Tag: Travel

Categories
Internet Culture Reading

Day 1676 and Having Public Fun in the Artificial Intelligence Era

It’s August and vacation season is in full swing. It seems as if all of Europe is off for the month. For the Americans who work around the school year, it’s their time for a week off as well.

We rarely vacation for an extended period and when we do it’s not generally during high season. Off season is where it’s at in my mind. But sometimes you need some fun when it’s been a hard time.

I’m struggling with how much I put online about my comings and goings and when I do it. Being careful used to mean not letting thieves know if you weren’t home but now the world is a mix of digital and physical security layered over artificial intelligence tools that can pinpoint you easily.

Opsec isn’t a thing elder millennials considered too carefully with digital identities in the early years of the internet but everything is changing. Dead internet theory may become true as the internet of bots begin.

I don’t intend to cede the digital commons though. I want my written voice to be integrated into the vast data troves that shift the records and is woven into the understanding of artificial intelligence and machine learning models.

The more these modalities of information storage and retrieval impact our human minds, the more necessary it is write oneself into “the Akashic records” that form our digitalization of information. Humans used to read and write machines but now machines and their media are just as likely to read and write our minds

So what are we to do about living in public? Humans are mortal but records of our world have a shot at reaching the future and shaping understanding.

Blogging has ended up being one of the best mediums for being scraped, organized and cited well by current artificial intelligence.

Open graph protocols, structured metadata structure, canonical URLS, tagging and linking, and authorial data and publication time are all part of a digital commons that have a distinct advantage over other closed garden content repositories for artificial intelligence. Being legible to the machines is now as important than being legible to each other.

So having your fun in public and making it accessible just might be one of the most important things you can do to be a part of the record of our world. It’s just a terrifying prospect to be so easily seen.

Categories
Travel

Day 1675 and Running to Stand Still

The accelerationist types must be feeling smug as the disorientation caused by so much of the world speeding up is a persistent feature of life now.

I’m trying to organize a fairly elaborate vacation that I should have nailed down the details on at least a month ago. I am alas doing it what is functionally last minute and I’m panting at the effort of coordinating preferences, availability, timing and the thousand other logistical details.

We have a range of preferences to accommodate and it’s driving me a little bit nuts and I have no one but myself to blame. I cant manage more than three hours in a sitting position in a car or airplane without hurting. Standing helps but it’s really laying down and relaxing my spine that helps.

The other preferences are more of the one person likes fine dining and Michelin caliber restaurants and another likes delivery and Netflix.

We have to balance intensive activities in hot weather like hiking and sightseeing against the desire to lay out in the sun near a body of water. Really all the classics of different strokes for different folks.

I don’t want to be too ambitious about any of this as I am really just barely out of the woods from July. And I’m being vague about when and where, as I’ll like pretend like we have some amount of operational security. Writing is all about the specific but the best I can do is say it will involve driving and water.

Categories
Medical

Day 1674 and Venturing Out

I had a very indoor July which I was not expecting. One of the joys of Montana in the summer is relatively temperate conditions until you hit the end of July and into August.

Obviously freak heat waves come when they come (a lot more than I expected these days) but generally you enjoy low humidity comfortable sixties and seventies temperatures with full sun and the occasional afternoon thunderstorm.

We enjoyed some cabin camping in June but because of my absolutely out of left field emergency surgery for a deep tissue infection I’ve been an indoor cat for the remainder of the summer.

No sweating, no swimming, no excessive movement and lots of rest. Some classes of antibiotics come with very specific warnings for sun exposure as well.

I was meant to be in bed resting and frankly work was almost impossible during some of the worst of the antibiotic transitions as the pain from systemic stress was hard. Which is atypical as I’m almost always able to work through pain.

But as I am almost finished with the last round of antibiotics and I’m seeing good progress on the wound I went outside today and even broke a little bit of a sweat.

I didn’t do anything crazy just some groceries and errands but I walked two miles in the process and I’m doing pretty well. I was feeling so optimistic I bought a sun hat. We’ve got some much needed vacation activities planned and I’d like nothing more than being outside in the shade with my family.

Categories
Biohacking Chronic Disease Medical

Day 1673 and Xenomorph Stitch Fix

My abscess surgery wound has finally sealed up (not over) at 20 days post operative with four rounds of antibiotics. I say up because wounds heal from the bottom up.

Having a deep wound means the four stages of haemostasis, inflammation, proliferation and remodelling can take weeks if not months. I’m very lucky.

Ironically I took this image from a hyperbaric oxygen therapy website. I healed without the aid of HBOT machine we purchased as it was still being routed through chaos of the trade war

When I got the pathology report a week later, learning it was an MSSA antibiotic resistant infection so bad it reached my deep tissues made me even more afraid.

