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Friday, April 14, 2023

When Getting Up Isn't a Win

My foot is way more swollen for no reason at all. I'm up most of the night due to charley horses in both my feet. The other neuroma is acting up now too. The second cortisone shot doesn't seem to be doing anything positive.


I did start taking magnesium. I've gotten away from my vitamin regimen, but I've been low on magnesium in the past so I started that up again in the hopes it might be helpful.


And I'm taking Advil and Tylenol at night again. I might try taking some during the day as well to see if that makes a difference with what happens at night. 


Ironically, I'm fine during the day.


When I lay down, it destabilizes everything and makes it worse. Same for swimming. Weight on my foot is actually better than being weightless. But I can't handle a lot of weight bearing either. 


I'm so tired. 


I don't know. I might try sleeping sitting up between now and surgery. I'm trying to picture how that would work and how to make it comfortable...


Geopolitics again...


So what's going to happen? No one knows, but the risks are concerning.


I keep hearing this war is an existential fight for survival for Russia.


But the thing is, it's an existential fight for survival for the West too.


No one can afford to lose in Ukraine now.


Which means we have a very dangerous conflict, much more dangerous than I think most people realize.


And, again, if you look at global leadership as a continuum with one end being leaders of functional democracies and the other being ISIS or Hitler, we have more and more leaders, most of the leaders with nukes in fact, moving toward radicalization.


Nukes in the hands of people who don't have to listen to anyone is a big problem.


If Russia loses, we can try to solve that problem. The West could pull back from the brink of being an autocracy like China or Russia and actually stabilize the world. There's a chance, at least. The amount of Russian and Chinese fueled corruption in Western governments is definitely a heavy thumb on the scale. We'd need a lot of grassroots energy coming in to counter that corruption, but do the people of the West have it? Eh. We'll see. Still, it's a better scenario than the West losing.


If Russia wins, we will eventually see some kind of nuclear exchange somewhere because autocratic states will be the norm in a world run by BRICS, and once autocracies run out of resources to plunder within their own borders, they go a pillaging with a side of genocide. It's just a question of time.


Given that Russia can't afford to lose, it's unlikely we'll see them withdraw unless there's a major change somewhere in their sense of reality. That leaves our best hope as a negotiated end to the war where everyone gets enough something to commit to a new status quo. At that point, whether we publicly admit it or not,  and if we're smart (which who knows!), we switch to a Cold War style footing and covertly work to destabilize autocrats with nukes.


This means, Ukraine may have to cede Crimea and perhaps other territory for now. And potentially Ukraine may be barred from joining the EU or NATO, although I think that's a dumb move on Russia's part. Limiting Ukraine's options will just result in them being a loose cannon. They have too much military experience and are far to interested in fucking up Russia to leave them at loose ends.  At least if they join NATO, they are a known quantity and you know the rules they have to operate by. But hey, it's Putin's mistake to make.


But it's all around mostly bad news. I am looking for whether we have better outcomes on the table but I'm not finding them so far. Sorry. I know it's distressing. Give what energy and support you can to democratic institutions where you live. That's one way to feed the world's better angels in this mess.


I think I'm about done with geopolitics right now. I've got more on AI and medicine in the wings and then psychedelics and feminism....which ought to be interesting. At the rate I'm going, I just might combine psychedelics with feminism. We'll see.


PS: Someone asked me if Clinton as president would have made a difference. I doubt it. A President Hilary Clinton might have done less damage overall, but I don't know that she would have outperformed the chaos machine on PCP that was President Trump. Clinton was Secretary of State under Obama, a president who was exceptionally weak on foreign policy. Trump was also weak, but was such a wild card that he accidentally landed some wins because people had no idea what he would do next...it was a weird presidency, more like a psychedelic fever dream than anything else. One that directly fed into Putin's fever dreams.


However, no president since the Cold War 'ended' was clear eyed enough about Putin to actually invest the political capital to deal with him proactively. Our leadership has largely been lacking on the geopolitical front for the last 30ish years. It's not any one president who did us in. It's all of them.


 (There's a conversation to be had about how we can improve our geopolitics. We have more guardrails on domestic policy than foreign, but given what we're facing now, I'm not feeling that has served us or the world so well. Trumps shouldn't be able to come in and just blow up policy because he feels like it. Bushes can't be allowed to get distracted by one issue. Clintons and Obamas can't be wilted wallflowers.)


Love him or hate him, Biden is probably the best man (of the choices we had) for this moment in history. He not only remembers the Cold War, he actually had a seat in the front row. He knows the game and that knowledge will serve us well. He's also less corrupt than other options and generates very little drama (I mean, they can keep trying to make senile and Hunter's laptop happen, but it's pretty hollow), which means national interests can lead over other, more self serving agendas.

Wednesday, April 12, 2023

I Talked to a Journalist and They Sucked

 US-A T0d@y popped onto my radar looking to talk to people with chronic illness about covid now that everyone's back to normal.


I offered to be interviewed and we had a call.


But I didn't meet the requirements of their narrative bias and was told a few weeks later that they didn't use me in the article, but that my thoughts informed their take.


And then it wasn't even an article published in US-A T0d@y. It ended up in some regional paper that had the kind of hard paywall conservatives could only dream of having at the southern border. 


The misrepresentation of their affiliation and allowing people to think they were national media was interesting. (Perhaps they do work at that publication or are part of the syndicate, but I wouldn't know the details because the journalist didn't disclose shit. Apparently, even as a nobody, I need to do due diligence with the media.)


The things I said that disqualified me from being part of the article...


1. We need better vaccines and treatment and it needs to be more widely available.


2. I don't need anyone else to wear a mask or be vaccinated because I can control my risk well with an N95. We don't get sick when we wear masks.


3.If we had better vaccines or treatments, I wouldn't even need the N95.


So guess what angle the article took? It focused on 'everyone needs to wear a mask and get vaccinated and this is why people with chronic illness are suffering, because people won't protect them' which is a flawed narrative when N95s (or p100s if you want to get hardcore) work and when the vaccines are imperfect. The latest reporting is that the boosters start waning after two months and are not protective for those with chronic illness...far from the efficacy we need.  (Here's the full preprint study if you need it: https://www.medrxiv.org/content/10.1101/2023.03.02.23286561v1.full.pdf --they have a whole discussion about why it might be the vaccines aren't working.)


WTF is a vaccine going to do better than an N95? Nothing.


The article was solely focused on interpersonal dynamics and fomenting the discontent that feeds the culture wars. People won't protect us. Other people need to get vaccinated. Other people should do what I need. 


Apparently we're still not allowed to say things like 'wear an N95' or 'the vaccines kind of suck' or 'I can't access Paxlovid or other treatments reliably, the system isn't working.' And I must be the only person in the world more interested in where science is on better vaccines and treatments, instead of trying to control or blame what millions of other people do.


We are moving too slow and fighting without effective tools.


We are choosing flawed narratives that ignore that. 


We are not having quality discourse.


Humans really suck at pandemics and the media isn't helping. Like, wow. I didn't expect everyone to be so awful. How have we not gone extinct long before now? Oh right. Smart people have been saving our asses for centuries now. But to what end? This? Is this the pinnacle of human achievement??? Is this what all our smarts have achieved? This bullshit? Really???


PS: From that article I linked above: "The omicron-targeted shots also did not reduce the risk of severe Covid in chronically ill adults younger than 65, the study found."


I just want to point out, I can feel the flu vaccine kick in when I have the flu. I can tell the difference between having the vaccine and not having it. In comparison, I could not feel any of the covid vaccines kicking in when I was sick. It was like I had nothing on board.


I know this is an unpopular take, that it counters the overarching narrative that's been crafted, BUT THE VACCINES ARE NOT DOING ENOUGH. The media and the government can scream all they want that people need to get vaccinated, but it's not working as advertised and the data is starting to show that.

Tuesday, April 11, 2023

Recap

Since the covid vaccines and covid itself...


I've had major irritation and inflammation of multiple nerve growths that has resulted in two surgeries now, with a third on the way.


A previously stable pancreatic growth has suddenly started growing.


(For the record, there are other people dealing with growths after covid and I've been talking to Infectious Disease about it. I'm not off base. At the very least, the inflammation is fueling things that were already brewing. If there's an actual growth factor beyond that, no one knows yet. But this isn't all coincidental, it's covid.)


I have the joints of a seventy+-year-old and I'm not seventy.


