Categories
Chronic Disease Politics

Day 1490 and Healthcare’s Sin Eaters

I went to see a rheumatologist today. I had the baffling experience of them wanting to actually get to know me. Which was surprisingly unhelpful in the moment but really nails vibe we’ve got with healthcare in America.

I kvetched on Twitter that I spent my week defending hot girls and open source software while I deride Big Pharma and public employee unions. That’s more of a humble brag about my priorities. But I felt bad that I picked on pharmaceuticals. I got replies. Why harsh on pharmaceuticals? And actually fair.

Drug companies are the least bad of some very bad actors. For all its faults, drug companies are not just existing to be parasitic like pharmacy benefit managers or generate wealth through regulatory capture like Epic.

If anything pharma is the sad scapegoat in healthcare. We pick one drug a decade to laud & then like clockwork do a hard reversal on it in a decade or two. Patients get hurt and doctors did their best. We saw with statins, SSRIs, opioids, adderall, and I’m sure soon GLP-1s will be next to have Netflix documentaries. Someone is always to blame and it’s usually the drug companies.

Some category is designated a sin eater for the system’s horrors. Which isn’t at all fair as all those drugs serve real needs. Sorry Oxycodone you remain a villain. But why is American in so much pain?

Which gets back to my surprise as having a doctor who wanted to get to know me. We came in with a typed up diagnostics sheet with a timeline of treatments, protocols and medications and the bastard has the audacity to ask me about the quality of my life.

I hesitate to say “well shit” because I am Protestant from Scandinavians stock because we pride ourselves on being “oh just fine”

And of course I’m the asshole who quotes Kierkegaard at my doctor. Sickness unto death right Doctor? Which I guess is a bit of a downer.

The man actually asked me if I’d consider managing my pain more aggressively. I am absolutely mogged by the audacity of the sentiment that I could suffer less.

Apparently no one scans you for drug seeking behavior when you chuckle and kneel before what God has decided for you. So that’s a good trick I guess for the less sincere.

You can really see how public perception of RFK Jr is so different from what elite narratives would like to see. People are with RFK’s righteous indignation. Why are so many suffering?

The cranks and the crazies are here because America is mostly gaslit by a nest of bad incentives. Doctors don’t want any of this. Neither do the drug companies. But someone has to be blamed and it’s usually the guys with the money. But they are trying as hard as anyone to actually come up with solutions.

Maybe no one deserves to have a righteous Kennedy come after them. But everyone feels a little bit crazy with how the system works now.

Categories
Aesthetics Biohacking

Day 1488 and Tune Ups

The back half of 2024 was such a whirlwind I keep discovering new eras where I am behind on keeping the engines of my life tuned.

While I’m adding in new excitement to my healthcare like hyperbaric chamber oxygen therapy (in the market to acquire one for my own use if you have recommendations) I’ve still got to make the various rounds for everything from my general practitioner to my osteopath to my dermatologist.

If the world is going to insist on going at this pace and I’m unwilling to slow down (because why would I?) then it’s full speed ahead on regular time ups and maintenance.

I hadn’t been to my osteopath since August. I hadn’t been in for Botox since October. And apparently I’ve not had a haircut since July.

Yes some of these are a bit more cosmetic than health driven but I’m somewhere closer to an old Mercedes than the family Subaru when it comes to appreciating form and function.

Categories
Chronic Disease Politics

Day 1486 and Odds and Ends and Migraines

It was a busy week. I felt physically well through most of it, but yesterday and today I am struggling. I’m in bed with a migraine that I think I accidentally kicked off by enjoying a quiet walk on sunny snowpack.

Amusing that people think we don’t get enough sun for solar power

While I prefer to have illness strike on a weekend, I feel irritated that I often get my personal time used up by health issues. I very much prioritize using my good hours for work.

Which on that note, I’d love for folks to check out a bill in Montana to secure a right to compute. What started as an idea has now officially been introduced into the legislative process. It’s a big victory to have this under consideration.

I was also in the New York Times this week in a column by James Pogue. It’s my second time being interviewed by him and I think quite highly of his reporting.

A few quotes in the New York Times on the tech right, the H1B debate, and a general sense of getting back to business

Categories
Biohacking Chronic Disease Medical

Day 1483 and Trending Up

I let myself get a little shook up by some poor health news early in the month. I’ve been pushing it physically all through 2024 as let’s be real it’s an exciting time. To fully capitalize on that acceleration we are all more focused on improving our health.

I’m taking action and optimistic about where we are headed with improvements in healthcare. I was able to rapidly iterate through options and set up surprisingly effective new treatments.

