I imagine poetry as an often misanthropic and lonely hobby with virtually zero demand for it’s output. Whether written or spoken. Moreso now there are LLMs.
If I die unrespected and socially isolated I like the thought of donating my body to medicine while providing a funeral for poets to crash and get their words out. It is an absurd concept, it would be nice if they connected socially before I died and provided the respect they are concerned about. But given the constraints of their own lives it is nice knowing my lonely death could provide social support to probably introverted intelligent thoughtful people who are likely at risk of social isolation themself.
What is the purpose of a funeral is an interesting question. I think it is to help the living to socialise and forge ahead with a cohesive story of the deceased ‘s contribution to their own lives and to navigate the gap and hierarchy left in the modified social network. I’m guessing this process reduces grief and conflict as people feel loved and supported through the process.
If you die alone you leave no gap. I think it’s brilliant that Poets seized this opportunity to get a reading in and strengthen their own social network. They are also attributing value and respect to life, no matter how meaningless, which is another positive. The futility and absurdity of the human condition is a beautiful thing we all wrestle with whether socially connected or not and I think this is the point they are getting across while having someone listen to their poetry.
> I imagine poetry as an often misanthropic and lonely hobby with virtually zero demand for it’s output. Whether written or spoken. Moreso now there are LLMs.
(1) In any big city in the US, you can easily find poetry workshops/meeting groups. I'm currently in one (Boston), we read each others' poetry and talk about poetry every week. It's absolutely ridiculous to think there is no demand for poetry, poetry is one of the -- if not the -- oldest art forms, I mean yeah there are people who read poetry even in 2024. My generic bookstore still has a poetry section where I pay $$$ to exchange for poetry books. There is even a dedicated poetry book shop in Harvard Sq (i.e. they exclusively sell poetry books) and they pay the same (expensive Boston) rent any other business pays.
(2) LLMs write dogshit poetry. Comparing a "good" poem with a GPT-4 generated poem is like comparing "2001: Space Odyssey" and "The Room". Other than the fact that they're both arguably "movies" the quality difference is extremely obvious to people who are familiar with this art form.
May I ask what a non-technical founder should look for in a technical co-founder?
I have two customers for slightly different businesses. The deals are made, I am building MVP's myself and JVing with established tech companies to get products to market.
I have a supply chain with a 30% cost advantage with customers.
and
I have a hardware software system that significantly improves hire businesses that has customers and development partnerships with research organisations and funding applications in progress.
Both have customers and large B2B growth potential.
I am building the MVP's myself while selling and JVing as necessary but would happily partner equally with a technical expert in Microsoft365 and PostgreSQL and PostGIS.
I'm an expert in business design and love technology without being talented or experienced building it. Someone with a business mind and opinions plus the technical skills to build an MVP and hire a technology team would be perfect. I can license my way to market but it will a clunkier more painful start. If I could work with someone who has deep experience with making microsoft365 work smoothly, for small volumes of data and a small number of users initially, then they would add value to both businesses instantly.
My question is should I grind through this myself with JV's where needed using architects on contract for the tricky bits and build the technical knowledge to be a really good technical work partner enabling recruitment of a better technical co-founder or should I recruit the best technical-cofounder I can and get on with growing the businesses.
I would happily take a smaller salary from cashflow than a technical co-founder initially, recognising their market value remuneration as soon as the business is able - likely early year 2. I would even consider technical guidance/mentoring for some equity if someone was interested.
And I know you are supposed to focus on one thing at a time but the software for the two business systems is similar, and I have systems and people to drive the sales and management for both so will offering a technical-co founder 2 bites at 2 potential rapid growth businesses make them think they were increasing or reducing their odds of success?
What questions would I ask to make sure the partnership will be enjoyable for the technical co-founder?
Are there any books/experts on keeping technical co-founders happy?
> May I ask what a non-technical founder should look for in a technical co-founder?
Breadth of expertise, ability to learn quickly, open minded when it comes to technology. Loves to work with clients and solve their problems more than they love the tech.
The B2B and PostGIS part caught my eye. I'm technical, but leading both the business and the technical sides of my spatial analytics company. I would be happy to share at least some of my technical knowledge. From infrastructure, DevOps, through database and data layer, and all the way to the frontend - I've been doing this for years and there could be a thing or two that may be useful to you.
On the other hand, I can always do better when it comes to B2B sales, so I am looking to learn too. Maybe we can have a chat sometimes.
Why is the medical profession obsessed with biomarkers but not the next optimal step in patient treatment plans?
Root cause analysis of dysfunction in complex dynamic systems is a waste of energy.
