Tag: Medicine

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Chronic Disease Medical Politics

Day 1895 and If Not Us Then Who?

Despite persistent efforts to mitigate the downsides of my various medications, as well as maintaining dedicated wholistic lifestyle routines for my chronic diseases, I am not making adequate progress. I’d go so far as to say today it feels like I am sliding backwards.

But that is partially a function of luteal phase acute migraines and not the full picture on the ground. Yes, it’s true multiple metrics have gotten significantly worse over the 15-month span of my IL-17 inhibitor experiment with Bimselx and I am preparing to make the decision on what to do next. Many biometric markers are much better but the trade-offs are severe. It just feels like I can’t overcome them right now because I feel awful.

Nevertheless it’s important to remain grounded in the here and now. I think part of my trouble may be I am adjusting both to a new time zone and my normal altitude. Maybe I’m overly concerned by data points that will get smoothed out over time but it feels very spik.

Alas there is little room in life for downtime or bad days. Portfolio companies are fundraising, politics is getting uglier by the second, and one key blocker in my life has remained unsolved now for years.

I’ve never experienced a blocker quite so persistent as the American State Department’s handling of visa and immigration work. And yes that includes being disabled and chronically ill. That’s how bad state capacity is right now. My years-long attempt to get visas for family members to come help has not seen an iota of success.

But we keep going. There is much to be done, both practically and at higher levels of abstraction, and I am being whipsawed by hormone migraines over the last 48 hours. It is not an ideal time for weakness in one’s body.

Yesterday the best I could do in terms of writing was some rambling about my irritation with new retail sales cadences at Sephora feeling down market. Not that I necessarily need this space to be filled with decent content but I know that I am not running at even 10% capacity.

We all have to contribute our talents to this moment in time and there are projects that I wish to commit more time and energy to, even though it feels like it may be the death of me. But if not me then who? It’s a question we should all be asking ourselves and I hope more of us rise to the challenge.

Categories
Biohacking Medical

Day 1890 and It Bears Repeating Or Does It?

I can’t say I have fully recovered from pushing myself to my operational limits to do work (which looks a lot like socializing in my line of work) while still recovering from an infection after dental work.

It’s always recovering from an infection these days. I’ve been on some kind of antibiotic or anti-fungal every day since October.

2025 for me was getting an infection and then recovering from an infection on repeat. Ever since I decided to swap my biological injection 15 months ago from Coesyntx to Bimzelx and I think I’ve hit my limit.

It’s just too damn depressing that it’s a constant threat that I’ll have either a soft tissue infection or an abscess or a swollen gland that turns into a staphylococcus colony.

It’s as if I’ve got no skin biome left which is almost certainly true. I think I’d rather have CRP and sed rates and risk other infections than be rotating antibiotic varietals like some kind of junky afraid to develop a dependency.

Except instead of pain pills or lady downers it’s amoxicillin versus doxycycline versus Cipro with the occasional dalliance with a macrolide. I’ve also come to appreciate the benefits of Fluconzole. It’s not great. If you want a quick AI generated overview scan along

  • Beta-lactams: This broad group includes penicillins (e.g., amoxicillin), cephalosporins (e.g., cephalexin), and carbapenems (e.g., meropenem). They work by inhibiting cell wall synthesis.
  • Macrolides: (e.g., azithromycin, erythromycin) These inhibit protein synthesis and are often used for respiratory infections.
  • Tetracyclines: (e.g., doxycycline) Used for a wide range of infections, they inhibit protein synthesis.
  • Fluoroquinolones: (e.g., ciprofloxacin, levofloxacin) Broad-spectrum antibiotics that inhibit DNA synthesis.

My problem is that going back to my old biologic will take three to four months to full dose and it’s not a risk free process. And my full biometric panel is better on Bimzelx so is it really so bad that my resting heart rate is in the upper nineties every other week?

I think it may be time for me to make a pilgrims to the remaining clinics and pretend that I have any remaining institutional trust. Maybe I can vibe code something usual along the way.

I intend to support others on this journey as I’ve been chronically this journey a long time and the times are changing as we bring more artificial intelligence to the inference issues around our biometrics.

Categories
Biohacking Internet Culture Politics

Day 1886 and Whoop There It Is

Quite a weekend for Americans and the wider Persian Gulf. Let us hope it is resolved swiftly and with the least loss of life possible.

It happened quickly. On Friday night policy types were arguing about artificial intelligence with our department of war about use cases and contacts. And then on Saturday we bombed Iran and they bombed pretty much every neighbor they have. No wonder they had a midnight deadline eh?

I’ll stick to human interest here but Chief of Staff Susie Wiles appeared to be wearing a Whoop tracker in a secure room which was confirmed by the company’s CEO by tweet.