As we’ve work through the significant impact of the pandemic on our understanding of post viral illness and autoimmunity, we’ve had a more systems driven approach to testing interventions beyond pharmaceuticals reach more people.

Not that all pharmaceutical interventions are bad obviously as I’m lucky to have interleukin inhibitors in my life. I was able to find a new option with my doctor thanks to help from Claude and Perplexity.

And this progress is happening across all areas of medicine. I am also incredibly bullish on the benefits of GLP-1 inhibitors and their next generations. Inflammation and metabolism are intertwined in ways we can control barely articulate beyond “mind body connection” and yet we are developing the vocabulary.

I enjoy strange adventures in the future now. I am going to be experimenting on my body as it helps me understand not only myself but the evolving opportunities in investing. Even science fiction is excited about biotechnology.

The problems I am solving for myself teach me how we will allocate resources across many industries. The energy required to power artificial intelligence and the chips required to run those models will be pulled forward by our desire for solutions to living healthy lives

Categories
Aesthetics Politics Travel

Day 1480 and Here We Go

I’m recovering today from transcontinental travel. My body is reconciling itself with my soul after moving through the liminal spaces of German airports through the threshold of Chicago’s regional transit on to my home in Montana.

Travel always feels otherworldly to me and it’s not just the amazement of being above the clouds. The dreamscape surreality of time changing is disorienting to me. Time shifts ambiguously on long journeys which lends an added dimension of unease that comes with the change of place.

It doesn’t help that I’m already feeling the end of the political interregnum in America especially strongly. We may have vibe shifted but it’s unclear what comes next.

It seems appropriate to be uneasy. Everything as a Joker-esque “and here we go” craziness aesthetic to it. Memecoins and the Village People and algorithmic inflections makes the topology of the now impossible to map.

Categories
Biohacking Chronic Disease Medical Uncategorized

Day 1476 and Don’t Stop Till You Get Enough

I’m thrilled to see that the very week I began my hyperbaric chamber oxygen therapy that we’ve had multiple experiments and data come in.

Bryan Johnson helped answer a few questions in my set up so I was delighted to see he himself was just wrapping up a major experiment with HBOT.

Step into my hyperbaric chamber courtesy of Bryan Johnson’s Twitter

Earlier in the week Harvard professor David Sinclair tweeted a thread on with links to the newest scientific literature on treatment. Stuff with names like Activation of SIRT1 by hyperbaric oxygenation promotes recovery of motor dysfunction in spinal cord injury rats

Esssays

A lovely meditation on what happens when you write 11,000 blog posts. In this case startup blogging. I’m written an order of magnitude less so hopefully I can avoid some of the negative consequences and enjoy the lessons.

Categories
Biohacking Chronic Disease

Day 1475 and Equalizing Pressure

I scared someone really badly today. As I was being locked into the hard shell for my eighth hyperbaric chamber oxygen therapy session, I realized I had forgotten my chewing gum.

At 2 atmospheres of pressure it can be a real challenge to keep your ears from getting painfully congested. Even with yawning and blowing oxygen out your nose, it’s like going into an airplane with a sinus trouble. It’s uncomfortable but it can also be dangerous.

Careful. Equalize the pressure in your ears. If you feel your ears stuffy, equalize the pressure in the following ways. 1. Yawn 2. Swallow saliva. 3. Close mouth, pinch the nose, out of breath, blow the nose (all spelling mistakes theirs)

I got a little panicked as I was trying to stop the clinic technician from finishing the sealing process as I wasn’t sure if they could stop it once it was sealed or if I would need a full decompression cycle.

I was texting frantically “I forgot my gum can this be stopped ASAP so I can get it?”

I was tapping the window on the hardshell with a worried look and showing the text. I kept trying to make the font bigger and be clearer. FORGOT GUM OPEN?!

But it was confusing enough that everyone in the room thought something was seriously wrong. Which it would have been without the gum as I can’t do a full hour at 2 atmosphere without the help of the chewing. All the yawning, blowing out through the nose and other techniques aren’t quite enough.

It wasn’t yet an emergency. If it was I would have hit the big red button. But everyone seemed to think it was. After 2-3 minutes of frantic miscommunication it turned out that it was fine to open it up but we’d need to restart the seal and pressurize it again. I got the gum. And look who was on the TV screen.

Just don’t die while inside the chamber

Categories
Emotional Work

Day 1474 and Process over Outcome

It’s hard to trust, well, anything. The uncertainty of the near future looks like the uncertainty of the far future right now.

It feels as if one is in a fog so thick that you can’t see your own hand reaching out to touch something at arm’s length let alone glimpse gjr far horizon

How do we set goals and work towards outcomes in that kind of world? I find it unsettling despite having years to prepare for a more chaotic world.

