Categories
Travel

Day 736 and Liminal Civilization

It must have been somewhere in the late nineties or early aughts that I first learned about the concept of liminal spaces. I’m fairly certain I got it from William Gibson. I’ve associated it with travel and the in-between spaces like corridors, escalators to nowhere and empty lounges. But it really means any in-between space that is not clearly claimed as one type of space or another. The rules of the space are unclear as it doesn’t have an identity.

After my most recent flight to Germany last night, I am wondering if manners and social contracts can be liminal too. Between the spaces where rules and social probity apply, and where we believe we can we can engage in bad behavior, is liminal civilization.

You are not quite bounded by the rules of your friends and countrymen nor are you fully bound by agreed upon civilizational manners when traveling. And nowhere is this truer than traveling when sick.

On the first leg of my flight a white twenty something gentleman sat next to me. He had an awful cough. He would sniffle, hack and then snurg up a ball of snot and swallow it down on repeat. I hadn’t put on a mask as the airport was mostly empty and so was the flight.

But I was next to a gentleman who was clearly in the grips of some type of viral infection. I put on a KN95 and didn’t remove it. He stated daggers at me. Like I was the rude one. But frankly I had no intention of getting his cold.

On my second flight I encountered a couple even further removed from decent manners and leaning full into liminal incivility. United had a huge fuck up on my flight which had them scrambling to reseat me after they gave away my seat when their own flight didn’t make it to Denver. I had bought another ticket on another flight and checked in at the lounge and has my husband call to confirm but alas I almost didn’t make it onto my flight. After pleading, I was reseated next to these two chumps.

I noticed the wife coughing first. A polite hem hem cough sniffle sniffle. She asked the flight attendant for a tissue. But her companion was far sicker. He coughed every 8-10 seconds while he was awake. A wracking hacking wet cough. And neither one of them had masks. A passenger with a baby asked if they would consider one. I said I had masks still in their wraps and NyQuil if it might help.

Whatever liminal edge of society in which they live, it is clearly one where the politics of masking has taken them so far beyond the bounds of basic decency, no one on the flight could convince them to cover up. Not even while the flight circulator was off during take-off, landing and taxi. These were visibly sick people. It wasn’t Covid paranoia. It was simply please keep your germs contained.

The gentleman thought it was so rude. Unless someone has cancer or another immune disease it was ridiculous for anyone to wear a mask. He explained has anti-bodies so it was clear he couldn’t get any of us sick. That’s how antibodies worked he explained. We stated incredulously. His argument was because he has had“it” before his immune system was fine. He couldn’t get us sick. In fact he wasn’t even sick really, just showing symptoms right? Needless to say this isn’t how infection works.

Furthermore, if he could get any of us sick from these coughing fits, it was because we were weak. I told him I took immune suppressants for a spinal condition and an infant was one seat away from him. The parents of the child and I both wanted to avoid a cold or flu if possible. He just laughed and said we were idiots.

I can’t really fathom living this far out of basic civilizational norms. It used to be impolite to cough in people’s faces. You were encouraged not to travel when ill. Other cultures introduced masks so the ill wouldn’t infect the rest of us. But since COVID’s disastrously overdone masking policies, we’ve now lost a basic tool of hygiene and human decency to keep those infected from harming others.

One reason I identify as a doomer is because of how often I see people like these three travelers completely ignore the needs, wants, desires and safety of others. It’s like they have their own bubble and fuck any of us with our needs and boundaries my desire to not get sick is just my opinion man. And it’s rude of me to ask.

I ended up masking till the air circulators came on. I slept without one. I hope the baby managed. If I were their parents I’d be furious some asshole decided his right to engage in society when sick was so much more important than theirs. Travel might be full of liminal cultural spaces where the rules of civilization no longer matter. Covid broke everyone’s brains.

Categories
Biohacking

Day 734 and Personal Maintenance

The culture of planned obsolescence in Silicon Valley is a pernicious mentality.