I suddenly have sleep apnea that waxes when I have covid and appears to wane when I don't.


I struggle to walk. I struggle to sleep. I pant like a dog and feel like I'm going to pass out if I'm too active. The asthma is worse.


I doubt science will be able to do much to counter this chaos in my lifetime.


But I just wanted to recap where we are.


Now...on to geopolitics...because at least I'm still very curious and interested in all the things.


I've got a few YouTube videos for you from college professors and topic experts. 


1. Professor Sachs is up first. Note his position mirrors Russia's, but I like his game theory and there's a lot in here to think about.


However, he's an economist not a geopolitical expert, and apparently he also doesn't believe in a nation's right to self determination or sovereignty. In this talk, he participates in the dehumanization of E. Europe--treating the countries and their people as pawns that can be sacrificed at will. This is a very Russian point of view, one that has resulted in genocide in Ukraine multiple times at this point. Perhaps, since Sachs has advised various Russian leaders, he's adopted their world view. It certainly sounds like it.


But, as I'm someone linked to E. Europe in a variety of ways that don't include keeping the leaders of Russia happy, consider this question...


If Russia is so awesome, why did the vast majority of E. Europe align with the EU and NATO?


Russia will tell you that it's because the West was meddling and connived to make it so, but in reality, it's because the USSR treated E. Europe as an ATM during the Cold War. They plundered and bullied and impoverished E. Europe, and as a result, are generally not perceived as good or trustworthy in the region. There is a history of abuse behind why Poland has armed itself to the teeth and joined NATO. And they are not alone in that.


Sure, you can find Russian apologists, but ask around and you'll find there's a large contingent that really dislike Russia and want nothing to do with them. They want to be like the EU. They don't want a mafia state. 


Keep in mind, for the last 25-30 years, Europeans have been working in the West and making money hand over fist, money Russia certainly never deigned to spare, and they like it. There are cities in the US that are the second largest population centers for some E. European countries. There are countries were 20% of their population is overseas. 


Compared to the two main exports from Russia during the Cold War--what's-yours-is-mine imperialism masquerading as communism and the heavy hand of the Russian Mafia--and the fact that's what Russia is offering now, there's no competition. Russia doesn't want to add value, they want to take it.


E. Europeans know what they're choosing. Their eyes are open.


So that's why E. Europe isn't going to war to kick out the EU and NATO, but does work to kick Russia's ass. It's not because the West bamboozled them into NATO. They want to be part of NATO. They will literally supply tanks and planes and bullets and aid to ensure they don't have to go back to Russia. The logic of Russia's premise on this doesn't hold. (A ten-year-old could figure out the truth on this. Russia lies to us like we're dumb, and well, sadly, some of us are...)


So when experts and pundits go on and on about how this war is the West's fault, what they are really saying is that Poland, Slovakia, Latvia etc... don't have the right to sovereignty and that we should sacrifice the countries and people of E. Europe to appease Russia.


Put another way: Russia demands that in order for the West to have security, freedom, and peace, we must deny E. Europe their security, freedom, and peace. 


How is that okay? None of us would stay in relationships with someone like Putin. It's toxic.


Sachs is also concerned about wealth inequality, which is very real, but note he doesn't talk about Latvia or Lithuania or Botswana or El Salvador. No, he talks about Russia and China. In this case, wealth inequality is code for 'we want to control everything.' I'm all for putting Costa Rica or Mauritius in charge...they're actually functioning democracies but economically disadvantaged compared to the West, Russia, and China. Like, let's go. Let's have actual democracies lead. But equality of any kind isn't really the agenda here so...


Professor Sachs also says that we know the problems of geopolitics, but no one has any solutions, which is inaccurate. We know that democracy, while imperfect, interjects enough churn into the power structure to keep agendas from getting a stranglehold on a nation. We know keeping dark money out of governments and fighting corruption matters. We know free speech and education and strong labor movements make a difference. We know that every nation needs to be vigilant about their geopolitical strategy, not only building bridges, but having expectations that productive things will cross those bridges too.


If we'd done half the above, we wouldn't have a war right now.


But hey, if you've been on the payroll of corrupt autocrats, probably you've gotten used to not saying that democracy is good and corruption is bad. 


Despite my criticism, Sachs' talk is a good listen for testing the merits of different ideas and provides a good example of how insidious Russian propaganda is. I will note, much like more pro Ukrainian analysis, he is very concerned about a nuclear weapon being used. That, I think, is more concerning. When all sides see the same danger, you have to imagine there's some clarity there. 


Next up is Julia Ioffe, a reporter and analyst who knows Russia well. Her take here is more psychological, but it's interesting nonetheless. Very good overview of Putin's machinations and some of the missteps and wins of the West in dealing with him. She also sees nukes as a possibility.


And here's Marie Yovanovitch the former ambassador to Ukraine sharing the history she witnessed and also highlighting how the West screwed this up. And boy, did the West screw this up. 


(Note: If you're interested, PBS has a whole series of interviews with different players involved in the geopolitics of Russia and Ukraine.)


Then we have Professor Kotkin, a historian with the Hoover Institute at Stanford. The Hoover Institute is a center right think tank, so pre-MAGA Republican. This is a largely factual interview and it gets more into the impact of Russia's war on China and Asian geopolitics. It's a very interesting interview that reveals some of the scope of Russia's actions outside of Europe. The long tail on all of this is insane. What happens in Ukraine isn't going to stay there.


I will say, no one that I've found so far is talking about the BRICS colluding to pull off this war (at least when I wrote this). Since the BRICS are all largely headed by autocratic leaders no one can say no to (imagine a room full of Trumps trying to negotiate with each other--to one extreme or another, that's the dynamic), sustaining a high level of cooperation is or will be difficult, but I do think there's some effort to pull together going on despite competing agendas, vainglorious narcissism, and international pressure to not do so. 


The payoff is too big for them not to work the spots where their interests align. If they can find a way to cooperate, they'll do it. 


If Russia pulls off a win, China probably gets Taiwan, Iran probably gets nukes, India gets to hang in the winner's circle perhaps taking Pakistan, Brazil and South Africa probably get to be the very rich autocratic Kings of their continents (whether their coalition will give them nukes, I'm undecided, but it's a possibility) and the dollar and the pound and the euro go pfffft and there's a massive, painful (for the West) polar shift in how the currents of global, economic, and military power flow. 


And then someone, somewhere will get nuked. Because the BRICS will eventually turn on each other. Again, global leadership is devolving to have more in common with ISIS than not. Quality isn't improving, it's eroding. We have leaders with nukes who kill people who tell them the truth so no one says boo. We already see how that led to major miscalculations in the assault of Ukraine. 


And you can bet the West will be in the mix trying to subvert and topple various leaders which will compound risk. We're not going to cede power quietly and we could very well make things worse in the process. A lot of people will die.


Not to mention Russia, China, and India all have long standing territory disputes amongst themselves. The second resources are scarce or the economy is bad, take your pick of which friction point manages to throw a spark first. 


So. Our biggest mistake was not dealing with Putin decades ago. A mistake we made worse by failing to mount a strong deterrence against aggression once we knew were in for it. There's still a chance to create effective deterrence in Taiwan...I hope the West takes it. 


And we should be destabilizing the absolute shit out of the rest of the BRICS. No more dollar diplomacy without an overt, tangible ROI. It doesn't work. Americans will abandon their principles for money, but the cultural ethos in other places isn't that shallow. (Yes, I just called us shallow. We are. At least on a nation state level. Individual results may vary.) We need to stop trying to buy outcomes from frenemies and take our dollars to our allies and build them up instead. 


Let the strongmen of the BRICS make do with Rubles and Yuan with a 1000 to 1 (or worse) exchange rate. Let them struggle to afford genocide or conflict that could go nuclear. 


Again, the West just sort of abdicated all responsibility for ourselves and the world except for the War on Terror, taking bribes from Russia, sometimes even China, and then being manipulated via social media until we're more divided than we've ever been. (Y'all there were literal Nazis protesting in my area this past week. Nazis. NAZIS. Like...what. the. fuck.)


Ultimately, even if he gets the root cause wrong, Putin is right to blame the West. This was our war to prevent. (This doesn't excuse Putin. He certainly could have been the better man here, but he decided to double down on autocratic dysfunction and start a genocide. No points for him either.) But now the West has been blind to reality for so long, we may not be able to pull everything back from the brink.


This is an absolute cluster. We'd better hope Ukraine can spank Russia hard enough that they give up and go home without escalating to nukes.


