Tag: Stress

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Medical Preparedness

Day 629 and Working in Chaos

If you have been following along for the past couple of days you may have noticed I’m at a wilderness medical first responder course. I’ve been soaking up an inordinate amount of information. Part of the reason I am here is personal enrichment, but equally I am here because I’m working to understand chaos driven industries and the opportunities they present.

And the class is not disappointing. As we’ve have absorbed more skills and are moving further into the course, the chaos factor is being ramped up. The particularly enjoyable aspect of the specific course I am doing is that it is not just imparting book smarts. It’s designed to be much more hands on.

If it were a business school class they would probably refer to the methodology as case studies. But instead of ruminating on what you would do if you were management you are reacting as if you were the actual first responder on the scene. And the cases are getting more and more complex.

We started out with with the basics. We were deducing issues and imparting stabilizing treatments. But as we got more comfortable with figuring diagnostics and rendering basic aid the complexity ranked up. At the end of the day today we were presented with a car accident and four patients.

As we ran (literally) onto the scene we had to not only unravel what had happened but also treat several patients in varying degrees of distress. One of our patients didn’t make it. There was nothing we could have done. But we didn’t know that going into the scene. When we arrived we had no idea what happened and had to untangle the triage ourselves.

I was surprised at how challenging it was to leap into action. As the chaos of the accident presented itself our group of first responders had to decide on organizing ourselves and our resources. But the instinct is to simply begin rendering aid.

And that tension between acting and organizing in a crisis never goes away. You just get better trained at how to approach it. Working in the chaos is the job. I honestly thought I’d be better at it. Taking charge and working in uncertainty is something I enjoy. But as with any new skill, it takes work and practice. A certain amount of pressure is the only thing that teaches you how to work in chaos. And I’ve still got a long way to go.

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Aesthetics Community Preparedness

Day 628 and Intensity

If my brain is a sponge I think I’ve been sopping up more than I am designed to handle. But I am holding on and facing a lot of new information and acting on it quickly.

I’m at a wilderness medical first responder class. And I’m the odd duck out on the class. Everyone else is living with much harder realities than I do. They are the ones that fight our wars. Provide our security. Fight our fires. They keep up with where our most vulnerable live. It’s an on the margin make your best call world.

My body can feel that this reality is very different from what I live with and on different class and wealth bands. People that are more buffered from harsh realities often don’t want to face the costs of our lifestyles. But we are not in a morally neutral systems. And a lot of violence still happens on the margins.

I feel somewhat invigorated by the immediacy of decision making in these chaotic environments. If you are in a natural disaster like a wildfire your capacity to react calmly under extreme conditions is a given. So naturally we arm these people with more agency and skills as it’s a set of problems with a lot of nuance and grey areas too.

I am frankly exhausted even though I didn’t do anything that intense. I did some traumatic brain injury drills. And I worked on how to properly stint and secure broken bones if you are in the back country and need to hobble back in to society. I learned a lot about agency and context and the need for high emotional intelligence as you cope with those who are in need or duress.

I suppose with that in mind, it’s no surprise that I’d like to enjoy a good long night of sleep and a big breakfast in the morning. One has got to enjoy living when you have the chance.

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Preparedness

Day 626 and Learning

I’ve been slowly making my way through a Korean show on Netflix called Extraordinary Attorney Woo. It’s about a young woman with autism who has a gift for the law. It’s warm hearted and charming and a bit of a relief to watch if you have autism or are on the spectrum. I highly recommend it.

The show really pulls on my heartstrings. The episode I am currently watching features the struggles of 10 and 11 year old kids who are at after school academic centers. I won’t ruin the plot but a young man sets out to “liberate” the kids by letting them play. I found myself tearing up the show went about discussing the need for healthy playtime.

I hated going to school even though I love learning. I found so much of the pressures of school upsetting. Being inside, being around lots of people and loud noises, and just generally being obligated to things like homework and deadlines to be exhausting and anxiety inducing. I found myself tearing up watching these Korean kids in similar situations.

I was quite lucky to have a mother who sent me to Waldorf schools and even the occasional home school year. When I could pace myself I’d would rapidly out run the curriculum. I just needed breaks and playtime and my own opportunities to self direct. I hated discipline from the outside but had plenty of my own if given the chance to be self directed.