A policy of producing consumer goods that rapidly become obsolete and so require replacing, achieved by frequent changes in design, termination of the supply of spare parts, and the use of nondurable materials

If you’ve ever bought an Apple product you are familiar with the term. Show me someone who hasn’t cursed an Apple charger change and I’ll show you someone who has accepted the lower standards of American consumer goods. And this includes almost all of us. I’m packing for a trip which requires a laptop charger, an Apple Watch charger, and an iPad charger so it’s in my mind.

I would much prefer we engage in a culture of maintenance and repair. If you aren’t familiar with the right to repair movement I’d encourage you to do so. We may never fully return to an era of simple machines and regular repairs but it’s worth a shot.

My bigger fear is that we’ve come to accept planned obsolescence for our own bodies. If you are older than thirty, I bet you’ve been told by a doctor “that’s just aging” about minor complaints from fatigue to aches. It feels incredibly dismissive and also potentially downright stupid in the age of post-viral illness.

But what if we didn’t have to accept inevitable breakdown? It might not be as simple as a pill and a ten minute appointment to fix some of your more typical bodily degradation, but it’s not impossible either.

I try to incorporate as much personal maintenance into a given day as is feasible. I took a battery of supplements today. I went outside for a leisurely forty five minute walk in the sunshine with my husband. We multi-tasked and ran through our to-do list. I stretched and used a Theragun to work out tension aches. I meditated. I used two devices I’ve got that are kinda woo-woo but the academic literature is promising. I did cold therapy.

Doing personal maintenance every day on your body is how you avoid having a doctor tell you that your issues are planned obsolescence. Don’t accept a lower standards of living. We may age and diseases will continue to ravage us but you can promote better health with simple habits.

And if you want to make an excuse for how time consuming it is, ask yourself how time consuming is it to have a health crisis. How time consuming is a chronic disease manifesting after years of neglect. An ounce of prevention equals a pound of cure. So go drink a full glass of water and stretch before you move onto your next activity.

Categories
Biohacking Emotional Work

Day 727 and Low Recovery Scores

I am chuckling at how excited my former self was for a productive holiday season. I was just overcome by enthusiasm for getting ahead over the break. I was so sure the relaxation would lead to creativity and connection. Pride comes before a fall I guess. But according to my Whoop & Apple Watch, my heart rate variability has been significantly worse than usual.

Maybe it was the extreme weather. Montana had a temperature swing of 95 degrees over the last week. Perhaps I’ve simply been overdoing it with cortisol and overstimulation, as I’ve had an exciting couple of days online.

I’ve wrote up a product road maps for Twitter’s messaging service and gone viral for therapy poasting. Those two activities are tied together. You can guess who the audience was for each of those and enjoy a chuckle.

I’ve got at least one post I’d like to get done before I wrap up year two of writing every single day. I think it’s important to do a year end “best of” overview. But that will require focus and time to get right. But I won’t be doing it today. Today I will listen to my body and let it recover. 2022 was by all measures a hell of a year. I look back on it and see a huge level up in my personal life across multiple dimensions. So if my body wants a little extra recovery time it earned it.

Categories
Medical Startups

Day 696 and Edge

I’m enjoying a migraine this weekend that was both strong and as of yet unbeaten. Perhaps I overdid things on Thanksgiving and Black Friday. But I’ve been stuck in bed in a dark room for the last 48 hours or so.

While this sounds a bit miserable, I can assure you it is also part of my edge. When my physical works shrinks my cognitive capacity unfurls. I very much liken it to the traditional super hero dilemma of being gifted with something that makes living a normal life a challenge.

I may be stuck inside struggling with light, noise and smell but I can still do most of my core deep work. I can’t take calls or go to meetings but I can be on my phone and my Kindle. I can intake information and I can synthesize that information when I’m in darkness.

And that is 90% of my job. Be informed and make the best decision you can. Those decisions are generally done when you are calm and fast. And I get the benefit of being in rest and digest as often as possible as it’s what keeps me alive.

I’ve got a generalized theory related to finding one’s edge. It’s pretty simple. If other people perceive it as a weakness but you understand how to wield it as a strength then your got an edge. People dismiss you sure. But being underestimated is one hell of a way to get on the better end of a trade.

