Web3 Healthcare

Imagine you’ve got a disease with a clear biomarker. I’ve got an autoimmune condition called ankylosing spondylitis. One of the ways to spot it on a blood test is to look for an elevated CRP or sed rate.

Maybe I want to find a way to connect with other patients. I provide proof of biomarker to join an autoimmune discord just like you provide proof of ownership of an NFT like they do in the Bored Ape Yacht Club. Maybe I want to join a group of other patients who are pooling their medical data so they can stop being in an N of 1 and have a chance to participate in new research for my own disease. I could join AutoimmuneDAO and contribute to funding, meme-ing, and researching my condition. If we discover a treatment protocol or drug through our DAO we’d have ownership in it. Imagine a token for your own patient DAO. This isn’t as crazy as it sounds. VitaDAO is doing this for longevity research. This is the future that web3 can bring to healthcare.

Quantified self and biohacking have improved my health significantly. But on its own my personal health data has little value. You would maybe pay me a few cents for my biometrics. The real value of that data is in the aggregate. That’s why I pay Whoop to manage my HRV data and why they won’t offer data interoperability.

The value is in the algorithm. But without me and without my data it wouldn’t be worth anything. They have a product and an algorithm because of my biometrics. And yet we’ve found no way to meaningfully integrate ownership and interoperability in healthcare yet.

Let me give an an example. There are multiple companies that make their money by recruiting clinical trial candidates. Why? Because you need aggregate data to run a study. Those companies have the same basic data analytic team as a marketing team at a direct to consumer product company. They know how much a patient (or customer) is worth and the cost to acquire them. You are worth a lot because you represent a demographic that has value in its totality. And yet most clinical trials fail to recruit people because patients just don’t see a benefit to participating. You’ve got no ownership or upside and the costs are significant. So science suffers.

But what if instead of being valuable to marketing and recruiters you could own a portion of the aggregate? Being a token holding biomarker “proof of disease” validated member of a patient research DAO flips the incentives. A breakthrough on a disease that treats you and you’d also own some of the proceeds of it’s intellectual property. Whoever brings web3 to healthcare is going to be doing a significant good for humanity. Web3 can improve diseases, move forward science and get us all paid.

Categories
Emotional Work

Day 347 and Self Acceptance

Because a huge chunk of this writing exercise has been tagged under “emotional work” I’ve had the good fortune of chronicling much of my emotional growth this year. A huge theme? Learning to love myself. I know, it’s pretty core stuff. You are probably working on the same thing as me. Just because it’s fundamental doesn’t mean it’s easy!

My favorite coping mechanism is working harder. Didn’t get what I wanted? It’s my fault. Maybe if I’d put in make work I would have! I’ve got a whole circle of abuse I pour on myself. It’s always my responsibility if something didn’t work out. Not happy? Time for self improvement. It’s rarely occurs to me that I should simply accept myself and that sometimes things simply don’t go my way. I don’t seek out self improvement for the joy of it. I do it to punish myself.

I’m terrified of letting go of my coping mechanisms. If I was good enough I would have felt loved as a child. This is a horrible inner child logic that I’m applying to myself. As if an infant deserves love because of its efforts. We love our children just for existing. And yet I struggle to express love for my own inner child.

If I stop using hard work as a coping mechanism I am afraid I’ll never be accepted again. If I let it loop even further I am afraid I will die. Because I fear I only overcame my health issues because I throw so much effort into recovery. I am afraid it is only through effort, punishment and improvement that I deserve to be in this world. Any wonder I find Calvinism appealing as a faith?

I tell myself these are rational coping mechanisms. The world does reward me for hard work and continual efforts towards improvement. I pay my bills through hard work. And sure if I don’t pursue basic healthy habits and fitness then yes I probably won’t feel as well. But these arguments are just an excuse to keep myself from accepting that I’m worthy as a human independent of my work or my health. And because I have a hard time hearing this for myself I want you to know you are worthy just for being you too. Our humanity is enough.

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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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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.

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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.

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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.

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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.