As to why I care...win or lose, this is going to change the world same as covid, same as AI. I pay attention trying to extrapolate--if I can--where the hits will land. I'm not so old that it doesn't matter yet and I've got a kid to launch, which means career choices need to be tight.


















Friday, April 7, 2023

How Many Ways Can You Cut a Foot?

 The podiatrist is recommending surgery. A neurectomy to be precise.


So. I'm having surgery. I know it's relatively minor surgery, but I'm not thrilled about it.


The treatment options for Morton's Neuroma run something like this...


A variety of injections and ablations.


Then surgery of which there are two approaches--decompression or neurectomy.


The injections can work but don't work for most, and thus, aren't preferred. So there goes all my previous excitement about maybe avoiding surgery.


Decompression surgery is the sole provenance of private podiatry practices and their marketing outreach. How do I know this? Well, there apparently isn't much to say about Morton's Neuromas in the medical literature which means search results are 90% sites for private clinics.


Private clinics where the doctor always seems to be an exceptional genius who invented a decompression procedure to treat Morton's Neuroma.


After like, the fifth site where the podiatrist had this whole spiel about how they invented a new technique and are the only ones who can save you with nary a mention of failure rates*, I was like...okay, this is bullshit. (See also: All the previous times I've talked about how surgeons will say anything to get you into surgery.)


Did they all hire the same marketing firm or something? How is this peacockery allowed by the state medical boards? Can you just claim to invent a procedure like that? OR are there that many super special ways to cut out a neuroma? 


100 Ways to Slice a Foot, Invent a Procedure, and Increase Podiatry Clinic Profits--some conference workshop somewhere.


Even more insidious, some of these geniuses start patient communities where they can shill their patented surgical miracles. There's a whole marketing machine that overtly manipulates patients.


But if decompression surgery for Morton's Neuroma is the second coming of Christ the private podiatrists say it is, mainstream hospital system medicine has yet to convert. 


Mainstream medicine cuts out the nerve and that's the only option on the menu I've been provided.


Either way, the procedures work about the same from what I can tell. So surgery here I come. Bah.



*For those looking for an ethical podiatrist...if their website mentions failure rates, if they talk about decompression surgery being an option in a specific use case (earlier in the development of symptoms) instead of trying to sell it 100% of the time, and don't claim to have invented the 5,000th special procedure for Morton's Neuroma, which is a condition so boring and unexciting that there aren't even 5,000 medical studies on it (this isn't cancer)...probably they are good egg. At they very least they're more up front than 90% of their private practice peers.






Wednesday, April 5, 2023

Why Is the Media Pitting Patients Against Each Other?

 A few months ago, I got a hot and bothered text from my anarchist extreme left sibling ranting about people taking Ozempic from diabetics. The injustice of it all was too much for them.


They'd seen an article.


An article.


Since then, that one article turned into dozens which has sparked all sorts of nasty commentary from the Greek Chorus that is social media.


No one will google. No one will shut up. No one will ask why am I jumping on the hate bandwagon? Or why the media is pitting patients against each other? Or where is the voice of authority that properly calibrates the narrative?


Hating on non diabetic users of Ozempic is a huge dopamine hit and nothing unites people like what they hate.


And everyone really hates fat people.


Never mind there are at least six other medications in the same class.


Never mind that Ozempic is new and expensive and likely not cheap compared to its peers. 


No one is dying for lack of Ozempic. Seriously. No one. They may have to wait a bit until they can get Ozempic, but they'll have medications they can use in the interim, likely at a lower cost than Ozempic to boot.


People are confusing the crisis around cost and accessibility of insulin with Ozempic having supply issues.


And then they hear people like Chelsea Handler dog it too. But, here's a headline for you, this is a person whose comedy act includes a bit about how she swallowed her yeast infection ovule like a pill. I don't know what vaginas out there reach the age of what? 50? and don't know how to take yeast medication, but apparently that makes you a medical savant when you're famous.


Why the media decided to weaponize the hate on this particular issue is beyond my ken. It serves no one but the stock market.


But yes, let Chelsea Handler be the medical expert. I mean, at least we're consistently stupid in the narratives we amplify.


Again, our ideal and actual culture are so far apart they may as well be in different dimensions. Again, how do we get back to center? Because if we don't, bad things will happen. Simple things like this go into the pot and simmer with everything else and the end product isn't good.


We are collectively having our pet hates weaponized, pushing us to choosing violence. That's my take on it, anyway.


Life update...


I'm still struggling with the post covid nerve and joint pain with a side of foot neuromas--taking lots of  NSAIDs--but I finally did get out into the garden to start preparing for spring proper. I was going to start a bunch of seeds, but I realized I'm going to be out of town and can't count on anyone to water them.


(I've paid people. Tried different people. Paid more. Asked family to do it. The reality is...no one waters the garden. They kill it. Every time.)


So starting seeds will have to wait until we're home. I'll just keep plugging away at clean up and organizing for now. Maybe clean out the one flower bed and sow the flower seeds...


The big question is whether or not we smothered the strawberries to death trying to protect them from -40 temps. Which I hope not, but...eesh I'm not so sure they're okay.


Shapewear for the wedding dresses has arrived. I realized a bit late that I need all new Spanx because everything's too big. Both dresses look great. Ahh. It's going to be hard to decide which one to wear!


Hair cuts are up next. I haven't been to a salon in over three years. I've been cutting my own hair all this time. I have hair that hides mistakes well so it's just been easier to DIY it, but I'm doing my best to spiff up for the wedding.


My energy is doing okay. I get tired faster, but my carrying capacity isn't as limited as it was with my first round of Covid. The biggest issue right now is the unrelenting 'painsomnia' from my joints and nerves. Yawn.


But the covid inflammation is going down. I think? My foot has been the main indicator. At its worst, it felt like I was walking on just the toe box of a flip-flop...there was a cliff near my arch where the swelling suddenly dropped off. It's gone down to more like half a thin sandal sole.


Maybe in another week the pain will mostly be gone?



Tuesday, April 4, 2023

It's Not Zero Luck or Bad Luck, It's Negative Luck

 

Oh the teen. The poor teen. Just when we think we've got a win, that we've got something sorted, it all turns upside down again.


The dynamics gunning for her beggar belief. They really do. This is unbelievable.


So. Got a new diagnosis. One we thought was simple and straightforward. It's common, there's a turnkey system in place, meds should be plug and play. Easy peasy, right?


Wrong.


It interacts with one of her medications, the meds we can't get to work, that we are constantly back at the specialist trying to find a solution. Naturally, medication #11 looked like it might be a win aaaaaand she can't take it anymore. It's not considered safe.


This has thrown everything into chaos for the teen. This is the #1 thing that limits her ability to function right now so not having it buttoned up is a huge problem. We start medication #12 now and have no clue if it'll work. After this, we're out of pills to try... 


The one time we had a medication that seemed like it might work, she's disqualified from using it because of another diagnosis. I can't believe it. I'm aghast.


If we can't get this under control, eventually she'll have to have surgery. 


I can't believe how complicated simple things can be. I really just can't believe it. 


Also, it seems to me that the teen has some kind of issue processing this class of medications. Like, a med will work initially, but then her body seems to adjust or stop processing it and then it doesn't work anymore. Times eleven. And now her options are even more limited because of risks associated with another diagnosis.


I know I've said it a lot already, but honestly, I can't believe this. Every other kid and adult takes these meds and is fine. How is the teen not fine too?????????????????????????????????????????????????????


(And yes, she does take everything as instructed. I've done the whole are you sure you're taking your pills correctly thing and supervised what she's doing. Like, yes, I did actually go down the rabbit hole of maybe my kid is screwing this up, or worse, purposely engineering problems and no...that's not the issue.)






Monday, April 3, 2023

Will the Lottery Get Better?

 

I'm having a moment of serious irritation that my main function in this civilization's healthcare system is to produce profit for those who really don't give a shit what happens to me.


The delay in the MRI didn't save the insurance company any money, and in fact, it let things fester to the point where I may never have proper biomechanics in my foot again. I'll be extra expensive on the back end dealing with that fall out.


Here we are again, proving what I keep saying...we need to get to imaging faster. Yes, I hate the contrast and that's not ideal, but we've also got to stop letting things fester into the worst outcome for patients.


We've got to stop delaying it because of costs. By my rough estimation, the insurance company will end up paying the equivalent of at least one more MRI in extra costs that could have been avoided by the time this is over, if not more.