The original concern being that some fitness trackers break NSA protocols as they have audio recording and other data recording which wouldn’t be appropriate in a dark room type the situation room.

Interestingly Whoop is approved by the NSA for use in these situations. Per the CEO the Whoop does not include a microphone, GPS, or cellular capability of any kind and has long been on the NSA approved PED list.

I myself wear both an Apple Watch and a Whoop everywhere but I rarely need to be out of the prying ears of recoding devices but it’s good to know.

Whoop’s CEO joked that given the success of the mission Susie Wiles must have had a green recovery score (quality sleep, low resting heart rate and high HRV) though I imagine she must be feeling the stress now that it’s over.

I wonder if her score worse than mine. I needed steroids and antibiotics to manage the flare post dental work and my body is under more strain than you’d imagine.

It’s somehow nice to know that the most powerful people on the planet use the same tools as I do to track their biometrics. From billionaire founders like Bryan Johnson to the Chief of Staff of the President to little old me. We all wear the same track. If you want a referral code here you go.

Categories
Aesthetics Medical

Day 1883 and Fill Me Up

I mentioned yesterday I needed to get my lower left molar 19 fix up. The filling placed there long ago by a dental student wasn’t holding up well and looked pretty nasty

A warning for the squeamish that I am going to post before, during and after photos. If things like gums, blood, funky messed up teeth close ups are upsetting to you this is where you should stop.

I was schedule for an hour as molar 19 needed a new filling while 20 was also looking a bit funny as well. First they carefully numbed the left side of my mouth which always feels weird. You feel no pain just pressure. Which is an experience I’ve had a few times this year.

A cleaning was required as well as a cool laser which smelled like popcorn as it zapped out the damage areas.

These hard‑tissue dental lasers (mainly erbium) ablate tooth structure by rapidly heating water and hydroxyapatite in the tooth, “micro‑exploding” tiny amounts of tissue rather than cutting mechanically like a bur.

Erbium laser preparing teeth decay for a small filling on 19 and 20

These systems are typically used for small‑to‑moderate decay especially when soft tissue injury is concern. These lasers can mean less pain and less anesthesia is needed.

A composite filling matched exactly left my teeth looking as good as new. My mouth is still a bit numb but I’m glad to have things fixed up with relative ease. Now I can only hope the healing goes easy as well.

Categories
Emotional Work Medical

Day 1865 and Letting Things Fester

I let something fester for far too long. A family member had some health troubles that were not immediately threatening and I didn’t want to push them. They promised to see to it after a lengthy set of other issues were resolved.

Well, now the list was all finished or at least that is the rationalizing we are all doing around it, as it’s gone too far to be left alone. And it has to be seen to with a surgery.

Now they are healthy, young and the damage can be undone with a little science but I can’t help but feel I failed them. I knew they were leaving it to fester but the first rule of medical ethics is informed consent. The patient chooses even if you think you know better. This goes for doctors just as much as family.

And so here I am feeling guilty that I knew they were putting it off based on actions that I was partially responsible for resolving. They kept pushing it off citing this and that needing to be done first.

Now budget was an oft cited reason and I aid on that to some degree but it was really about a whole tangle of issues or managing till it was unendurable. And I don’t control their endurance or capacity to tolerate discomfort.

I know I couldn’t have done anything to force the issue, especially when the pride of an individual is concerned, but I still feel like shit about it.

Why couldn’t I have pushed forward the other issues and projects to rid the excuses? Why wasn’t I more forceful insisting they get it looked at sooner?

You know how guilt works when you have some responsibility but no ultimate say in the doing of the deed.

Not only did they let it fester but now it will fester with me as I try to forgive myself for something I couldn’t have changed. The body is sovereign and it wasn’t mine so I better let it go and help them recover.

Categories
Biohacking Medical Travel

Day 1856 and Always Something So Always Trying Something

The world is a topsy turvy place and I am doing my best to meet it head on. Physically I’ve managed a surprisingly steady period from December through January, even though I spent a decent portion of that on the road.

I credit this mostly to using antibiotic and anti-fungal regimens prophylactically. The biologic immune suppressant I currently take for my ankylosing spondylitis is quite frankly too good at its job. And I’ve tried quite a few.

That means I am locked in a battle of constant vigilance in order to keep my inflammation numbers down while also not becoming a host to bacterial, fungal or other infections. It’s a balance that is anything but delicate.

In 2025 I had been unable to fight off skin, soft tissue and mucosal infections seemingly at all. Even with extensive protocols for decolonization (intranasal mupirocin, chlorhexidine washes, environmental decontamination) I had four major infections.