Someone has the biomarker but they are a heroin addict which confers them a protective mechanism. What then?
If you have 5 heroin addicts with similar symptoms you can just experiment with likely beneficial next treatment steps. Then let machine learning track the treatment response patterns and reccomend next treatment steps.
Grouping health histories and symptons then recording responses to treatment plans then using machine learning to recommend next treatment steps is - surely better than searching for biomarkers so Drs can stick their hands up faster. Rockefeller gave us the Johns Hopkin Medical System , Can’t Bill Gates give us the complex chronic illness extension?
Why don’t Doctors have a 300 question questionaire for patients covering all aspects of the patients health? You could then group the patients into health dopplegangers. No need for biomarkers.
Combine the good part of alternative medicine ( carefully understanding the patients symptons) with machine learning.
There’s 8 billion humans. There are alot of sympton dopplegangers out there to experiment and record the effects of next treatment steps on.
Medical professionals are obsessed with being trivial pursuit champions and seem to lose sight of the fact that they’re often invited to play invisible bridge.
It is fantastic that they are great at trivial pursuit (The Johns Hopkin system is a modern marvel) and they do untold good above and beyond the measure of most citizens and far far more than myself but doing good doesn’t cure complex chronic illnesses. (I admire Doctors).
But it’s frustrating that we have to pretend that because Dr’s are great in one area (acute medicine) that the greatness translates to other areas. The halo effect is really strong.
Look up the research for recovery rates from cfs. Abysmal.
Machine learning doesn't actually work very well for that. Attempts to apply it as you suggest in medical research have mostly not produced clinically useful results. More basic research into root causes is the only approach that is likely to lead to truly effective treatments.
The data is crap. Patient reported data is notoriously unreliable. Even data reported by clinicians is highly inconsistent between organizations so it takes a huge cleansing and normalization effort to get anything usable for clinical research. Applying ML to it tends to find a bunch of spurious correlations that aren't clinically actionable.
I would use fitbits with daily step count, sleep duration and heart rate variability and breaths per minute and resting heartrate and body temperature to monitor patient progress.
I can ask the questions that would partition the useful dopplegangers. If you ask great questions you get the great answers. Then you just need to group the data intelligently.
What I can’t do is be a machine learning expert and database/sys admin and front end developer and negotiator with a public health system.
I’d let the patients vote on their next steps initially. I’d also have psych questionaires to measure their personalities. That would form part of the sympton /genetics doppleganger groupings. As would genetic profiles.
For CFS there aren’t that many logical next best steps. Most things have been tried, there is a sensible order to try things.
This is the case with most chronic illnesses.
However subsets within cfs are better off trying certain treatments before others.
The better a subset responds to a next treatment then the tighter the coupling of their doppleganger to that treatment. Then when any new people match that doppleganger you can reccomend they try that treatment. You’d shift there next best treatment orders around.
As you get more and more data the treatment recommendations get more and more granular and effective.
I could hire a naturopathic md to assign the treatment steps initially.
If anyone wants to do a start up - reach out, I can find funding. Just need a team. I’m going to do it.
I appreciate you sharing your knowledge. But I think you’re assessment of the situation is wrong. I think the general consensus is wrong and I have enough energy now to fafo. Given what I feel I know it feels immoral not to.
You might think that but it doesn’t heal anyone. Recovery rates for cfs are abysmal, I’m surprised you aren’t ashamed of your profession’s performance in this area. You seem comfortable placing responsibility for the illness on your patients “avoidance”. Yet it is initiated by a virus and everyone has different levels of mitochondrial density, resilience and health and different inflammatory cascades. “Avoidance” of what?
The medical profession has a chronic pattern of avoiding the fact they can’t heal anything involving more than about 4 variables. Explain how vitamin d, k, and serum ferritin interact in bone marrow please Doc or cholesterol’s role in cellular permeability as an immune defense or a vitamin D deficiencies effect on the permeability of cartilage and subsequent concentrations of potassium in the inner ears please doc, or latent hibernation responses, or the effect of obstetrics on the mitochondrial health of a population, or unknown pathogens or a combination of all of those things.
Because any combination of a breakdown in those things could be contributors to the fatigue you’ve attributed to avoidance yet your profession has avoided researching all of them. Your profession avoids the fact that medical research is mainly focused on fast financial returns.
I do think there is a chronic pattern of some doctors avoiding shame at their self-perceived inadequacies caused by their medical school trivial pursuit trauma conditioning that is useless for complex problem solving and then projecting that shame onto their patients in order to minimise the cognitive dissonance surrounding their ineffective treatment plans for chronic conditions . I cured my chronic fatigue - no thanks to your professions expertise - the avoidance was a necessary part of the cure while my body healed.