Of course, apparently the math holds that most people don't need any imaging at all and they've decided all the extra they pay delaying imaging is still cheaper (in my experience, corporate finance sucks at capturing all the cost impacts of poor management so...I have some reservations on that...they make the numbers say what they want and there's a bonus incentive for it*). So I guess I win society's Shirley Jackson style lottery here. Again. Unfortunately, I'm not inclined to be gracious about it. This is bullshit.


I wonder what happens as our demographics make people more valuable and less expendable? We see this new term 'labor hoarding' being bandied about in financial analysis. Companies are giving raises to retain staff now because they know they can't replace people easily anymore. If they can't afford to lose people, they also can't afford for them to be medically fucked by insurance companies and inefficient standards of care. You don't want people out on disability for longer than necessary. And competitive employers will poach your best people with better insurance.


Will we see things shift toward more proactive healthcare to preserve the output of the population? Or will large corporations suddenly discover a newfound love for immigrants who will bolster the demographics and maintain the status quo? (Or will AI just take over? But then who's earning enough money to buy what AI produces?)


Low wages and lots of people have allowed corporations to make healthcare costs a high deductible personal responsibility complete with a heavy dose of moralizing gaslighting when people can't afford it. What does it matter if people die or end up disabled when there are 50-100 in the labor pool who can replace them at any given time? 


What happens when you don't have those people anymore? Even if we increase immigration there'll be a gap period while people get up to speed in a new country...perhaps there'll be a short lived, but golden era of improved care and access for people. Maybe we can win a better lottery for a while. Or somehow AI will fill all the gaps and it'll be same ol', same ol'.


*Oh man. Now I'm really wondering how AI is going to hit corporate taxes. Maybe I just worked with particularly stupid C-suite execs in my corporate days, but to my mind, you just know they're going to eliminate the Accounting Dept, turn it all over to AI, not realizing it doesn't know the loopholes and tricks, that it'll follow tax law as written, and then they're going to be so surprised when the shit hits the fan. At some point somewhere somehow AI is going to get the C-suite crew fired lol.





Friday, March 31, 2023

Much Medicine Too Doctor

 It feels like we're aiming to break a world record over here. Four different medical things today. Two appointments. Two tests. Two medical campuses. In five hours, which isn't bad to be honest. I got lucky that the tests could be done at the same campus as one of the appointments and the waits were short.


I saw the rheum, who is being proactive. I have to say, the ageism in medicine at some point works for you instead of against you and I appear to be there. I didn't ask to be tested for RA. I don't think I have it, but they want to test to be sure. I've never had doctors who wanted to test to be sure of anything until the past year.  It's like opposite day.


Also, I'm hypermobile too. But like, normal hypermobile. It's not causing issues* like it does for the teen. Still...kind of interesting to be told that. I had no idea.


The rheum plan is once my foot surgery is over, I'll do PT and then we move on to injections. 


So blood work. X-rays. And two appointments.


Kiddo had a specialist follow up. Doc was super dismissive and rude and a poor listener. Akin to the doc who told me I had diarrhea and just didn't know it. Needlessly contentious. Unwilling to hear it. Denial of reality to the point where it's ridiculous. We're going to be switching to someone else. 


It wasn't a total bust. We got some things sorted and the treatment needed. They did their job, but it'd be nice to not be told that, essentially, everything we're telling them isn't true and that everything we do is wrong...when that's not what we said we did.


We have a day coming up with 3 appointments in 3 different cities. That's going to suck. Hubby has to  cover for me with the teen as I have my presurgery stuff for the neuroma.


I hope we're about done for the teen. I think we're zeroing in on some things that are working and that will, hopefully, keep working. In theory, we'll have a formal baseline established shortly that she can work off of to see what can be optimized and how she can work around her limitations. I hope. I mean, I can't see how much more we can do.


There is that one lingering issue that may require us to travel because it's a major quality of life issue. However, at the moment, medication #11 is apparently working. We are all holding our breath hoping this is THE ONE. 


*Per se. It's not helping me now, but has been largely a non issue aside from also being clumsy and prone to falls as a kid myself...which it all makes way more sense now that I have additional context. I just never had it to where it caused enough dysfunction to hold me back too much. I could control my body whereas the teen flails and has a lot more pain. Huh. 


But part of the reason I take the teen so seriously is I was breaking bones and dislocating joints at her age. My falls down stairs didn't end well. We're lucky she hasn't had those injuries yet, she bounces better than I did. 


But the knee I dislocated at 14 --doing something that typically doesn't cause dislocations-- is a huge PITA as I age. I expect I'll need a joint replacement or some kind of surgical intervention down the road. 


Sometimes I wonder why we aren't more interested in injury prevention. A lot of injuries have major impact on quality of life in our later years. Like, football as it's played now makes no sense to me. That's just asking to be disabled in your 40s in an era where you could, in theory, live to be a 100. Same goes for a lot of activities. We all ooo and ahh over Tom Brady's long career, but dude will have won the luck lottery if he doesn't have to fuse his spine together and replace half his joints before he's 60.


We don't need to wear bubble wrap, but we could do more to prevent injuries with a vicious long tail. Why we don't bother is weird to me.




Tuesday, March 28, 2023

My Sharona Neuroma

 It's a neuroma. Another growth. Morton's Neuroma. (What did I ever do to you, Morton?) Oh and another joint has some bursitis going.


I think this growth likely came from a PT related injury I sustained in my foot trying to deal with my hip and knee back when we didn't know I had a cyst compressing my spine. (Wow was that a mouthful. But that's what happened, when this all started.)


I don't know that this one is part of my broader pattern of growing all the things everywhere.


At the same time, I can tell there's one in my other foot. It's nowhere near as bad yet, but it's brewing and I'm not clear on why that one is happening.


Not sure what the deal is with the bursitis. I do have a hard push off that I've worked to soften. Or maybe it's from that original injury too.  Weirdly, between covid and the fact I can't walk without pain and severe, nigh intractable, charley horses in my foot, which is to say, I ain't walking much, it hasn't resolved. I thought rest was the cure with bursitis???


Anyway, my goal now is to get another cortisone shot or even actual treatment, as apparently there are maybe some non surgical options. (It would be amazing if I could avoid surgery OMG. I hope, hope, hope.) Depending on the plan, there's a chance I could actually be in a good place by the wedding. (!) Failing that, a cortisone shot will at least keep me comfortable and let me sleep until we can schedule whatever procedure.


Hopefully I can claw back some mobility for a few years before I get clobbered by the next thing.


It's frustrating. Zero stars.


PS: The MRI report is wild. Apparently I have cirrhosis, colorectal cancer, and need a CT and MRI. There's just a random rambling paragraph of nonsense in there that I can't even begin to figure out how to summarize here. I don't know who triggers that...radiology or podiatry? Was it something I said? I was pretty doped up on Benadryl and a metric ton of prednisone...in fact, I conked out and slept through most of the MRI. But yeesh. I'd think it wasn't my report except the doctor called me and confirmed the neuroma.


PPS: The doctor's office was SO nice and trying so hard to make sure I wasn't worried but I kind of figured it would be a Morton's neuroma so I'm in a place of AMPUTATE ALREADY MOTHERFUCKERS. I have no anxiety. No worry. I know it's not cancer. That I'm not going to die. Just kill the fucking thing already. But they were so careful with me, working so hard to ensure I wouldn't panic, and I was like, look, this is growth number 35 at this point. A foot nerve tumor thing can't scare me. You don't have to baby me. Fire up the napalm, bitches and SEND IT TO HELL. K? Thanks ever so much. ROLL TIDE.





Monday, March 27, 2023

Taking Bets

 

Had my foot MRI.


My system is still weird from Covid, and I discovered during the MRI, that my nerves are insanely hypersensitive right now. OMG did the IV sticks hurt. Like 8/9 level pain. Like obliterate thought pain. Like right up there with broken elbows and hepatic resections and imploding tumors pain. 


It was crazy. I almost yelled out motherfucker at one point, which I've never ever in my life been tempted to do for any kind of pain involving healthcare before. I didn't even swear at anyone during labor. Lectured them all about how they were counting wrong during the pushing phase, yes lol, but no swearing. 


Wow. Again...covid is a weird little fucknut of viral bullshit.


Anyway, either....


Nothing is wrong,

or I have a growth,

or joint issue,

or some combination thereof.


I'm leaning towards growth because of the way my toes have shifted out of place, but what the fuck do I know?