Of those infections, three required surgery and the fourth was the result of a very minor incision to insert testosterone and estradiol pellets. Those surgical interventions proved very trying and also very expensive.

The last one (testosterone) helped quite a bit with energy but being energetic doesn’t matter much if you can’t fight off infections.

So while I know there is an individual and social long‑term systemic risk in using antibiotic prophylaxis, I will say it does seem to be helpful in mediating say outbursts of allergens flaring into soft tissue infections from skin breakage or having exposure to molds and fungal growths that fester in old damp buildings and water systems creep their way into any opening available.

Since it is always something, I figure I need to always be trying something. Frankly I am over the push and pull of managing medical care in America. It’s a mess and mostly designed at risk mitigation for the health systems.

I have found going abroad to be much more useful and cost effective in many cases. I may even find that it would be useful to document the experience in a format beyond a blog as I doubt I’m the only person manage complex chronic disease.

Categories
Biohacking Medical Travel

Day 1846 and Doctor’s Orders

I have had a lot of experience with doctors over the last few years. A chronic autoimmune condition isn’t the sort of illness that gets “better” like a virus. It can only be managed.

I have come up with endless ways of collaborating with people who far too often believe they are more informed, powerful and intelligent than me.

Sometimes they are even right about that perception. It’s a frustrating fact of life that doctors value their status occasionally more than their patients.

Today I went to a tourist hospital renowned for its extensive offerings and professionalism. My usual interpreter (it’s in a foreign country as many nations from Mexico to Turkey to South Korea serve American patients) had a number of procedures and visits organized for me. I felt confident I’d learn a lot and maybe find new pathways to healthcare management.

I happened to have an aesthetic elective treatment first. A plastic surgeon met with me to refresh some Botox. That seemed excessive given a nurse does my light work back in Montana but why not get a professional opinion while you have the chance.

I’d intended to spend the afternoon at the hospital doing a number of more productive activities than smoothing my fine lines. I’d set up rheumatology and immunology lines of questioning and I was excited to get some holistic work done including ozone and an IV infusion of vitamins and minerals.

Alas I was stopped in my tracks by a physician who simply would not approve the IV I had set up, the ozone work, nor would she approve the alternatives I suggested (an intramuscular B vitamin shot). I made my case with the interpreter and my AI.

The doctor wouldn’t budge. She even obfuscated suggesting that glutathione was illegal though backed down when it turned out to be a malpractice issue related to compounding pharmacies.

I very much wanted to buff up my immune system, especially having chosen something elective to go first, and I could not make progress. It shut down my whole afternoon. All that was left was tests and waiting.

There was no order the doctor was willing to give for short term immune improvements unless I committed to five weeks of procedures which given it was a tourist hospital seemed a little ironic.

I am demoralized but doctors will be doctors. I never seem to manage to convince them when I really need it. Doctor’s orders are not always for the benefit of the patient. Maybe no one wanted a woman sitting around hooked up to a vitamin infusion. Who knows. I probably would have skipped the Botox though.

Categories
Biohacking Chronic Disease

Day 1810 and Bodywork and Open Sourced Tactile Physical Data

I had a really excellent massage recently. The body worker really got under some of the tension points in my body and the compensatory patterns I was hoping for them to work through. I felt like the flow of my energy was reset.

This type of relational work between two people, one with body issues and another one who knows an efficient path for soothing them, need each other. I need relief and they need a payment that reflects their expertise.

Typically this has been labor paid in some increment of time. I paid for an hour long massage but I’d be willing to pay for more hours and the knowledge and capacity to execute that work on myself or through another body worker or tool.

I’ve got a Theragun, a Tiger Tail, lacrosse balls and foam rollers and I try to work through knots and pains. But I know way less than your average massage therapist or Alexander Technique practitioner so these tools are in the hands of a poor craftsman.

I would love for there to exist some type of Open Source Bodywork Database. I’m thinking work flows, anatomy training from video to textbook and routines input by every type of knowledge tradition and patient.

There are humorously already types of open source startups that work on body based API calls. One is called buttplug.io so you get the idea.

I’d love to see workers get paid to contribute their video, audio, and tactile experiences to an open world and ideally be paid a percentage each time it’s used.

Imagine being about to boot up this massage with an automated massage options. Or open share the repo with a therapist with less experience looking to learn. You pay the therapist trainee and for the routine and everyone benefits.

It’s a bit of a fantasy now but I’m sure we are closer than anyone realizes to being able to train these movements into automated systems. Imagine celebrity osteopaths with programs built into something you can use.

I would prefer this be an open source program for human body knowledge so that we learn mechanically the many physical routines and options that exist to make our bodies function better thanks to aligned incentives for everyone to participate. Dare to dream right?