I’m still an autodidactic type as an adult. This week I am taking a wilderness medical incident certification course. I’ve got some strong sense that this is meant to wrap around some wider learning experience about the practicalities of living in a more chaotic world. It’s a bit of learning by doing. Some perspectives have to be unraveled first hand.

Categories
Aesthetics Biohacking

Day 624 and Goblin Mode

A trigger warning for folks. This post contains discussions of poor eating habits, food trauma and possible eating disorders.

As much as I like being a bit of a loner, I am often comically inept at having to take care of myself. My husband has been busy with work and I have been left to my own devices to manage cooking this week. Let’s just say it went a bit poorly. Or at least it was comical. My husband is practically a chef and I can barely microwave a hot pocket.

I’m exactly the sort of person that Soylent, the tech bro reinvents NutriSlim beverage, was designed to appeal to. I am easily overwhelmed by the thought of even basic cooking. I’m extremely picky about texture, smells and presentation (thanks autism). And if I’m really honest I just don’t want to eat anything that isn’t perfect. So if it’s not exactly what I want, I might has well have a nutritional slurry. I hate to waste calories in unappealing food so I’d rather get in my macronutrients and vitamins.

I’m embarrassed to say that I did exactly that for a few meals this week. I tossed 2 scoops of protein powder, a scoop of vitamin mix, and some GI stomach support into a glass of water and called that dinner. Even lower rent than a packaged shake but probably healthier. I got 35 grams of protein out of this bad boy.

A protein slurry in water.

I realize this sounds like I’ve got an eating disorder. And maybe I do. Before anyone has a clue that I might be autistic I had some knock down drag out battle of wills with doctors.

One of the defining traumas of my childhood was my pediatrician telling my mother I needed to eat more dairy. I hated the stuff and refused milk & yogurt as small child. My doctor’s solution (and I am not making this up sadly) was to not allow me any food till I ate dairy

Julie Fredrickson from Day 368 Eating Disorder Season

That story doesn’t end well. I didn’t eat the dairy. I passed out. Starving kids into compliance is perhaps a bad idea. But it did leave me with a sense of comfort and control with fasting. If I cannot eat for any reason I know I will be able to manage feelings of hunger. So not a total loss.

I have enjoyed some of this feral goblin mode stuff but I’m glad that Alex is back at his cooking now that the week is over and it’s Friday. Pulled pork is definitely better than nutritional slurry. Well, sometimes slurry has its place.

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Emotional Work Uncategorized

Day 623 and Pausing

I am feeling a bit anxious about back to work season. I’ve traditionally had a terrible relationship with work. I’m a workaholic and struggle to pace myself effectively. I particularly love riding on the zeitgeist of a season like the fall as “everyone” is back at the grind and I like to ride the energy of the moment.

But I also need more frequent and shorter pauses than the American work week or season has ever allowed. I’ve always been afraid to take them because I fear being seen as lazy. “Only the morally weak rest” is a truism of English and Germanic lineage well prior to the Reformation. Though that’s kind of an aristocracy needs the serfs working thing.

But Protestant Work Ethic aside, I’m not really cut out for hustle culture. Being disabled, even modestly with something my spondylitis, is like the double whammy of being weak and lazy. I need to maintain a different schedule because I cannot overcome the foibles of my own body? That’s an affront! I’ve got a lot of self talk that basically goes like this

You soft feminine pathetic weak bitch get your ass back to work.

Me to myself. Sadly.

Does someone have internalized issues with feminine cycles? Oh yes she does! I guess it’s not just being lazy but it’s being female and a waste of productive worker all in one body. Super fun! And yet here I am a libertarian and I work in finance. Square that circle my friends.

Capitalism has enjoyed patriarchal structuring because it allows us to categorize the inconveniences of bodies that are harder to regulate. Women in the workforce was a pain in the ass until we figured out chemical birth control I’ve got to assume.

But all these legacies of who is worthy and who is strong and who is valued are kind of bullshit constructs. I can take what serves me. I don’t need to get all up in my head about having a less productive body because who even set the damn standard right?