Some times people have bad luck. It is unavoidable.
I think you're reading the term "avoidant stress response" and the consequent term "chronic avoidance" as having a moral value. This is an issue with many medical terms.
In my understanding, these terms simply refer to how an individual tackles problems: do they avoid asking for help to the point of dysfunction, or are they able to ask for help when needed?
edit: Once an individual's systems are out of balance, it can be difficult to rebalance without the right perspective. If an individual cannot regain equilibrium due to interacting factors (such as someone who grew up without ever knowing equilibrium), the lack of balance becomes chronic.
> You seem comfortable placing responsibility for the illness on your patients “avoidance”.
You are misunderstanding this. Subconscious avoidance is not about responsibility. Think of the way rabies makes people hydrophobic. That is a psychosomatic response. A person is not in firm "control" of these responses, although they sometimes can be addressed with therapy.
> I do think there is a chronic pattern of some doctors avoiding shame at their self-perceived inadequacies caused by their medical school trivial pursuit trauma conditioning that is useless for complex problem solving and then projecting that shame onto their patients in order to minimise the cognitive dissonance surrounding their ineffective treatment plans for chronic conditions
The fact that patients consistently react in this way (or worse) I think is why we rarely discuss true causes of CFS nowadays in the medical industry. Many, many lay-people assign strong negative moral associations with having any somatic cause of their symptoms.
> The fact that patients consistently react in this way (or worse) I think is why we rarely discuss true causes of CFS nowadays in the medical industry.
Well, it’s a vicious circle isn’t it? A lot of issues are dismissed by the medical community (and I disagree with the characterization that “it’s somatic” isn’t dismissive in practice) for decades and decades and simply not studied, until the cause can be medicalized and then suddenly it was real the whole time.
It’s not just that “patients are being irrational and picking up the wrong message”, that’s actually the same message that the medical community itself projects. These aren’t real issues worthy of study unless a causal mechanism can be identified. And for a lot of issues that’s simply been a matter of time, despite decades of doctors insisting it’s all just in your head.
Fibromyalgia and cystic fibrosis are classic examples of this. People have real, objective pain and the response of the medical field for years and years was “no you don’t” or “it’s in your head, you’re just stressed, you need to relax and it’ll go away”.
Microbiome is probably another that the needle is starting to swing on.
But in general, medical practice suffers heavily from the problem that if you can’t identify a mechanism, and you can’t prescribe a pill or cut something out to make it go away, it’s not treated as real. Medicalization is real and has a highly negative outcome on the direction of research in the field. And that in turn produces this barrier where doctors just want to make “somatic” patients go away and patients perceive this and know doctors aren’t really taking the issues seriously. And that degrades their trust in doctors and the medical community and creates this barrier to patient outcomes. That is largely your fault and not the patients, and the answer isn’t just “better bedside manner/explain the situation better”, it’s to stop ignoring issues that have negative QOL effects until they can be medicalized and then turning it into a $50k/y drug the next year.
It’s really that flip from “your pain isn’t real” to “it’s so real you’re going to have to pay $50k a year to treat it” that really drives the wedge. And that’s something of a US-specific problem of course.
But when people are paying $300 out of pocket for a GP visit they actually expect their concerns to be taken seriously and not just “it’s all in your head”. And I recognize that’s not a great position for practitioners either but again, the price tag you have chosen to associate your care with produces this need for acfual tangible outcomes and not “just change your whole life and make a bunch more money and life a much lower-stress life”. That simply is not actionable to most people. Just like semaglutide has done more for obesity than decades of doctor tutting about diet.
And again, this piles on top of doctors themselves providing objectively sub-standard care for vulnerable populations due to inherent biases etc - women, obese, etc tend to have actual medical symptoms dismissed at highly elevated rates due to inherent biases in practitioners, so these “weird” diseases tend to get the double whammy of doctors who don’t believe in the disease and doctors who don’t believe in the patient.
My aunt’s uterine tumor wasn’t clinically recognized until it was the size of a volleyball and all her pains were dismissed because of weight and because she was a woman. Imagine she had fibromyalgia. What do you think that doctor-patient relationship looks like? And that’s really on doctors not patients. This is the problem with the “we can’t recognize it and won’t treat it” - a lot of times the problem is doctors won’t recognize it, and this extends to the system of diagnoses itself. If it can’t be medicalized it’s not real.
> These aren’t real issues worthy of study unless a causal mechanism can be identified
There are plenty of people studying somatic causes of CFS, they just get death threats [0].