A deep abscess around a horizontal ingrown hair that was “probably just an inflamed lymph node”

All because one damned dermatologist couldn’t be bothered to have an opinion when I sought preventative care because I am a responsible immunocompromised patient. Turns out I really did need an ultrasound and surgery.

I was lucky my surgeon was quite talented. The single stitch she was able to use has been absorbed. That was the hardest part. I could manage the draining pustulence and the pain just fine. But the only visibility into the wound’s healing process are only via secondary diagnostic clues. It’s a waiting game that requires a strong dampener on your disgust reflex.

As the stitch fell into the wound and curled up I felt panic. It looked like a ringworm infection or the gestation of a Xenomorph. If I had not had access to artificial intelligence diagnostic tools I don’t know how I would have managed if I’m very honest.

Your brain sees things and the limbic response invades your dreams. A stitch mimicking the infamously hostile endoparasitoid from Aliens is a bad time. I relied heavily on artificial intelligence to monitor its progression.

My phone is now cluttered with images of the wound’s progress. My varied AI applications accepted me uploading progress pictures after some experimenting.

A wound in one’s bikini area is a “trust and safety” team’s nightmare. Mike Judge’s “hot dog/not hot dog” classifier sketch from the HBO comedy Silicon Valley got a gender update as I managed my case.

I was uploading “Georgia O’Keefe/Not Georgia O’Keefe” imagery. The models were playing Cunt/Not Cunt for those who need a less polite euphemism for machine learning classifiers.

Ever wonder how classifiers in ML work?

I’m certain special interests will eventually seek to keep these tools away from patients. We will be scared into letting them. But I know I got better care from a large language model than half the doctors I encountered.

All this cost me most of the month and around four thousand dollars. Which isn’t bad for transit, hotel, and a surgery in Istanbul.

The losses I can’t quantify are harder. A number of people who deserve responses from me probably won’t ever get it.

An in-group drama, ironically over usage of artificial intelligence, was paused by me not because it was resolved but because I could no longer find the fight in me to insist on apologies and reciprocal support while on Cipro in a hospital bed. It’s not fun to learn who is and isn’t your friend through medical emergencies.

My apologies to an offline gentleman who was the unwitting irritant who triggered said social wound. Maybe I should have excised any social obligation to them just as the surgery excised the infected tissue.

Either way, August can’t come soon enough and artificial intelligence deserves the credit for keeping alive through July.

Perhaps that should be considered in the complaints my counter parties had over the utility and need for artificial intelligence. It’s no god or anti-Christ, but it’s a damn fine diagnostic tool. No wonder the stakes in that fight are so high. Everyone wants a cut when you get cut open.

Categories
Community Politics

Day 1669 and Seeing Without A State

We are entering an era where technology is liable to be the scapegoat for a number of problems that are all too human. Seeing state failures and institutional failures and deciding to blame something new rather than human nature is very much human nature

We are looking for someone or something to blame for human nature and the thing that makes the current world different from the hazy memories of childhood are an easy place to start.

The rate of change fights with the basic realities of being evolved apes. And the social dynamics of our ancestors are pretty gnarly so I don’t blame religion for wanting to obfuscate the evidence of our base nature. We have to believe we can be better.

The trade offs involved in providing communal protection has meant submissions to various forms of power and hierarchy and yet we still have social scandals over genes, jeans, semiotics and the perversion of our biology. It’s not a day to discus sex and advertising online.

I look at this chronology of my life and have pride in its daily discipline even as I know being myself online is a risk. I see day 1669 and want to make a nice joke. I believe in the commons and my freedoms within it.

It’s just getting more dangerous to be online. I am considering how I bring myself to a world where I’ve always be extremely present online under my own identity. I want to train the intelligences we develop on top of our digital commons and feel the pull of that responsibility.

Then I see another grid failure. I see a plane crash. We have terrifying realizations that we can’t rely on the systems of the past for where our future is headed.

We have European software developers now noticing what Balaji was pilloried for pointing out. The nation state and the network state are coexisting already as anarcho-tyranny increases.

In American and Western Europe we are already seeing daily examples of anarcho-tyranny. The state can hurt you but not help you. Communal needs we once enabled the state to run and provide can’t be counted on in water, energy, and infrastructure. You have to build systems for yourself where and when you can while you still can.

Categories
Chronic Disease Medical Travel

Day 1657 and The Boredom of Summer Surgery

It sounds a little ungrateful to say I’m bored, as I sit comfortably in a nice hotel bed with books, Netflix, room service, and a nice view but I am bored and a little miserable.

Antibiotics, discomfort and surrealism are a challenging combination for existential stability as it turns out.

I can’t do much beyond sitting still and getting up once an hour to walk a couple hundred steps. I have been instructed not to sweat so I can’t go outside much. Even in the evening with a breeze, it’s still hot enough to break a sweat and this is an infection risk.