I am learning to let go of grasping for specific outcomes and lean on process to bring me to outcomes. I work the problems in front of me. I maintain the protocols that work for me. When they cease to yield results I change as rapidly as I am able.

Categories
Media Politics

Day 1472 and Odds and Ends

I have now done six days of hyperbaric chamber oxygen therapy (HBOT for short) in a row. I also did a vitamin IV with glutathione so my morning was well occupied with maximizing wellness.

Because I was inside a chamber and tied to a chair for a few hours I was able to enjoy my backlog of reading. If you enjoy essays and e-ink books I personally use a combination of Readwise Reader and Daylight.

News and Essays

Peter Thiel has an op-ed in the financial times about the American ancien regime and the chance for the Internet era to enable us to grabble with the trouble of our elites.

A fan of Leibniz? The New Yorker reviews two books on his life. The polymath wrote quite a bit which endears me to him but our real debt to him goes beyond calculus notation. George Boole’s logic is partially informed by Leibniz.

Leibniz loved the simplicity and the suggestiveness of binary: he titled a draft paper “Wonderful Origin of All Numbers from 1 and 0, Which Serves as a Beautiful Representation of the Mystery of Creation, since Everything Arises from God and Nothing Else.”

Jacobin asks where all the good American Marxist academic work might be given that we perceive universities as hotbeds of socialism. Spoiler alert it’s hard to find.

Is middle age sexy? I went to read the styles piece in the New York Times only to discover that one must be over 50 to count. This elder millennial keeps trying to claim the mantle of middle age but Gen X and Boomers refuse to age.

Tips and Tricks

It’s wise to have a medical plan when traveling. American medications may be unavailable or even banned (Japan does not permit Adderall in the country).

I travel with a box of about 30 core medications to cover everything from allergies to food poisoning to bacterial infections.

Interested in becoming a Normie Man? Go on Joe Rogan. Not notable enough for an appearance. Let me suggest the rousing version of Copland’s Fanfare for the Common Man.

Categories
Biohacking Chronic Disease Medical

Day 1470 and Disappointing Biomarkers

After my anaphylactic adventures over New Year’s, I decided it was time for a fresh round of bloodwork to see just how my inflammatory responses were doing.

I got them back and it shows exactly what you’d imagine from a patient with an active autoimmune condition. My sed rate, or erythrocyte sedimentation rate (ESR) made a significant jump from last measurement.

I’d been on the high end of normal for almost two years and this set returned with doubling of the previous number. This biomarker is used in conjunction with C-reactive protein (CRP) test to determine overall inflammatory responses. That test came back modestly elevated but not atrocious. I also have elevated IgA levels, also known hypergammaglobulimia so that’s a bummer.

It would seem that my relatively well controlled autoimmune disorders (psoriatic arthritis and ankylosis) are moving to an active phase.

Given my use of IL-17 inhibitor injections along with a pain management protocol, lifestyle and nutrition management and a focus on holistic interventions, these results are obviously quite disappointing to me.

It would seem 2024 was harder on me than I’d have preferred and 2025 will be a year of doubling down on holistic therapeutics. Red light, infrared sauna, cryotherapy, hyperbaric chambers oxygenation, and any other anti-inflammatory treatment I can throw at it. Not that I’m looking forward to trying get another round of elimination diets but needs must.

I’ve not changed my the cornerstone therapy secukinumab since the pandemic, so it may be time to see other options like Janus Kinase (JAK) Inhibitors.

I’ve tried Tumor Necrosis Factor (TNF) Inhibitors as well as methotrexate (otherwise known as chemotherapy) and none of those treatments (Humira, Embrel) helped much and dosing on and off of biological injections is a long process. It can take up to six months to see results and changing a treatment that has been working comes with significant risks.

I’m lucky that even with these biomarkers I am still functional. I am able to work semi-normal hours and am able to groom and exercise. I have no personal life to speak of nor do I have hobbies beyond my work (unless reading counts) so I’m lucky to love my family and work enough to have it provide enough meaning to keep going.

Much of my success in treating this chronic complex case has been made easier with the breakthroughs in artificial intelligence.

Even as my physicians have retired and my care team rotates, I am able to progress and learn more thanks to large language models and search tools like Perplexity. I’m confident I will find a way to get back to remission quickly with little disruption.

Nothing provides me as much motivation to work as disease. I see how I and other patients like me suffer and I double down.

The progress we’ve made on autoimmune conditions in the wake of Covid and the rapid progression of protein discoveries as more AI tooling comes online. A chaotic world with a chaotic body drives my investing. We can do better as I see so much progress.