Motherfucker.


PS: The dresses for the wedding came and are lovely. I have my choice of a smidge too small or a smidge too big lol. We'll see if my weight shifts to help me out. I'll probably go with the slightly big one as it gives me nicer lines than the one that's straining a bit. But I'm covered no matter what my weight does.


And I scored them on Amazon for $60 each by way of China. I was sweating it because you never know what you're going to get from China, but I studied the size chart and the reviews (which were good) and made an educated guess to go up one size...which was just about perfect (a size down or up wouldn't fit right in either dress--likely I'm between sizes at the moment). 


The quality is excellent too. A nice, but unusual win in my experience.


I took the risk because the one department store dress I ordered was a hot mess of shoot me now lol and I didn't like any of the other designs in stock. So that expensive tragedy will be going back to the store.


Also, I like weddings and I'm excited and this is a big deal wedding for everyone...it's not some cousin fifty times removed or coworkers. So that's why it keeps coming up. In case that wasn't obvious.

Friday, March 24, 2023

Oh Yeah. I'm Uninsurable. You Didn't Know?

 One gap in medical care knowledge that I find interesting is how often geneticists tell me they don't know I'm uninsurable. I get the song and dance about how genetic testing can impact things like life insurance. Yadda yadda.


And I tell them, "No biggie. I'm already uninsurable."


They freeze, apparently gobsmacked. And then they say almost verbatim every time, "Oh we didn't know that. We're not taught that."



I shit you not. "We're not taught that." Really? I guess so based on my small sample size.


It just came up again with a pediatric geneticist.


So y'all...asthma makes you uninsurable by and large. You're not getting good life insurance or long term care insurance as things stand now. Add in issues with cholesterol or blood pressure or weight and you're never getting insurance. 


I do have some life insurance that we locked in when I was younger, but we've been unable to increase it (and I have some doubts on if it'll actually pay out). We also do the company insurance offered to employees as well because it has almost no barriers to entry.


So anyway, when the time comes, I told hubby to burn off my fingerprints*, drop my body in a ditch somewhere and let the state deal with it. Take the money and run, hon. Lol. Not really, but it's an option lol. I kid! The plan is actually cheap cremation. Ditch dumping is just our second funeral insurance policy. 


*I'm in the database because hubby is from Europe and you get fingerprinted because marrying someone from overseas is apparently crime or something.


 

Monday, March 20, 2023

My Dogs Got High Last Night

 

I've been delving into the world of CBD looking for something to help me deal with this latest round of covid firebombing all the things that are wrong with my nerves and joints.


The first place I tried also had dog treats, and since our doggos are getting older, and the fetch addict (I mean that literally) is getting stiff after her fix these days, I thought, why not?


I gave them their first CBD dog treat last night and OMG. 


When our doggos are high, they are filled with love. 


I got massive snuggles from the chocolate rescue, his tail windmilling faster than I've ever seen it spin. He then ended up splayed, belly up, on the couch. This was unusual as he's usually very guarded. It's taken him years to show us his belly and he is always careful to do it at a side angle so he can get away if he needs to. But not with CBD on board. With CBD, he lolled like he was doing a boudoir photo shoot.


The black doggo, the crazy one, the one who stalks and calculates and manipulates and steals, she just stared at me with all this love in her eyes and then crawled into my lap. Now, she isn't usually a snuggler. She wants to chase balls. 


Her behavior schematic is all about getting us to play fetch with her. Every interaction is an effort to get us to break out the balls to the point where we have to hide them because if she finds one she'll be insufferable until we cave. Fetch is her entire personality. If we didn't throw balls for her, she wouldn't give us the time of day and would happily leave us to die in a fire...that she probably would start out of spite. 


But CBD turned our fetch obsessed sociopath into a loopy love bug. Deep down she doesn't only love balls...


As for me and CBD...I got a menthol CBD cream and meh. I'd rather eat the dog treats lol. Yes, it worked, but not for long. I also seem to have more joint inflammation today--like maybe a rebound effect?-- and it seems to make me tired and groggy now that I'm awake. I feel hungover, which isn't supposed to happen so I'm not sure what's going on.


The dogs though, they are desperate to eat the cream which is a problem. I tested the cream on my foot first, knowing I could use my slippers to keep the dogs away, and that move turned out to be prescient. Once I got my slipper on, they pawed and licked it, trying to get inside. I had to keep telling them off and go to your bed. They were like sharks that had scented blood. I've never seen them like that.


Obv I don't want them licking this off me and it's not going to be safe if they're this intense about it. As a result, I've gone on to order some gummies and we'll see what those are like. 


I did feel like I slept pretty deeply from the cream, which I need. (I'm so sleep deprived from Covid eating me alive. I have a lot of catching up to do.) But again, I don't think the cream is known to make you sleepy, yet I felt a distinct cause and effect along those lines. I'm curious to see what gummies can do. If I can sleep through some of the pain that's been waking me up without a massive hangover, that would be a major improvement.


Meanwhile I'm starting up with the leg lifts and squats again. It's tricky because things are still flared enough that sometimes that hurts more than it helps, but I can only determine what the right choice was in hindsight. Every day is a gamble. Fun.


PS: In teen news...she applied for an advocacy non profit thing and was accepted. She'll do one week of training out of state and then an ongoing project in our local community and then a week in DC working on national advocacy. So we're very excited!


I will say homeschooling during a pandemic when the kid and the parent have health issues has made it tough to create a lot of opportunities for her to practice independence and interact with the world without us. I've had to really look for opportunities that would work for her.


She's been volunteering (and will soon qualify for the presidential service award), she has her little part-time job, and the co-op, which despite a tendency toward bigotry, has been a good social outlet, and while we don't like the bigotry, it's good practice in navigating groups of difficult people. (When I'm not wearing my momma bear pants on top of my extra tight cranky pants, I try to be philosophical about these things.)


When I saw this advocacy program, it seemed perfect. It gets her away from us in a productive way, it will work with her limitations, broaden her horizons, and give her more chances to test her mettle so she learns she can rely on herself--that's really important to learn at this age imo. It'll be a great learning experience. I'm so glad she was accepted.


So yay!


And then her English teacher* sent me a message about how smart and talented my kid is and offering to create a class for anything the teen was interested in. 


And then the co-op director told me my kid is so smart and so kind.


Clearly everyone got a memo. So today was A DAY with all the parenting wins at once lol.


*yup we homeschool but she still has an English teacher. With a PhD. We aren't perfect, far from it, but we do take education very seriously.

Tuesday, March 14, 2023

Urp

Accidentally ate gluten. Hubby gave me chocolate that's been gluten free in the past and I ate it assuming the crunchy bit was a nut. Nope. Pretzels. Surprise!


I've been sick all day as a result.


Always always check the label. Yeesh.


Tomorrow should be better. Just gotta get past the purge.


Joints and nerves are largely behaving now too. Thank God. That's been really unpleasant. 


Once I catch up on sleep (I've lost so much from the nerve and joint burning) I should be pretty much back to normal. I don't think I'll have a long tail with the fatigue, but we'll see.


I managed to do some gardening and my stamina was about what it was prior to this last round of covid. Which is to say, I eventually start panting like a dog and feel like I'm going to faint, but it takes more and more time to get to that point...which is still a covid legacy but it's an improvement over the long covid baseline. Does that even make sense? You know what I mean, right? Like, I'm not normal, but I've improved.


It is a little concerning that I'm almost at the year mark from the OG covid infection and still struggling with that, but I'm mostly just happy to have made any progress at all.


Friday, March 10, 2023

3am and Making Appointments Online

Pretty much the title.


Like, on the one hand, I'm trying hard to remember everything is awful because of Covid. That I was pretty much pain free up to this point. That my leg lifts and squats had been working their magic.


Yes, my nerves are angry and all the osteoarthritis in their path is glowering like Sauron's evil eye, but it's temporary.


On the other hand, it's spreading to more joints now.


And on the other other hand, the pain woke me at 3am and I hit a headspace of 'can osteoarthritis kill you???'


I mean, I remember pathophysiology class and it's not supposed to outright kill you but this FEELS like maybe science missed something here.


I figure by the time I'm wondering enough to start googling, a lookie-loo might be useful.


Oh fun fact...by some medical criteria, I'm already due for a hip replacement. I had no idea. (I'm really hoping that's just a weird internet blip and not really true.)


(Everyone likes to mock Dr. Google but no one talks about how our bodies drive us to it.)