Categories
Internet Culture Startups

Day 1805 and Dark Leisure, Time Violence & Outputting Value

Any other software developers out there remember the mythical man hour? It comes from Fred Brooks’ classic book The Mythical Man–Month which argues that adding more people to a late software project often makes it even later. This is also known as Brooks’s Law.

The man‑hour is “mythical” when tasks are not perfectly partitionable and require significant communication, shared context, and integration.

I think in the age of artificial intelligence we need to be revisiting this classic complexity insight as it applies across a world where we understand even less about how the time of input drives its notional value.

Measuring productivity in hours is a relic of a past labor era. And most workers have little incentive to improve output when they aren’t paid for it.

If we had quiet quitting during the pandemic where jobs could be done in minimal ways without getting fired, in this new artificial intelligence roll out we see another type of value capture mismatch between input labor and firm.

We are seeing what Fabian Steltzer calls Dark leisure. Others call it shadow user innovation.

Innovation happening through employee adoption of new technologies that is opaque to management doesn’t get counted and workers are reticent to be transparent.

the reason ppl hide their AI use isn’t that they’re being shamed, it’s that the time-based labor compensation model does not provide economic incentives to pass on productivity gains to the wider org

so productivity gains instead get transformed to “dark leisure”

Fabian Steltzer

Anthropic released a study on the supposed stigma attached to using artificial intelligence at work. Humans are already reacting to artificial intelligence as if it were an existential threat.

Except it’s been generally existentially freeing up to this point. Anyone who has used commercial large language models on healthcare can attest to that. So why are hiding its use?

Even coders are doing it. And who can blame them. It’s a lot less fun for some folks to coordinate a swarm of agents than it is to write code for a living. If you wanted to be a product manager, well you’d already be one.

The boss makes a dollar and I make a dime so that’s why I prompt on the company dime!

We are seeing the early artificial intelligence era take off collide with industrial-era systems of management that are no longer relevant in age of increasing complexity.

We’re putting intelligence into systems designed to measure hours and surprised when there is a misalignment. A Twitter mutual has a theory of consciousness systems they believe makes this is a form of time violence.

Human beings can tolerate NP hard moments of complexity, but cannot survive continuous low-grade complexity

The gap between human adaptability and systemic inertia is now wide enough to generate an entirely new form of harm: time violence

– Idea Nexus Ventures

We just cannot keep up with the varieties and types of complexities that are arising, so any advantage that can be used is being used. And you’d want to hide that advantage as long as you can. Sharing it has no rational basis. I find that disappointing.

I’d rather we not vice signal artificial intelligence as it only harms us. The value capture won’t always match up, but the gains to be made are worth having so keep using it where it works for you.

Categories
Biohacking Chronic Disease

Day 1786 and 40 HBOT Sessions Later

The days becoming shorter has hurt my attempts at getting out in the sun for a walk every day. This matters to me as I’d like to get regular readings of my V02 maximum and my heart rate. I rushed out without sunscreen to get in a mile.

I hit an important milestone in my current biohacking regimen this week. I made it to my 40th session of hyperbaric oxygen chamber therapy or HBOT. I began on September 13th and did session 40 on November 20. I only traveled once during this period (a five day trip) so I could have fit it all in within a two month period but I was consistently doing two hours a day.

I intend to get bloodwork for comparisons next week, but in some ways this was a terribly experiment period. I had a small procedure to insert testosterone and estradiol into my left buttock which turned into a saga when I got a skin infection. Not the procedure’s fault and I’m glad I did it as my numbers are already better.

Fortunately HBOT is renowned for healing soft tissue infections so if I was going to suffer for having compromised immune health across my skin biome, then at least I had the state of the art treatment available.

We didn’t purchase the HBOT for its skin benefits. In fact, I didn’t even know I’d be have skin immunity issues. They began with my new IL-17 inhibitor which I started in January We’d acquired the HBOT around the same time but I had no idea how challenging Bimzelx would be. It could have gone worse.

We had originally acquired the HBOT as several of our friends and acquaintances had succeeded in managing impressive inflammation rate reductions as well as progress with a slew of autoimmune issues from long COVID to mold toxicity. The kind of troubles we only test in fancy labs with extreme athletes or the enterprising technology brother.

My wound has mostly healed save a small lump, my V02 max has improved despite virtually no exercise (hard to do much cardiovascular exercise with an infection in your posterior chain) and I have overall found the balance of improvement in my energy and pain to be significant.

Thanks for noticing Whoop

If I could just get a month without a health crisis where I have enough energy to workout consistently I just might make some progress. So if I disappear for a bit that will be what I’m doing. Once I’ve got bloodwork I will share obviously.