And so while I’m here looking like I might not be worthy because of some set of heuristics that’s have typically worked well for you I’m actually the one that has a leg up on you. You would do well to think about all the ways in which you can leverage talent and insights that trade below their value. You can make a lot of money betting off of truly underestimated viewpoints.

Categories
Aesthetics Politics Preparedness

Day 679 and That Escalated Quickly

My week started out great. I was focused, energetic and on my game. And well, I think we all know how the last 72 hours have played out. Chaotic as hell.

Twitter is having a meltdown. Crypto keeps discovering how badly centralized over levered balance sheets can go. Fuck you very much Sam Bankman Fried for setting back the cause. Really the only bright spot is America’s swift decline into a regressive reactionary right wing state is in its entropy and reversion to the mean phase. Guess no one felt like rewarding Republicans even though we all kind of hate Joe Biden.

And lest you think I’m happily sitting pretty having mostly predicted we’d be entering a newly chaotic age, I woke up this morning covered in hives. That haircut I was so excited about yesterday? Turns out I was allergic to all the styling products.

And because we had some as yet unresolved issue with our well pump, I couldn’t even shower it off immediately. I woke up to the water being out. Neat. Thankfully a hacky solution got me a hot shower before noon to rinse off all the itch inducing salon products. I might still be a little high from all the Benadryl

The funniest part is I knew I might have some trouble with products at the hair salon. I just didn’t want to be that white lady that comes in with all her own products and a sob story about allergens.

I thought how bad can it be if I just let the stylist use the salon products? And boy do I regret that. Let that be a lesson to everyone to always take up the space and resources you need to stay healthy. It may be cringe as fuck to explain an allergy but you know what is even more cringe? Giving yourself hives and Benadryl brain because you didn’t have the energy to be a little bit of an asshole and insist on protecting yourself.

Categories
Biohacking Chronic Disease

Day 668 and Health Multitasking

I didn’t take my own advice recently. When folks ask me how to begin biohacking I tell them to take it slow. You should change only one variable at a time.

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.

Day 91 and A Beginner’s Guide to Biohacking

My biohacking has been focused on improving my core inflammatory markers for several years. Secondary metrics like pain and energy got better as my erythrocyte sedimentation rate and C-reactive protein went down.

What I did to improve those metrics was complex, time intensive and expensive but it was pretty clear what outcome I was pursuing. My broad goals were simple. The tactics merely a function of one overarching strategy to lower inflammation.

Recently I’ve been a bit sloppy about my goals as my SED rate and CRP approach normal. I got excited that I might be stable enough to pursue some new goals. I am always looking to lower my doses of pain management medications. But the real shiny object for me has been fat loss.

I’ve struggled to stay lean as several medications that improve inflammatory markers have weight gain as a side effect. I struggle with shame about my weight. So much of popular culture portrays weight gain as a function of poor impulse control. It embarrasses me on some deep core level that others might think I’m lazy. If immediately trigger’s defensiveness for me.

I can rationally know I was pursuing a responsible health by taking prednisone during acute phases of my illness, but a part of me is still so embarrassed by the side effects. What must people think of me? Even if I explain that it’s a side effect of medication I fear that it’s still perceived as been slovenly.

So I decided to go back on metabolic drug called ozempic because I just hate carrying excess fat. I thought I could add it into my routine. But I am not doing as well as I’d like with the side effects of the injection. I’ve now vomited two Sundays in a row and been unable to eat. That is destabilizing enough that it is impacting my other goals like a slow dose down of non-steroidal anti-inflammatory drugs.

Maintaining low inflammation rates with lower pharmaceutical intervention is obviously a huge goal of mine and far more crucial than dropping a few pounds of fat. Especially because my metabolic markers are all in the clear.

I just so badly want to put behind some of the visible markers of my disease. It was hubris to pursue ozempic when I know I have other metrics that are more important than my shame about having steroid fat. So next time you see someone who is overweight I encourage some empathy. You never know the whole story of someone’s health.