I think the focus should be on destigmatizing 'somatic' explanations. That we view somatic explanations as dismissive for real conditions is not a problem with the explanation because some real conditions are psychosomatic and that is a fact of life. It is a problem with the stigma we assign to it.
You know, the point of this post was that “medical science is pretty bad at recognizing real, non-somatic causes of these diseases when the cause is not obvious, and instead tends to handwave onto somatic causes, and people generally find this offensive especially when the cause is determined another few years later and they’re asked to pay $50k a year for something their doctor was sure wasn’t real two years ago”.
And yet you’ve somehow both completely missed this point, and deflected onto “but doctors get pushback and even personal threats when they try to double down on this even harder”. Yeah, don’t default to telling patients it’s all in their head, after a while it gets offensive, especially when a few years later you try and charge them $50k a year to treat a disease you told them wasn’t real.
“Somatic research” is fine on paper but in practice it’s usually an excuse to deflect from a disease that cannot be adequately explained in medicalized terms. Everyone knows “somatic” means “in your head” and that inherently leads to a course of treatment that’s “get the patient to believe it’s not real”. And since many of these diseases do have medical causes that are not somatic (but not adequately medicalized for treatment) this gets offensive after a while.
I gradually figured out what activities, supplements and foods reduced my susceptibility to fatigue and pain and then repetitively used them until I got to a point that I was no longer susceptible to fatigue within the bounds of what I consider a healthy fulfilling life so that I can now convincingly pretend to myself that I don't have cfs. I'm no longer staring into the abyss. I can't run a marathon or do too much mental grunt work but I can just make a modest living, go for a 40 minute zone2 run or 3 hour hike, be a parent, sustain a relationship and keep some friendships going. In the midst of cfs I could only really be a part time parent with support, everything else stopped and I had no certainty that it would ever start again.
I think conditioning medical students to race other medical students to label health problems quickly- efectively turning medical school into a sleep deprived game of trivial pursuit for competitive, high IQ, mentally resilient, energetic people - only prepares those people to heal simple medical conditions involving 1 or 2 body systems. This functionality is becoming largely replaceble by llm’s who are also competent at that level of system complexity.
The leading medical solution for CFS is pacing and a web link. Chatgpt could do that.
Once you are past a certain level of system complexity - root cause analysis becomes useless as changing one part of the system affects the other parts unpredictably.
I am diagnosed with CFS. Didn’t seek the diagnosis, denied it initially which is not the norm.I now pretend I don’t have it as that is the best way to cure it.
But beating it was hell as you literally get given an A4 sheet of paper explaining the condition when diagnosed. And your brain is exhausted after reading the sheet. But that is all you have.
So you are supposed to take that A4 sheet of paper and troubleshoot your way out of the condition when the instructions on the A4 sheet don’t even work.
The best way I can describe it is you find yourself in a shame riddled labyrinth, your brain doesn’t work, you are tired and in pain and you are told to accept your new normal.
There are ways out of the labyrinth. A doctor doesn’t have the map though.
The best way to describe chronic fatigue is extreme sensitivity to over exertion. You walk to the mailbox and 24 to 72 hours later your body reacts like you’ve run the boston marathon and the mind reacts like you’ve just pulled an all nighter to manually sort 7 tabs of 3 columns and 10,000 rows of a spreadsheet on a 17 inch monitor under time pressure while hung over, 3 days into the flu in order to resurrect hitler.
CFS exhaustion and brain fog can get triggered by any stress response. And it kicks in 24 to 72 hours after stress exposure.
The Doc says pacing and mindfullness will save you. Except it won’t.
The body can get stuck in unhealthy stable states. I always encourage people to look at the roche biochemistry chart (with about the same success rate as treatment plans for CFS) to understand that the body can be hypersensitive to overexertion (mental or physical) for an infinite number of combinations.
Fortunately there are a quite a number of things that you can do to escape the labyrinth.
- Explain to anyone that cares that there is a medical field dedicated to assessing levels of debilitation and that cfs is as debilitating as cancer. (Very few people care)
- get stable accommodation.
- Get a comfortable supportive bed to convalesce in.
- Eat a diet that minimises inflammation - deeply boiled veges, rice, potatoe or sweet potatoe, grass/algal fed free range protein, olive oil. Maintain steady blood sugar.
- Body strength train.
- Sort out a vitamin and supplement regime with a genetic analysis.
- Take an anger management course to understand the anger of others.
-Understand pain - the curable app on chronic pain management is highly beneficial.
- Learn to forgive. Resentment ruins health.
- Get a career you are capable of. Aim low.
- Get regular physical activity.