So I find a doctor who can see me pretty quickly and I can schedule online which works because it's 3am, and then, since I'm up, I start googling the doc.


Just cuz.


And then it starts getting weird.


I find their Instagram which is fine even if it's all selfies in 2021 (which, by 2021 I think we all knew it's supposed to be more than selfies, but okay).


I can't figure out their medical training information. The databases are filled with bogus responses. 


Like...


University: Attended a university


Someone is clearly tinkering with the data inputs.


And apparently this doc is straddling practices located 2-3 hours apart across multiple states which seems hella weird. They've kind of been all over the place. Old locations now closed...that kind of thing.


And they have a very unique name (although surprisingly there are a few of 'em out there).


And then I find a person with their name getting an MBA and I'm like okay, what are the odds of the same name from the same country in the same geographic area as someone who is ping ponging back and forth between two cities in different states with this university in the middle?


Like, it's weird. I did eventually find their medical education information but it's still a strange digital footprint. One I don't typically see with doctors (look, you go to the doctor a lot, you get curious). I would guess coming to the US was hard for them--they're not from a country you see a lot in US medicine--and maybe that warped some of the inputs. 


And either they're really bored or hate themselves or love driving all the places all the time or one of their very unique name twins is somehow also in the same area. I don't know about you, but if I was a doctor commuting between two cities in different states, the last thing I'd do is enroll in college.

 

But anyway it's 3am and I'm up and my Google-woo is on fire same as my nerves and joints.


And no, technically osteoarthritis can't kill you outright--or so they say--but I'm pretty sure the sleep deprivation from the pain could.


PS: And then I went and learned all about their country. Because I'm up. Now I'm looking for ethnographies...


PPS: Covid does trigger arthritis it turns out. At least some science indicates that. Here I thought I was having some really unusual unheard of thing lol. It's weird. They're still saying there's no association with sleep apnea and covid, but the patients are giving a strong signal that actually there is, yet they figured out this arthritis thing, which isn't nearly as prevalent among patients who go online to complain.


PPPS: I guess I'll call the long covid clinic next as looping in with care providers who understand covid can do this is probably ideal. We'll see what this rheum says first though. Maybe they'll be awesome. After all, they attended a university.





Thursday, March 9, 2023

The Body Is Lava

 Aaaand hello nerve firebombing.


OMG.


Stupid covid.


GO AWAY.



Wednesday, March 8, 2023

The Pacing of Covid Recovery

I'm annoyed that I'm so tired when covid itself was so mild. Bah humbug. 


I wake up in the mornings feeling as peppy as a popcorn kernel under a blowtorch, convinced I can rocket to the moon.


And then it all goes poof.


Boom.


Done.


Fin.


My big accomplishment was to schlepp the teen to her school stuff, run two loads of laundry, and do some work. I spent most of the day in bed.


Today I couldn't wake up. Although to be fair, I woke up super early, thought I was up for the day and instead dozed off again. I think it messed up my sleep cycle.


At least I know how to pace. So. For today, I have one cleaning project. I'm hoping to make dinner. I'm doing a little bit of work. And that'll be it.


That's the architecture I'm aiming for. One household task a day. What work I can manage (I'll note I'm too foggy to do a lot, I've ditched my core projects and am working on less finicky things until my brain brains properly again). And make dinner. I'm still feeling my way through, not sure I can handle it yet. 


I'm hoping this is more like the booster side effects, which were much more short lived than the fatigue I had from actual covid. 


Crossing fingers.




Tuesday, March 7, 2023

A Weird Kind of Better

I'm pretty much over it. Just waiting to see if the fatigue (definitely feeling mono-y) and brain cotton and nerve/joint fire are going away anytime soon or if I'm in for months of misery. I haven't tested my stamina too much yet so I'm not sure how impaired I'm going to be.


Right now I'm getting tired pretty quickly and not up for a normal routine so...we'll see where it goes next.


I have a bit of a cough. An eensy weensy smidge of lung stuff.  (The asthma is behaving even.)


Sense of smell and taste is dodgy. I keep looking for what's burning or rotting lol.


Oh, and I was, until recently, snoring and mouth breathing all night in a way that's abnormal for me. I think covid is doing something to people's sleep as I didn't have sinus congestion. As I mentioned earlier, patients see a correlation with covid and sleep apnea, but science doesn't have a lot to say about it yet. However, my sleep this time materially changed for the worse. I didn't really notice it the first time I had covid, despite being diagnosed with sleep apnea afterwards, but I can see it now.


My question is...do you go back to your baseline as you heal? Or do you just have sleep apnea from covid forever? What does it mean that it's happening now? I had gotten to where my energy was much more normal, back to where I have the energy to go all day. I didn't have sleep apnea symptoms outside of covid as far as I know. So what's the deal?


But overall it's been very mild. Nothing like it was before. If it could be like this all the time, we'd all be fine.




Sunday, March 5, 2023

Getting There

Definitely not as sick as the last round of Covid.


I'm very tired and sleeping a lot right now.


Lost my appetite almost completely again. Doing my best to make myself eat because I really don't want to do the covid starvation thing again.


But the lungs are doing much better and so far, the joint/nerve inflammation hasn't been as bad. It's there but at like, 20% power compared to last time. 


That gives me a little hope. Maybe Covid's not going to be such a dire thing. Maybe my body is learning finally. Maybe it's more survivable than that first infection led me to believe.


And the teen isn't sick so far either, which is great news. Here's hoping...


Saturday, March 4, 2023

Hanging In

 Covid is currently hitting my heart and at the moment I'm sprinting a marathon without moving. 


I've slept most the day.


If this stays true to pattern, I'll be past the worst of this phase soon.


Lungs are holding up. This is wild, but not bad. 


Covid is such a weird little fucker.






Friday, March 3, 2023

Huh

 So this seems to be a glancing blow of Covid. 


It's been really weird.


Going at warp speed.


Slammed my throat. 


Then onto my lungs for a solid day of wowza sharp hurting.


Then fogging me until I couldn't think straight.


Then into the nerves to burn me like a gender reveal gone wrong.


That was just the first 24 hours.

Now, I can tell I'm sick. I'm chesty. But I'm not super sick at all. Nowhere near as sick as I was with the first infection.


I have not started the Paxolvid yet. I'm going a little off the map here. I have time yet to start it. If the symptoms are going to be this light though, I'm not sure I need it.



That may be a mistake though. We'll see.


But when I started calling around begging for Paxlovid, I had no way of knowing covid would be this low key.


All right, next in geopolitics...


You do realize that global leadership is devolving to have more in common with the leaders of ISIS than it does with democratic principles, right? The media and think tanks don't put it so bluntly, but they've said as much.


But take it a bit further...


Global leadership is devolving to have more in common with the leaders of ISIS but with nukes than it does with democratic principles.


Given that, in the current world situation, at a minimum, I expect Putin to make a huge mess at one of Ukraine's nuclear power plants. That'll fit with Russia's M.O. of maintaining plausible deniability and it'll make building a consensus on the response from the West difficult and fraught...Putin will love the schadenfreude. (If it already happened and you're asking whaaat? I wrote this a while back and didn't get back in time to update it.)


And autocrats and dictators have violent life cycles. It doesn't matter who dies, so long as it's not them, and external conflict is one way they maintain control. Mix in Russia's rhetoric about limited nuclear use eroding the idea of mutual assured destruction. Combine that with aging autocratic brains amplifying any inherent narcissism or sociopathic traits (think of the most obnoxious entitled Boomer you know, now imagine if they had unlimited political power and nukes) and we should all be deeply concerned.


But hey, let's drag our feet on Ukraine...going back years, long before this war started. And Putin. And China. And India. Our own growing corruption doing its best to ISISify our leadership. Just slow roll it. It's no big deal, right?


I mentioned being called into the boardroom and being asked to fix their mess. There was no easy answer then and there isn't one now. There are just some things you can't fuck up and expect to get back. Geopolitics is one of those. Once it spins out of control, physics takes over. We're locked into the ride now, and the only way off may be after the whole thing derails, catches fire, and explodes.


Welp. Sorry. I wish I could be more positive. But the world, collectively, has made an absolute mess. We're not getting out of this without paying our pound of flesh. Each.


We will be very fortunate indeed if I'm wrong. I hope I'm stupid. I really do.


 

 


Tuesday, February 28, 2023

Oh. Ha. Covid.