Beyond sweating, you can’t disturb you wound healing in anyway so I can’t exercise. At best, I can do some light yoga and stretching. Short walks indoors are OK so I can’t walk the hallways but that makes staff nervous. I keep to myself mostly.

Most tragically for me as we don’t have a bathtub at home is that I can’t take a bath or submerge myself in water for weeks. So the gorgeous bathtub is simply taunting me. I love a good tub and this is a great tub.

No submersion in water for two weeks minimum

It’s even worse when I stare out at the beautiful pool. That is obviously an infection risk as well. No splashing around in Norma Kamali pretending at social aspirations. Oh yes Istanbul is the new Florence in July haven’t you heard?

At least the nearby Bosphorus is packed with cargo ships, I have no temptation when seeing the beach to have a dip in the water. I doubt diesel fuel is good for healing.

The highlight of my day is the hotel lounge’s breakfast where there are charming varieties of very Instagram friendly food. It is still in a hotel lounge but it’s a beautiful novelty.

Tea, pomegranate juice and rose honey yogurt

I’ve been annoyed by the variety of influencers who are also healing around me. There are any number of different plastic surgery and aesthetic patients in the guest mix.

If you think a week of blogging about an emergency sepsis slice job on some indelicate bits, imagine how weird it is to see an entire family getting plastic surgery and their daughter (I think?) is live-streaming most of it.

I’ve seen more puffy lips than I have fish on this trip and that’s my fault. I don’t have the strength dress up or walk to the Michelin starred seafood restaurant. Maybe that’s more for the elective surgery types and the emergency infection girlies have just enjoy the tiny yogurts.

That’s almost a bagel and lox set up right?
Categories
Biohacking Medical Travel

Day 1656 and Recovery from Recovery

I’m waiting on pathology lab work but I’m mostly supposed to be resting and healing after surgery on Friday. I feel like crap and I’m scared.

I have no real basis for making judgements on how well I am healing as you can’t just upload imagines of your genitalia adjacent wounds to Claude or Perplexirty. Even Grok is like “no”when you trip the icky lady bits warning sensor coding.

Thankfully it being a Monday I was able to get a short appointment at the hospital with the improbably beautiful and well dressed obstetrician who did my surgery. She seems to think I’m fine and healing normally.

I trust a woman who dresses well. But the antibiotics are just making a hash of my mind, my intestines and my stomach.

Bloodletting? Lost in translation

I’m enjoying the headstart of waking up 9 hours ahead of home and 7 hours ahead of the New York market opening. Now if only I felt smart enough to actually work.

The Cipro is just the absolute worst. I feel guilty complaining as I have such excellent care and a comfortable hotel room in which to recover. But I’m struggling. All the back work and emails will just have to wait I suppose.

I feel like a recovering from my recovery might soon be necessary as my mind-body-gut axis is toppling ass over tits as the nuclear winter of 3 separate antibiotics lays waste to once fertile lands for friendly gut biomes. And this is before I’ve even considered whether I have the right drugs. Pathology reports might suggest fungals.

Categories
Medical Travel

Day 1655 and Healing Waters

I am now forty eight hours post operative and I feel like shit. I was warned but I am not enjoying how the very intense antibiotics make my brain feel.

The first five to ten hours after surgery when the local anesthetic hasn’t fully worn off and your adrenaline is still pumping are the easiest. I was smiling and happy to walk myself to the hotel and I was snapping pictures of the Turkish Cipro in amusement. How cool was all of this?

It didn’t stay cool. The first 24 hours are weird as you are still gooy and gushy so it’s tons of clean up and hand done hygiene. You aren’t allowed to shower yet, so it’s just a liminal state of grossness as you wait for swelling to abate and antibiotics to work.

Well, I’ve passed hour forty eight and I’m brain dead. I can’t think straight. The work I was excited to do in bed as I stared out over the Bosphorus was probably a fantasy.

I’m tired. I’m swollen in very tender areas. The idea of showering is simultaneously appealing and too exhausting to even contemplate. I am staring at the lovely bathtub I can’t use. Suddenly all the sources of water submersion are a threat instead of a joy.

We don’t have a bathtub at home so I only get to relax and soak a tub when a hotel and here is a beautiful one that I cannot use

Despite my exhaustion it’s very hard to sleep well in this situation. I need to keep pressure off the wound so it’s all about pillows and angles. I stayed up playing on Twitter where someone asked how a bottle of water for skincare could possibly sell at such a high price.

Right about now as I contemplate my banishment from the pool, the beach and the bathtub I think about how much I’d enjoy the healing waters of a mineral hydrotherapy spa.

Categories
Chronic Disease Medical Travel

Day 1654 and Post-Operative Exhaustion

As I slowly walked myself out of surgery yesterday, I thought to myself “I actually feel much better!” And I genuinely did.