Categories
Politics

Day 664 and Political Disabilty

I did not watch the Pennsylvania senatorial candidate debate between Democratic Lt. Governor John Fetterman and Republican tv personality Dr. Mehmet Oz because I live in Montana. Why the fuck would I do that? But I have caught the discourse surrounding it and I do not like it.

If you are not following this saga, Fetterman had a stroke a few days before the primary in May. He is recovering but but is still having trouble with speech. People who are not familiar with neurological recovery processes (otherwise known as 99% of normal humans including me) are freaking the fuck out about what it means that his speech is impaired. It looks particularly egregious when compared to Dr Oz who is professionally competent at communicating clearly on television because that is his job.

Naturally we are seeing the absolute worst possible response to Fetterman’s current disability from just about everyone. Supporters of Fetterman are insisting that there is no evidence of mental degeneration or acuity issues. Which might be true but I don’t know. But the general sense I get from supporters is one cannot even suggest that there might be processing issues because doing so would you an awful ableist human being. Neat!

On the flip side, Republicans and other opponents are insisting Fetterman isn’t fit to hold office as he is not capable of speaking clearly. The Republican position seems to be that a speech impediment is a clear sign of mental decay and electing him is maybe a diverity and inclusion policy so wrong it should insult us all. Also extremely neat!

I’d say naturally both positions are ridiculous but I’m not sure this is natural to anyone. Ableism, or discrimination against the disabled, is an exciting new front in the culture wars. Being being disabled is a hot new identity marker despite the fact that a quarter of Americans have some form of disability. It’s not that unique or cool to be disabled. But modern medicine is a miracle so we can’t rely on Darwin anymore to keep us damned cripples out of sight anymore making light eugenics kind of a popular position. I don’t love it.

I am someone with a modest disability. I have a spinal condition called ankylosing spondylitis which is basically arthritis in my spine. So I don’t find any of the commentary surrounding Fetterman’s disability status encouraging. I don’t love that the basic assumption is being less than abled bodied is disqualifying for work. It depends! This shouldn’t be a whole fucking thing.

A disability doesn’t mean you can’t work like a “normal” person but it does mean you have some limitations to work around. This doesn’t make you better or worse as a person. Being disabled has no moral valence. Alas we tend to valorize suffering and demonize perceived weakness. Neat!

My position is most disabilities are sort of a modest inconvenience that on balance forces you to hone other abilities to be competitive. This is my super hero theory of disability and might be a contributing factor to the side that valorizes disability. How cool is it to be an X-Men? Extremely! But I don’t overweight this position as I largely think a market economy fixes by forcing us to all to compete and find our niche.

If this is scandalous to you, I’d say everyone has something that is a struggle to overcome even if most people’s thing is just being kind of an idiot. Half of us are by definition below average. But imagine if I thought you being stupider than me was disqualifying for holding political office.

My whole point in this long ramble is that the Democrats are being ridiculous in insisting we cannot look at the strengths and weaknesses that come with bodies being sick. We are on year three of the pandemic so that ship has sailed. The Republicans are being ridiculous insisting that speech impediments are disqualifying. Tump didn’t even have the benefit of a stroke to blame for his speech patterns.

It isn’t ridiculous to ask someone to be transparent about recovery and abilities. I’ve got no idea if Fetterman has slower thinking after the strike or if it’s just slower speaking. I don’t really care to be honest. Not my senator.

But if we all keep insisting on physical and mental perfection from our elected officials we might not have any politicians left. Which actually on second thought might be ok.

Categories
Medical Politics

Day 656 and Genetic Material Storage

What feels like a lifetime ago, my husband and I pursued fertility treatments. I didn’t have any known issues but we wanted to freeze eggs and embryos while I was still young. At the time we didn’t feel stable or wealthy enough to predict when having children would be feasible. It seemed like the responsible choice to have a backup plan. Everyone we knew was doing it too.

I remember a gynecologist telling me off for considering freezing eggs as she managed medical school with a toddler so surely an easier career like startup CEO would have no trouble with resources for becoming a mother. I never saw her again after that incident. But knowing me the shame I felt from her judgement simply cemented my decision to free my eggs.