 

My live in parent finally has covid. Amazing. They've been going full face commando for over a year inhaling everyone's germs and have been fine. I thought they were one of those lucky ducks who were immune! Nope. They have covid. 


And now so do I.


Yet again, the people who aren't masking, who can't maintain vigilance are the ones infecting me. Sigh.


Today in Geopolitics...

I first became aware that China was a problem in the mid 1990s. I was working in international trade and that gave me a front row seat to the actual dynamics of things that were just headlines for most people.


I saw the sheer volume of trade funneling into China. It was insane. To where you couldn't help but wonder why there was so much of it.


At the same time, Chinese foreign agents would literally show up at the company doorstep, cameras hanging around their necks pretending to be a customer, and they would do anything and everything to gain access to manufacturing intel. They were aggressive and clearly doing this at scale, stealing everything that wasn't nailed down.


Then you get into what it takes to open a company or factory in China. China/Chinese businesses must have an ownership share of 51% and they basically get full access to everything; your tech, your formulas, your best practices. China wasn't going to be used, they were going to use you instead. They were always very clear-eyed about making sure their interests were served first and foremost.


It's always been interesting to me that China hasn't been able to go further than they have because they were gobbling up intel nonstop. Sometimes I wonder if they got too much data and struggled to make sense of it all. You could see signs that they had trouble getting their quality to match their aspirations.


At one point, my employer opened a factory in China and it was a shit show. Americans think once something is taught, you're good, but other cultures have a different sense of training and quality. We flew in the chemists and engineers for a short training period and then they came home. Well, the manufacturing went to shit the second they weren't there. The folks running the plant ran into issues and then got 'creative' about throwing what looked to them like input equivalents into the work flow.


Some of you may remember, there was a scandal with toys (if memory serves it was Disney) being painted with lead paint. Someone made do with what they had. That was the ethos of the Chinese manufacturing sector at the time. If you wanted a red toy car, you were going to get one. It's just the paint might be made of polonium. 


They were very serious about making their commitments without much interest in the fine details. Even if they had to make it out of toothpicks and dryer lint, you were going to get your order. The fact it fell apart or caught fire once it arrived on your dock...well, that's your fault. 


Anyway, I got called into the boardroom and asked how to fix it...which is another story so I'll skip it as it's too far off topic, but I'll never forget being the only woman and the youngest person in the room and none of the good ol' boys making bonus knew what the fuck they were doing. It was like, 'oh, you won't promote me, pay me, or consult me on the front end, but once you've turned it into a circus of clusterfucks with your collective micropeen energy, it's on me to wave a magic wand?'


So I was in the soup, watching all these dynamics simmer, and there was just too much money going into China. Way too much money. I handled logistics and supply chain all over the world and easily 90% of the volume was going to and from China. Global trade was strangely lopsided. Looking back, I can see that the West failed to realize we needed to develop other markets too. It was a warped tunnel vision version of globalism, one where all that mattered was China.


And then there'd be some political drama with China in the news and they'd throw their weight around. They weren't working with us. It was and is really obvious if you're paying attention. The West gave China all this investment to try and move the world to a better place, to improve relations, but China had their own agenda. 


(Namely to build a military full of weapons they could point back at us. 


We paid for their warships. Their air force. Their nukes. Every made-in-China item in your life...it links back to destructive weapons.


Weapons they now want to send to Russia.)


So the soup was sloshing along and geopolitics would occasionally heat up (although compared to current events, I can't believe I thought anything before this latest era was serious lol) and lil ol' me would wonder 'why the hell hasn't US foreign policy developed an economic counterweight to China?'


Which should have been India, but the West has a lot of baggage with India. They were aligned with the USSR during the Cold War and have a long standing relationship with Russians. And the US sided with Pakistan against India in their 'threatening to go nuclear' dust up of, I think it was, the late 70s. Meaning, India and the US aren't BFFs. The nations work together and are friendly, but it's an edgy relationship. We're far from ride-or-die best bitches.


And the West just...never did anything. We lost our sense of urgency. We never made much progress with India. We kept feeding the tiger. And at the same time, we fed the Russian bear, too. The West thought trade was the cure for every ill and kept leaning into that, waiting for money to turn everything it touched into a friendly democracy. 


Meanwhile, China and Russia joined a club called BRICS which stands for Brazil, Russia, India, China, South Africa. (I would add Iran as well to that.) All countries with populist autocratic leaders (although Brazil seems to have broken the cycle for the moment). 


And did you know? BRICS nations don't just weaponize social media against us and meddle with elections, they also do military exercises together. They just did one a few weeks ago.


The West likes to think it won the Cold War, but would you call this winning? What did we win exactly?


Because it looks to me like the prize is more war.


The Cold War didn't end, it metastasized and the West didn't even notice until it was too late.














Monday, February 27, 2023

The Unignorable Minutiae of Dysfunction

I spent the last few days getting clobbered by some GI issue. I'm not even sure what it was.

Then the asthma started up again. I am hoping I can beat it back with just inhalers. I took the Pulmicort for a full 15 days just to be safe after the last flare. I'd just stopped using it. I thought I was finally better. And here I am regressing to where I started.


I've started marking the asthma on my calendar so I can show the pulmo and get a better sense of the chaos pattern.


Why are the lungs and GI working in tandem???


I don't like having such finicky health. I can't ever rely on myself. I never know what I'm going to get from day to day. Ever since I had covid, it's just been complete chaos.


It does remind me a little bit of the dynamics I experienced with adrenal insufficiency, which caused me to start this blog. With AI, things can radically change from moment to moment. Especially when you're tapering and purposely creating a gap to force the body to fill it. That can be an intense ride.


But obviously this isn't AI...


And on top of all that, I've reached the point where, because of my foot, I'm trying to figure out how to maintain some degree of muscle mass and strength and fitness without standing. Like, I've entered the chair aerobics era of this mess. Fantastic.


But I can't do anything anyway because my energy is just really low from the GI stuff and the asthma. 



On a more positive note...I'm waiting for my dress for the wedding to arrive. Excited for that. Even though we switched to flying, we are going to do one sightseeing stop from our original road trip plans and have arranged for it to be little to no walking. 


This whole thing is hideously expensive so since we're in for a pretty penny, we're going for a pound and doing it all while the doing is good.

(Did you know you essentially buy a full price ticket for your luggage now too? On all the airlines? You're lucky if they include a carry-on. And a wedding is never light on the luggage so this is costing us a small fortune. It's doubtful we'll be going back anytime soon, if ever.

So. Fuck it. Let's party.)


I've started ordering the next round of fruit and nut bushes to plant. Hopefully, my skeleton and sundry body systems will be up for digging some holes so hubby doesn't have to do it all. If I can manage it, I'm going to try and get outside to get some pots ready for growing cold hardy stuff to take advantage of the increasing sunlight as spring approaches. 


We'll see how far I can go subsisting on seltzer and inhalers.

And, lastly, no one asked, but geopolitics is a bug up my ass.
I think we're missing the forest for the trees at this point.
First, geopolitical degree here.
Second, US and Western foreign policy has been a mess for at least 20-30 years and we are reaping what we sowed now. None of this started recently. It's been brewing a long time and several leaders have made mistakes that are compounding now.
So now we have headlines saying China is planning to send lethal aid to Russia. If that's true that means their calculations say Russia will win.
But if we'd done our job, they wouldn't be able to generate an analysis that leads to that conclusion. The fact they can suggests someone is fooling themselves and it might be us.
And while we like to think China needs the West, that they can't live without us, that's not as true as it as twenty years ago. World population and consumer patterns are changing and China, Russia, India, and various nations of Africa have enough people and resources to keep on rolling just fine without the West, and that appears to be the coalition they're trying to built.
Yes, the West has the advanced technology, but that's not insurmountable. Especially if it's already been stolen. (I have seen nations steal US military tech back in my corporate days. It happens. China is particularly famous for it.)
I'm watching the West and wondering if they have the leadership to get this done.
And I'll add...even if Russia loses the war, a China, India, Russia axis with heavy influence into all of Africa is still a possibility. Between demographics, technology, AI, and ecology we were going to see massive changes in the world over the next 5-20 years anyway. There's no escaping change, it's just a question of how many people and how much environment we want it to kill.
The West thinks it's awake because it's supporting Ukraine, but we're actually still lightly dozing. The fact China is even considering sending lethal aid to Russia is proof of that.