So I am reminded I can pause without crashing. I choose to pause at my own leisure. I can choose to self nurture so I operate from my own point of maximum strength. I have to chose to pause. A pause is not is weakness.

A pause is like the ocean cresting before the wave breaks. And I can choose to ride that momentum. This is all a part of my own work on not just surviving the current moment but thriving with optimism. It’s peace from strength. While I recognize and even ride the chaos outside, I do not feel chaotic inside.

Categories
Chronic Disease

Day 621 and Pain’s Anxiety

Before I was diagnosed with my spinal condition ankylosing spondylitis, I didn’t really understand that I was in pain. I know that sounds weird, but I just knows I felt like shit. I hadn’t yet pinpoint the origins of the crisis in my own body. I was a stranger to myself.

Back then getting a diagnosis involved a lot of questions about my mental health. Are you anxious? Would you consider taking an anxiety medication just to see if it help? Are you sure it’s not all in your head? No doctor I’m not sure of anything that’s why I’m asking you.

The thing is I did feel anxious. My central nervous system was in a perpetual state of fight or flight from the pain. I had tachycardia. I was twitchy. I wasn’t a sleeping well. I didn’t want to be touched. It hurt too much. I was exhausted all the time and felt overwhelmed that no one seemed to know what was wrong with me. I’m lucky no one asked me if I was depressed or I might have been put on Prozac.

I’m one of the lucky ones. My chronic disease has a simple blood panel and physical exam to diagnose it. It only took me a few specialists to get to a rheumatologist.

I fear I would have been given an anxiety diagnosis and told it was all in my head if I’d had something more complex. But thankfully we untangled that any anxiety or depression I felt was simply a function of being in an inflammatory condition so acute every movement was painful. You’d have a racing heart and a fear of movement or touch too if everything was painful to the touch

The thing is I am scared of my pain. I do regularly get caught in fight or flight fear responses if the pain appears and I’m not prepared for it. I am militant about certain aspects of self care and my biohacking as I fear flares. I fear the drugs that are required when it isn’t controlled. It makes me anxious to need drugs at all to control my symptoms. Especially in America where a war on drugs has made it hard to need anything stronger than Advil.

Everything about pain and it’s treatment is anxiety inducing in America. And that’s a hard comorbidity to live with in a disease. As if pain wasn’t enough, the latent fear that you might not be believed lingers.

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Preparedness

Day 620 and AQI

I am in the throes of a horrifying migraine. The take two Imitrax and pray type. It’s also the nausea inducing type so I’ve not eaten all day. I feel awful. And it’s mostly not my own fault even though I often like to blame flares in symptoms on my own lack of discipline or purity in maintaining some Platonic ideal of lifestyle or wellness regimen.

It is fire season in the west and I’m sure some, if not most, of my migraine is tied to the horrifying air quality that is choking out thousands of miles of California, Washington, Oregon, Idaho and Montana.

An AQI reading of western America on September 12th at 3:48pm Mountain Time from PurpleAir

The AQI or air quality index in my neck of the woods is 160. Unhealthy for sensitive individuals is the coy and somewhat misleading phrase used. It means in practical terms visibility is so bad I can’t see the mountains a few miles away.

Montana is at the moment free of any major fires. Our colder temperatures, lack of pervasive fire beetle blight, and reduced density makes it statistically safer than the Colorado front range when it comes to total fire danger. But it’s no safer from prevailing winds and the pollution from fire in other states. In order to escape from it entirely I’d probably have to leave the continent.

I’ve obviously opted not to leave my home region of the mountain west even if I have accepted moving to a more northern and protected corner of it. But there is a certain existential “No Exit” sense I have with AQI and fire season in general. It may just be my lot in life. Maybe it’s everyone’s lot. To give up your homeland is a complicated fight. I expect for some of humanity it must involve either certain death or the prospect of great riches

Categories
Aesthetics

Day 619 and Indoor Clothes

I have one issue on which I am a little obsessive compulsive. I hate when someone wears dirty clothes on a clean bed. It just drives me absolutely up the wall.