But I was equally poorly served by the fancy fertility clinic that glossed over risks and side effects. In hindsight I wish I’d been more concerned about ramifications. I also which I’d listened to my gut which was screaming that this felt more like a luxury shopping experience than a major life decision. The ease with which I was being sold a life where I could buy an insurance policy about a decision that I was ambivalent is almost shocking.

Now I’m faced with another choice. The genetic material needs to be moved to a safe state. In the wake of Roe v Wade being overturned, there is concern that fertilized eggs (embryos) might not be fully under our control as red states pursue stricter and stricter control policies. No one is quite sure how embryos will be treated. And frankly no one wants to find out.

Embryos that were stored in states like Texas and Florida are on the move. Clinics and storage facilities cannot guarantee their safety and usage as too much is still uncertain. Of the storage options we have, only two are in safe states unlikely to be impacted. Minnesota and Connecticut.

We picked Connecticut. Even if Republicans take it over we are banking they will be of the WASPy moderate types who see value in family planning for nice white married couples. Our privilege is at maximum there and that’s worth a premium.

I am so conflicted on even addressing the issue of what we are supposed to do with our generic material. Is this the moment we give up and admit it’s not a life path that we want? The chances of Alex and I have children together are getting slimmer. It’s not impossible but it’s also not looking likely.

My health is stable but I use several pharmaceuticals that shouldn’t be used during a pregnancy. I’d need to be on bed rest and dosed off everything to proceed with a pregnancy. I’ve been warned I could lose my progress on controlling my autoimmune disorder, the worst case scenario is I’d have to repeat the last four years of stabilizing treatment. I would be in a lot pain that couldn’t be treated for the duration.

Needless to say I’d not be able to work during the pregnancy and possibly for an extended time after. It feels perilously close to a choice between living my life and organizing my entire life and healthcare for a child I don’t even know if I want. It might be a permanent off ramp from work as the recovery would be significant. Everyone says you will regret not having children but I’ve only ever met people who regret having children.

At which point I have to admit to myself I don’t want children so badly that I am willing to be physically debilitated for another five years. I am so excited to be living a semi-normal life where I can pursue my personal and professional goals. The last few were hard. Perhaps we could pursue surrogacy but that suggests a level of wanting children that I just don’t think either Alex or I have. Because neither one of us strongly desires children this additional effort and cost simply to preserve our own genetic material isn’t under consideration. If later on in life we find our preferences changed we are both comfortable adopting or raising children not related to us genetically.

Perhaps the problem was that we never strongly wanted children in the first place. Maybe that shitty gynecologist was right. If we’d wanted kids we would have found a way. Instead we bought an insurance policy. And now that insurance policy is a scary liability with an uncertain political future.

With the way America is headed if we don’t move the embryos to a safe state now it’s entirely possible the government will decide we actually already have children. Unborn children. Who might have more right to life than I do. To be honest that’s an ethical question I don’t have an answer to. All I know is that I am absolutely not willing to let the government decide if it is my life or the embryos. That’s between Alex, myself and God.

Categories
Community

Day 639 and Act Local

I grew up in a hippie college town that was fond of bumper sticker activism. Showing off your sense of humor and your political priorities was a fun thing to do with your Subaru Outback in the late nineties and early aughts before Facebook and the rise of social media.

A classic of the genre was “Think Global, Act Local.” I found this example on Etsy. And no I’ve got no idea what charity it ties back into.

Think Globally, Act Locally Bumpersticker

Maybe it was just less cringe to have this sort of thing on your car before we all spent half of our days yelling at strangers on the internet. I personally remember thinking Visualize Whirled Peas (a band from Austin) was a hilarious way to protest American war mongering as a teen. Of course, I still wrote Amnesty International letters at the time.

Now I’m not even sure who to donate money to at the end of the year as institutional trust continues to break down. Thinking globally is often the source of much anxiety. Currency collapses and the threat of nuclear war from Russia might be throw backs, but doomscrolling and feeling helpless is too modern. What is old is new again but in more potent anxiety inducing form.