Side Bar: War is a regressive approach to modern geopolitics, at least when it comes to the world's super powers, but that's what happens when autocrats are in charge. If we threw Putin and Xi into a time machine and dumped them back into the 1600s...they'd fit right in. Might makes right has been the driving force of geopolitics for centuries.

I find it fascinating that Russia and China are obsessed with land when, in reality, in this era, power comes from demographics and technology more so than mileage. They aren't microstates at risk of being swallowed by the sea, they have enough land and the technology to overcome topographic limitations. What they need are more people and better technology. Right now they can wreak havoc, but they'll be subsumed next as their populations start to fall. Any victory now won't last.


If I were the West...I'd be hauling ass on a lot more weapons to Ukraine yesterday and then immigration, but clearly I'm no one and not in charge.

Friday, February 24, 2023

Two Lines of Squirrel

 

Every critical diagnosis a doctor makes is a singular triumph for medicine.


For the patient, it's a multiverse shitshow.


***

As for the braces for the teen...I'm not feeling confident that we'll ever have a good solution. I was hoping custom medical grade stuff would overcome the issues we've had with the off-the-shelf braces we've been using, but no. We were told the problems with digging, breaking skin, and sliding will persist because they are not yet able to overcome the biomechanics and physics.


Sooooo I'm guessing we're going to spend $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ for things that end up in a corner in the teen's room. Sigh.


For that one person saying...'well, then she doesn't need it,' I invite you to wear something that will break and bruise your skin and slide, requiring constant adjustment for 8+ hours a day, all with the maturity of the average teenager, and see how long you last. Also...you can suck a bag of moldy lemons. 


Data: The orthotics person we worked with has similar problem knees and uses the same braces the teen will have, but even they don't wear them all the time.


For that other person saying...'well, don't buy them then.' Other parents may chose differently, but we feel our duty is to provide every option we can. It's tough on stuff like this that's expensive and that we won't know how well it will work until after the fact. But anything that might help, we feel we have a duty to provide if we are able to do so.


And I will say, on a more positive note, albeit in a completely different vein...despite all the health chaos, I released 5 projects (which were already done so probably this isn't as amazing as it sounds but still...progress is progress) and continued to work on others. I've kept up my momentum pretty well this latest cycle of WTF now. 


I seem to be adjusting to the constant interruptions and developing a work flow around it. Which is great. I hope it keeps up. I tend to be sensitive to disruption (which I hate! I loathe my working process! I would love to be one of those people who can sleep and work anywhere instead of the Snowflake Princess and the Pea that I am but no). Going places in the middle of the day often derails my productivity, but lately, not so much. So...winning???


In terms of AI being nowhere near ready to take over the world, here's an anecdote from the front lines for you...


I found a new audio AI company that had excellent quality, far and above anything else I'd seen. I got really excited and spent a week using it to generate a project.


All the exported files have glitches that were not in the original content generated in the interface. The whole thing is unusable and I wasted a week making it.


So the AI might be great, but you can still have major problems with other pieces of the AI supply chain. I notified the company and they've been ignoring me which suggests to me that they don't have a fix.


I was also looking into the ChatGPT guy and looking at his educational background wondering what the fuck kind of ethics these universities are teaching. Of course he's a college drop out (read: never got to ethics class) and affiliated with Elon Musk whose brain and personality are decomposing long before his soul leaves his body. I dug up an interview and this genius is quoted as saying (paraphrasing here) that he and Elon want to make sure that AI doesn't destroy humanity.


So apparently that means...


1. Release an AI system that doesn't fact check or provide a bibliography to a population on the cusp of fascism and where a large % can't figure out that masks work.


2. Monetize it.


3. Get sued non-stop for training AI on other people's IP without their permission.


Humanity is saved! Huzzah!


And you know, none of the 'journalists' push back. No one calls out the bullshit. What ethics did their universities teach?


The longer this polycrisis era grinds on, the more I can see the media as it exists now must be replaced and it's the one power center we have a shot at undermining effectively. The problem is, the outlets that could be utilized, their algorithms heavily favor all the anti science alt right nuts*. It's clear that's not a mistake. It's an intentional information blockade to protect the triad of corporate interests, media power, and corrupt politicians. 


And at this point, pretty much everyone is seeing the problems with the media, which actually has a tricky downside. Yes, it's a unifier but will we unify behind the right solution? Fascist strategies leverage this energy better than most, and history shows us angry crowds aren't particularly discerning.


We're in very dangerous waters here. We can't rely on the courts. Or the politicians. Or the media. Or the corporations. Online outlets are manipulated both by algorithms and bots and foreign interests. Which gives populists a lot of power.


When you know you can't trust your institutions, it creates an opening for one iconic figure who understands the zeitgeist to grab power.


We're in a new Dark Ages. A time where truth is going to be hard to see because it's purposely obscured by various agendas and autocrats. 


Science isn't too bad because so long as your education didn't suck or you're fast to pick up things, you can parse it out for the most part. But large scale dynamics (for example, all these droughts and the war and bird flu and the impact on food supply or the manic hype campaign online for AI to where it's difficult to suss out reality) and politics or situations that are infused with a lot of rhetoric and spin...forget it. 


Good luck out there. Try not to feed the fascists.


PS: Ha. Well this was a wild ride. I didn't know when I started this was going to all come out. Welcome to my squirrel brain. Yes, the gray matter really does go in a million directions inside my skull. 24/7/365. Sometimes it's useful because I spot something. The rest of the time it's chaos.


*YouTube is currently the best example of algorithm alt right bias. You can 'weed' the other algorithms fairly effectively (so long as you understand you have to curate it yourself) BUT YouTube will continuously dump alt right BS into your feed no matter what. Or you'll have good sources in your feed, but the ads are all alt right dipshits.


I keep interacting with outlets like PBS and Democracy Now and blocking the alt right channels I see to try and fix my feed. Nope. Still getting fed alt right bullshit.

Friday, February 17, 2023

Adult Protective Bullshit

My foot is still an asshole but it's slowly reverting back to its usual baseline of dysfunction...which is an improvement at this point. That'll teach me to go out and try to have fun, right?


However, while my body seems to have settled down somewhat, this is me we're talking about so as one thing stabilizes, another hitter in the line up comes in aiming for a homerun of fuckery. And at this era of my life, it's not always my health shit that's the problem. Other people's health shit wants to take a swing too.


My addict parent and stepparent are at the plate now.


I woke up to an email from the family reporting that my parent's spouse--who is also an addict but with Alzheimer's as well (but note, not end stage)--is now apparently 75 lbs. My parent, between aging and addiction, isn't able to organize the executive function that would ensure adequate intake.


There is already an active case with Adult Protective Services, but somehow nothing is happening.


Knowing 75lbs is not compatible with life, I tracked down the APS caseworker to make sure they were aware of this.


And holy shit, the amount of toxic gaslighting I got from them was horrifying.


First, I'd like to note that no one answered the phone initially. It took three phone calls to get someone. Because no one answers the phone anymore.


Second, I had the most bizarre conversation with this person. Holy flaming bull poo. They deflected everything. Defended my parent. And blew me off. Zero interest in investigating this.


And to be clear, I've never called APS before. The open case isn't because of me. This isn't a situation of one person with a potentially biased narrative. Oh no. There are lots of calls from several people. But I was treated as if I had ulterior motives.


So anyway, APS looks to be complicit with starving my stepparent to death. 


Apparently this is normal for APS. Which I didn't know until it slapped me in the face.


There is a lawyer in the mix and the person with the lawyer is going to try APS next, so hopefully that'll accomplish something. We're working together behind-the-scenes doing what we can.


But the bar for guardianship is ridiculously high given my current experience with APS. My parent and stepparent are literally going to be allowed to kill themselves. It's so sad. They weren't always like this.


And someone texted me a 'how are you' social thing in the middle of all this, and I was just deer-in-headlights trying to think of a socially appropriate response that ignores the gravitas of learning the government is tots coolio with my parent starving my stepparent to death.


What the fuck? That's how I am. Just what the fuck?


Not to get too dark, but honestly, if this is aging...I'm fine with not living that long. It's a nightmare. Your brain decays. Your worst self is in the driver's seat. Yeesh. Just let me go out in a blaze of glory without dragging my family through absolute hell because aging has melted my cognition.


And if you've got kids and you want them to visit you, resolve right now to not be a burden and get your ass into assisted living or senior apartments linked to assisted living LONG before your brain melts and you become a giant flaming asshole about it. 


Yes. Only the good die young.