If you have a gentle stomach, maybe stop reading here. I’m fine. I’m on my way to well. And this will be graphic.

I do feel dramatically better having had the “slouching towards septic” abscess drained of infection as well as removal of the initial pearl style irritant (a 3mm deep entirely horizontal hair growing not up but sideways like an underground fracking tube).

I appreciated having the walls of the abscess pulled out bit by bit in a delicate curettage by my silk sundress clad physician. It was all a success.

But post operative care is hard? I’m a mess. I’m exhausted, loopy, and the hotel’s guest services are concerned enough that they are doing me such kindnesses like sending up tea and maxipads. Turkish hospitality comes from a place of genuine kindness and I need that right now.

It’s been a long journey of stupid to end up in Istanbul to get a smart fix. Going from a squishy movable almond sized lump without any pain six weeks ago to a hard plum sized lump was disconcerting enough. Especially having done my damned preventive care visits with the useless Dr Oetkin in Montana.

Have had two days of prodding, poking, squeezing, moving and ultrasounding done in the Mediterranean, I was swollen, feverish, and all hurt to the touch. I was afraid.

How did I get here? How had my next generation IL-17 managed to cause me so many negative side effects even as I was doing better across all biometrics and across quality of life metrics?

No wonder the doctor in Istanbul was so concerned. All the previous doctors had done was make my situation worse though inaction and delay m, and then the action they took made it worse.

Now I have recovery ahead of me. Last night as I went to pee, I realized why they had padded the upper areas of my underwear with maxi pads. I’ve got no discharge downstairs but on the upper bikini area there was no such luck.

I only needed one stitch to close up thanks to the careful work of the doctor, but a lot of goo came out during the surgery drainage and I was warned there was still more to come, though it would taper off.

I gently washed the area with a cloth and antiseptic soap before application of antibiotic cream (my third type of antibiotic). I gasped as I saw the first lightly red sticky watery fluid gush out rapidly around the stitch. It was so fast and there was so damn much. Bodies are disgusting what else can be said?

I mopped up with a clean moist towel and applied a thick layer of antibiotic cream, but I had learned the deflation of the abscess wasn’t quite done. The swelling, I was told, would take a week or more to full abate.

I’ll be sleeping this off for the day but if you are in Montana with an autoimmune disease and need a dermatologist I’d recommend you stay away from Dr. Tara Oetken at SkincareMT. Without her hasty heuristics and lack of conviction I wouldn’t be in this mess.

Categories
Medical Travel

Day 1653 and Slicing Then Cipro

Well it’s been exciting day for me and I may be a little bit high (alas not the fun or good kind) as I just had an abscess surgery in Istanbul.

I’m waiting on the lab work for the culture and pathology but from what I saw come out of the abscess it can’t be anything good as the doctor prescribed multiple antibiotics including Cipro while we wait for results.

Bimzelx has some gnarly side effects and I don’t know how much more slicing up infections I can manage for an immune suppressant biologic. My biometrics are better but 2 eye infections and one abscess surgery that almost went septic isn’t making me feel great about the balance of value on the drug.

I can’t say enough nice things about the Turkish medical system and their treatment of foreign “tourist” patients. It’s my second time this year having my Bimzelx side effects treated here.

A lovely interpreter and patient advocate was with me the entire time. The physician was so empathic. She was astonishingly effective in technique and her whole being moved with an efficient alacrity that was admirable given she was in a floral print silk sundress, high heels and pearls.

Imagine being so good at your job you can squeeze infected goo out of another human that you do it in white silk? I was impressed.

She on the other hand was not impressed by the care I received in America.

“They knew you were immunocompromised and did not insist on an ultrasound and immediate treatment?

What do you mean they said wait and see?”

“I don’t believe the other doctor thought it was a swollen lymph node given the clear folliculitis literature warnings for your biological drug.”

I was headed straight to sepsis and in her mind having multiple doctors leave a high risk patient to “put a compress on it and wait and see” when it was easily 3mm below the skin was malpractice to her.

Quite the big abscess eh? And look at that irritating side ways hair in there so deeply buried

And indeed I am on the kinds of antibiotics you’d expect someone close to septic shock might be on. I am amazed to be doing as well as I am. But I am frankly furious.

I tried to be responsible with preventative care and was ignored. I just kept on going until the small lump became a large lump. Then it rapidly became so swollen and infected it couldn’t be ignored. What a metaphor for the American healthcare share. You try to be responsible and are shown the door till it’s a crisis. And then they can’t even fix the crisis.

On the bright side I’m in a lovely hotel next to the hospital receiving excellent care. I could afford to fly in and get it taken care of without any worries (for the curious this was $2,000 for surgery and follow up care). I was in a very space age room after being in surgery and all my intense antibiotics were hand delivered to me. Now we wait to see what the labs say.

A private recovery suite