So it was a bit of a relief to enjoy the “act locally” part of the classic bumper sticker this morning. Our local volunteer fire department had a pancake breakfast. Now as an adult my husband and I live outside of a completely different college town in the wider surrounding Gallatin Valley.

The rural (as opposed to city) county fire departments operate with a lot of local good will. They have a professionally trained but all volunteer force and cooperate with other districts through mutual aid frameworks. Practically, that meant a lot of college students taking advantage of living at the fire station to offset their costs while deepening ties to the community. A pretty ideal set up for a tight knit rural community. We get talent and they get skills and housing during their college years.

But calling them volunteers makes it sound less professionally run than the reality. I was impressed with not only the depth of knowledge of the entire department but also just how well maintained all of the equipment clearly was. Sure they probably cleaned stuff before letting their neighbors come in for a visit but everything was so shiny and new. I came away feeling a lot more secure about making a 911 call.

Now maybe that’s just function of meeting the fire chief and chatting with EMTS. And that’s probably exactly why they host these pancake breakfasts. But after two hours of touring equipment, and talking to everyone from the Medivac helicopter pilot to the youngest college kid on the squad, I felt like this was a team that has its shit together.

Now I’m actually excited to vote for a bond issue to get another fire truck or two! But in the meantime we dropped a few twenties into the boot on the table.

Pancakes and a fire boot for donations to the county fire department.

Categories
Medical Preparedness

Day 630 and Sympathetic Nervous Response

One of the downsides of having any kind of medical bullshit is having to keep an eye on yourself. If you over do shit you’ve got no one to blame but yourself.

I’ve been doing a wilderness medical incident first responder course this week. I initially went into it slightly concerned with my ability to physically keep up given my ankylosis. I was easily the odd duck out in a group of former military folks, paramedics and wild land firefighters. If I’m honest I didn’t want to embarrass myself by showing too much frailty. I was already the only woman in the class. I didn’t need to be the cripple on top of that.

But over four days I’ve managed just fine. I did wound packing and splints. I did a number of incident scenario responses ranging from anaphylactic shock to heart attacks. I even did multiple mass casualty response drills. Today I managed one as a triage incident deputy and comported myself quite well.

I was feeling pretty cocky about how well I’d managed through the week. I was enjoying that sense of accomplishment right up until 5pm or so today when we had our last assignment of the day. We’d just finished up a drill with five patients who had been caught in a tornado. It was an hour of field work and triage outside. I was thinking alright maybe I’m getting the hang of thing. But no I was about to embarrass myself on one of the easiest tasks in the course.

It was time to pack up our own medical kits. We got a big baggie with all the supplies we could possibly need for our our first aid kits and dumped it out on the desk. Our instructor began going over all the items and how to pack them up into the bright orange brick that serves as your kit bag. I was doing my best to follow along but my brain was just not having it. I kept trying to figure out what items went where and how it was meant to go. And I was not remotely keeping up with the class or the instructions.

I’m starting to feel overheated and I’m struggling to concentrate. And it’s then I realize “oh shit I’m in a bunch of pain” and I realize I haven’t taken my pain medication for hours and it is starting to show. I just ran around in a big field doing triage for an hour. So I think to myself well I’m having a sympathetic nervous system spazz out. The pain and fatigue is sending me into fight or flight and I’m losing decent coordination and fine motor skills. I am becoming one of my own patients.

I didn’t finish packing out my kit. I had to excuse myself. I briefly considered if it would be funny to have a medical incident in a first responder course. But I was fully capable of treating my own acute stress response. I was getting worked up by an inflammatory response from my ankylosis and low and behold the pain in my spine was going to spike.

The end of the story is that I’m in bed and the non-steroidal anti-inflammatory drugs have kicked in. My pulse and respiration are fine. I’m no longer in fight or flight. And yes I’m a little embarrassed that packing a bag is what did me in. But on the other hand, that’s a very “Julie” way to learn a lesson.