I suspect this is born of some totally rational preferences. I am very outdoorsy and always have been. As a child I spent as much time as I could negotiate at the barn. I worked as a stable hand as part of keeping my own horse’s board and feed paid. If you’ve ever kept animals or worked on a farm you know how barn clothes smell at the end of a long day. You don’t wear your barn clothes except when you are choring. It’s rude.

Then when I left Colorado for New York City I found another reason that your work clothes should be taken off at the door. Instead of smelling like manure, urine and stale sweat after a long day mucking stales you’d smell like shit, piss, the subway and traffic exhaust. City smells are no more polite to bring inside than barn smells. Getting splashed by a cab or sitting too close to someone who hasn’t showered in a while on the subway is just normal life in a city.

You can probably imagine now a routine in which I take off my outdoor clothes and swap them for my clean indoor clothing. I try to do this as fast as is possible. I can’t fully relax unless I know I’m in my indoor clothing. Because unless I’m clean I cannot get into bed. And there can be no dirty clothes on clean beds.

I simply will not let myself even get on top of the comforter of my bed with outdoor clothing on. If I want to get under the covers and fully relax at home, I better be in clean designated “indoor clothing.”

It still upsets my brain when I see a teenager on television lounging on their bed with shoes and jeans on. Maybe suburban sitcoms neighborhood are a cleaner environment than the one I grew up in?

Or when an adult couple is about to get it on and then tumble into bed with their coats and jackets and high heels. I just hate that. I shudder. I don’t want to bring dirt and shit into my love making. Sorry it’s just my preference no shame if that’s your kink. But absolutely not in my house.

I’ve finally fully trained my husband on this quirk. He keeps a clean set of pajamas to change into and is careful to keep barn clothes to the barn. As for me, I like this quirk. I keep a cleaner house because of it. Sure it’s a little weird but I love a nice clean safe place.

Categories
Chronic Disease Politics

Day 618 and Personal Politics

I hesitate to share too much detail about this but, I’m an opioid user.

Actually I’m not hesitant to share that at all, it’s in fact the core salient point I want to make today. I have a chronic disease and sometimes, blessedly more and more infrequently, it can only be effectively treated with pain medication.

Why am I talking about this? And in public no less? Because unless powerful people that have a degree of social, personal and political capital discuss things we deem unsavory we never make any damn progress on humanizing our inhumane responses. And our response to the opioid epidemic is inhumane.

The backlash to the crisis, a mash up of intense scrutiny, government intervention and rigid rules, has now reached a point where it is doing as much harm as the original crisis of overprescribing. And I hope my personal story allows you to see why.

My spinal condition (ankylosing spondylitis) can be so debilitating that the only way I can get out of bed to accomplish basic tasks is by taking a mild opioid called Tramadol. It’s not in the same category as OxyContin or Percocet but it’s not risk free either.

I’m lucky that my condition is relatively well controlled. I don’t need pain medicine all the time and I work very hard on alternative treatments in the hopes that I won’t need it at all in the future. I spent a small fortune making sure I don’t need a core useful medicine. Let that sink in.

I’m not an addict. I am monitored by a team of professionals. Every step of the way is in fact monitored extensively by state and federal systems along with massive insurance and hospital system oversight. It’s the closest I’ve come to experiencing the Panopticon. It’s life altering in its scope. My entire life by necessity has to revolve around when the system deems it safe for me to get a prescription. Not when my doctor thinks I need it. When Uncle Sam does.

I fucking hate relying on something so dangerous and so demonized but also so regulated. I hate that my entire private medical life is so closely monitored by the state. I hate all of it. But, on very bad days, the choice is immobilization or Tramadol. And I’m not at all ashamed to say I pick Tramadol. I want to be a working productive member of society and that’s hard to do when you are unable to move from the pain.

There is no grace in suffering but what it teaches us. And I’ve learned we use pain as a cudgel to control people in our society. That it is so effective is why I am both a libertarian and fiercely against the carceral state. One day it might be you suffering and you won’t deserve it either. And I pray that you will be shown grace in your personal circumstances.

