Tag: Medical

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Biohacking Emotional Work

Day 349 and Vibing

When I injured my ankle two weeks ago I was angry. I had been so focused on doing things. Every day was packed with obligations and routines. Walking, supplements, weight lifting, stretching and appointments all took up huge portions of my day. So I wasn’t exactly thrilled to add in an entirely new thing to my day. I was worried it would set me back on my progress both at work and with my health.

And yet it’s been delightful. I’ve just kind of let things happen. I’ve been in bed. I haven’t been pushing to get in steps or raise my heart rate. I’m just vibing. Whatever the day brings I’m taking it in.

And I feel fantastic. My mind is sharp. I’m moving forward all the projects and investments I prioritize. It feels like by pulling back on all my other routines because I needed my ligaments to heal I’ve suddenly improved everything else in my life. It feels like life is fun again. That I’m spending my time on things that make me happy.

It reminds me of a favorite line from my therapist. “Be a human being not a human doing.” Was it possible in my efforts to improve my resting heart rate or put gains on my lifts that I was affecting my happiness and my intellect? By trying to improve myself had I been making myself miserable? Once again I’m learning that just letting myself live is the best way to achieve my goals. If you feel stuck maybe just chill and vibe for a bit?

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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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Emotional Work

Day 340 and Unconscious

I have reached the stage of my recovery process over my ankle injury that I am wondering what unconscious desire did I have to put myself in a position where I’d be reliant on others again. I’d only recently felt fully independent and healthy within the last few months. I had come to consider myself recovered. And yet here I was laid up back in bed.

A lot of folks don’t appreciate the therapeutic process of plumbing one’s unconscious desires. It has an uncomfortable hint of victim blaming to it. If something happened to you, well you must have wanted it somewhere deep inside. That sort of misses the point though. The freedom to become responsible for ourselves is hard work. It is actually much easier to allow ourselves to be a victim of our past patterns and behaviors.

We have to regularly inspect our deeply held emotions and their origins in order to live up to being an adult. Sure we all have wild inner children with deeply felt but entirely irrational reactions. Sometimes those unconscious pieces of ourselves runs the entire show. We might even fear it is the source of our unique genius. But it doesn’t have to be that way. We can appreciate the benefits of our joyful creative wild sides while still being a responsible adult that manages our inner child’s emotions.

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Medical

Day 337 and Good News

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

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

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

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

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Chronicle

Day 335 and Ankle

I was going for a walk and misjudged coming down a stair. We’ve got tiny stairs of rock and wood and hand poured concrete in the courtyard of our complex. They aren’t the most even. I don’t know how I came down so hard but Alex said he heard something as I came down. I tried to get back up and put weight on my foot and immediately collapsed. I must have screened loudly as everyone came running.

I couldn’t make it up the stairs to get back into the house. I had to scoot myself up the stairs using my arms to lift me and shimmying my ass. I kept trying to test if could manage any pressure on it. I had tears running down my face and my iPhone giving me tachycardia warnings.

I initially crawled myself upstairs to get in bed so I could elevate and ice. We weren’t sure if it was a sprain or an actual broken bone or ligament. We called around to see if anyone had doctors who made house calls. The last thing I wanted was a four hour emergency room visit while I was in excruciating pain. But eventually the feedback from a virtual visit was I needed X-rays as it’s not a good sign that I can’t apply any pressure to it.

The urgent care center got me a boot and crutches and I’m waiting on the X-ray results. I am so angry as I don’t want a random health thing requiring surgery and physical therapy and months off my feet. I feel like I just got to a great place with my health recently. To have a set back with my existing issues would have been more of the same. To have something new feels profoundly unfair.

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Internet Culture Politics

Day 326 and The Long Now

A culture lacking optimism is a culture without a future. Even before the pandemic, American youth had plenty of reasons to temper their optimism. Inequality, corporate dominance, rising debt particularly for school, unaffordable housing, lack of social support for family, the changing climate and the frequency of natural disasters all tend to weigh on you.

I’m a optimistic person so I always presumed I’d find a way around things. And I largely did. I got an education. I started my own company. I sold it. I found I had developed a valuable skill set. I met a man through one of my best friends and we got married. All was well in my American dream for many years.

But cracks had always been there. Little details that made me question common cultural, social and political assumptions. I discovered the limits of modern medicine with a chronic disease. I saw the disaster that financialization could wreck on families with a bankruptcy. I wasn’t naive about our systems and their inequalities.

But the knowledge that the future could be worse than today wears on you. Once you start living in a liminal state it gets worse. The pandemic made it harder for me to believe in the future because the present became a holding pattern. Ben Hunt at Epsilon Theory calls this The Long Now.

The more we put off investing in a future the more the long now stretches on. We borrow against all the things that could build us a better tomorrow. And we fall back. We put off doing things that would make our future better because it’s rational to do so. What if things get worse?

I’m tired of living in the long now. I’m investing in myself. I have been investing in my body and my health. And I’m ready to invest in a home. Not because I particularly want to own property but because I want to stop the long now and believe that my future is something I can build.

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Preparedness

Day 325 and Preparedness Reading List

Since I’ve been yakking on about being a prepper recently I thought I’d take a moment to share my recommendations for thinking about a more resilient life. They range from the extremely practical to the oh shit I hope I never need this information.

Homestead & Practical Skills

Escape the City by Travis J Corcoran is literally pound for pound the best value in preparedness. It focused largely on folks who want to build up a piece of land or otherwise want to homestead. But it’s extremely practical advice on everything from planning a home to what tools and skills you will need.

Encyclopedia of Country Living by Carla Emery: an absolute classic with everything from recipes to practical how to guides. If you want to see what practical skills might be for you this is a great start.

Back to Basics edited by Abigail Gehring: it’s not as comprehensive as Carla’s encyclopedia but it’s a bit more accessible if you want to think about gardening, food preservation and the like.

Land book by Neil Shelton: a very specific little book on how to evaluate and buy rural properties for families.

Emergency & Disaster Preparedness

Beginners Guide to Emergency Survival Preparedness by Jeff Kirkham and Jason Ross: these dudes write the Black Autumn series which is a weirdly racist but packed with surprisingly good detail fiction series. Their beginner guide is actually short and reasonable information on preparing for the 3-10 day emergencies.

Urban Preppers with Pets and Kids by James Mushen: exactly what it claims. I used to be an urban prepper and it’s one of the first books I read after Hurricane Sandy got me prepping. Likely the first place to start for most of you.

Philosophy

Lean Logic by David Fleming: it’s subtitle is a dictionary for the future and how to survive it. This isn’t practical so much as a deeply comprehensive look at a world that isn’t flooded with cheap oil and requires a more decentralized approach.

First Aid and Medical

The American Red Cross First Aid & Safety Handbook: pretty self explanatory. This is the text everyone uses when they get certified.

The Survival Medicine Handbook by Amy and Joseph Alton: preppers love this doctor and nurse husband and wife duo. The book is super practical and frankly you should pray you never need it. But if you are outdoorsy you appreciate that medicine looks different if a doctor isn’t on the way to help.

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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.