But I’m lucky. I’ve got other pharmaceuticals, like biologic injections which treat inflammatory conditions, that I can rely on. I’ve got THC and CBD for their anti-inflammatory properties. I’ve got good old fashioned steroids like Prednisone. Which interestingly, my physicians universally believe is more dangerous than my Tramadol usage and did actually require an extended titration down as I was physically dependent on it, as your body stops producing the necessary hormones. They’d rather I use Tramadol for flares.

But you notice the government isn’t up in your face with a massive publicity campaign showing cops busting down Prednisone rings. There are no political advertisements showing how an opponent supports big steroid. Even though if you saw Donald Trump after he got Dexamethasone during his fight with Covid it was pretty clear he felt pretty good. Steroids have gotten me far more fucked up and also higher than any opioid ever has. But no massive surveillance program has ever come down on anyone for anti-inflammatory drugs.

Because that would be fucking ridiculous even though it’s just as addictive in driving physical dependencies , just as debilitating and depending on your body chemistry, just as “fun” as narcotics. Fun fact about me, I don’t have whatever chemical makeup that allows an opioid to give me a high. Which as I’ve learned is a saving grace. Not everyone does. That’s kind of the rub. The risk profile on opioids is a bit worse because some pharmaceutical executives lied about the percentages of people who get addicted. Or who found it’s side effects pleasurable in the absence of symptoms. They did not lie about the benefit of not being in pain.

And that ought to give you a good sense of the problem at hand. The iron law of prohibition strikes again. A massive bureaucracy imposing a fix that intervened in crude and inflexible ways is causing more suffering than it fixes. It wasn’t the intent but it is the outcome.

The iron law of prohibition is a term coined by Richard Cowan in 1986 which posits that as law enforcement becomes more intense, the potency of prohibited substances increases. Cowan put it this way: “the harder the enforcement, the harder the drugs.”

Because doctors were lied to about the risk profile of certain types of opioids in the first place, the backlash is now as bad as the original sin the pharmaceutical companies committed.

Regular law abiding people are getting fucked in their treatment plans because hard enforcement is making it harder to get the low dose drugs. We treat Tramadol users with arthritis with the same tools as as criminals addicted to illegal fentanyl. I know shocker that the American federal government can be as evil as Purdue.

But also historically you know it’s true. And now a huge portion of normal people like me, who just want the benefits of not being in constant pain, are being turned into an over surveilled over controlled population. And I’m not saying there are no risks. But who do you want deciding that? A doctor who knows you well? Or the government? Yeah I’d pick the doctor too.

Categories
Politics

Day 617 and Overnight

I plowed through a bunch of choring yesterday. Which apparently tuckered me out. I took maybe an hour nap before dinner. I had a little extra CBD beforehand and found myself drowsy as hell. I passed out sometime around 8:30pm.

Alas the napping and the early bedtime, if you can call just utterly losing consciousness “bedtime,” had consequences. I came to around 1am and found myself wide awake. Oops.

At first I wasn’t quite sure how to approach this unexpected moment of being lucid and energetic in the middle of the night. I toddled over to the bathroom to pee. I crawled back into bed. I debated if I should try to force the issue with an Ambien. But I didn’t have anything in the morning so I thought maybe I should take those sleep hygiene folks seriously and just do something till I get tired.

Of course, the thing I decided to do was read on my phone. I cleared a few back logged essays from my collections on my favorite reader app Matter. I logged into Bloomberg to check pre-market sentiment. I opened up the New York Times and read Queen Elizabeth’s obituary.

Around 2am it seemed clear I wasn’t sleepy at all. Whether from the back lighting of my phone or the five hours of sleep I’d logged earlier. So I said fuck it and opened Twitter. I dig deep into the feuding discourses of “God Save the Queen” versus the survivors of British empire. Monarchists loved their kindly grandmother and the Irish did their best to be polite about the genocide of it all.

If the sun never sets on the British Empire the doom scrolling through the celebration of the end of the longest reigning monarch seemed like the way to go out. But unsurprisingly there was a lot of darkness to be found in the pre-dawn sentiment. I tweeted a reminder to myself to explore how enclosure movements and anti-colonial “fuck the federales this is our land” historical context plays into the American political moment.

Eventually I got drowsy. I feel asleep around 5am just as the rest of the country was waking up. I slept till 9am or so.