- Perform improvisational comedy to condition the mind to cope with an onslaught of public social pressure.
- Pretend you don’t have chronic fatigue syndrome.
What doctors get wrong ( it is hard for them to comprehend the condition as most aren’t susceptible as they were tough enough to get through medical school) is that chronic avoidance is the right strategy until your body can cope with stress without fatiguing.
It isn’t all in your head. I’d say ability to sideplank and neck strength are probably two of the most important recovery metrics. Drs don’t understand the psycho-somatic balance of the illness. There is a psychological component but it is a minor component and is driven by physical constraints.
The sad thing is that cfs is quite treatable but the medical profession says pacing and mindfulness is all one needs to cure something that is as debilitating as cancer.
You don’t need to be mindful to beat chronic fatigue syndrome. I think sarcasm is more beneficial when coping with a bleak future.
And I really like and admire Doctors - it’s not their fault that their system is terrible at creating healing treatment plans for complex chronic health conditions.
I have CFS too, going on 8 years now. Small fibre neuropathy in my limbs too.
Aside from pain management (opioids, ketamine, cannabis), I haven't found anything else to be helpful, and pacing was the opposite of helpful.
You mentioned strength training... how is that possible? I don't know about you, but I have a constant, lactic acid-like burning sensation in my arms, which becomes much worse upon exertion - for example, if I life a kettle full of water, my arm is burning with a strong need to put it down within a few seconds.
Because the best way to think about the syndrome is that you are a really terrible athlete.
I find it a healthy way to reframe what I’m dealing with.
I laughed at Eric the Eel, he’s laghing at me taking out the rubbish now.
They say athleticism is a reduction in recovery period.
Combine this with the fact the brain burns loads of energy and certain aspects of the brain uses things like the inner ear and vagal nerves and lateral light receptors as specialised instrumentation to save processing power when coordinating one’s balance. (I swear one day they will figure out lying down in the dark convalescing can affect the potassium concentration of your inner ear to the point you get stuck in fatigue cycle but any how).
Keeping your head steady while walking saves mental energy. A stronger thoracic spine and neck keeps your head steady for longer with out fatiguing the muscles or the mind.
Everytime you overtrain there is a inflammatory cascade that goes with the overtraining. Building up physical body strength is the easiest way to generate athleticism.
Once you can recover without fatigue you don’t have chronic fatigue.
I also think stabilising the thoracic area helps get a neurogenesis/cellular regenerationtype response going in the spinal cord that was ravaged by a viral load.
Basically if someone is strong enough to recover from an illness they recover. If they aren’t they don’t. Hunching over screens for long periods with only stress holding you up before convalescing is probably the worst preparation for cfs. Accounting is the worst profession for it. Their low autonomy detailed complex work that is surveyed in 6 minute intervals so they have a large forced cognitive loads for a long time periods combined with minimal physical exertion. It is an anti-athletic career for a lots of people who struggle with the cognitive load.
But the docs are also right anout a psychological component - whinging doesn’t help, there is a grit component to getting better. There is also lots of overtraining while you get better which is helpful to understand. Recovery is 3 steps forward 1 step back. (My whole point is help the poor person in the brainfog choose the next best recovery step and I also understand it isn’t Drs fault they haven’t the tools to do it because there is no profit motive to create the recovery system). Exercise physiologists are really helpful for avoiding overtraining but I also think you are better taking some overtraining hits initially on the strength training side if you aren’t wealthy to get the body to the point that it escapes can escape some of the fatigue.
Strength train to at least the point of sideplanks and throw in lots of propioception band balance exercises. And remember there is 24 to 72 hour delay to overtraining. Docs do have extreme amounts of grit as do successful accountants. They are admirable but also lucky, their dopamine systems are genetically robust.
I started strength training with a fragmented swimmers stretch. 1 limb at a time. The good thing about body strength training is you see progress which is important for hope. Which is another important aspect of recovery and dopamine generation.
I couldn’t sit and work for more than 20 minutes for about 3 years. I tried to design my own cheap reclining chair so I could lie back and stare at a screen for long enough to earn some money.
The other name for cfs is myalgicencephalomyelitis which means inflammation of the thoracic spine up to the brain. Really you are trying to get the body into a band that it can operate comfortably without causing inflammation to the point that you can earn a living. And being physically strong helps with that.
Exercising your arms will aggravate your thoracic spine. I guess I’m saying train for thoracic and cervical stability (strength) accepting some overtraining initially because it is really hard to judge what is overtraining when you are weak. You have to be really patient. 3 steps forward one step back. If you can only hold a kettle bell for a few seconds then don’t. Just work on swimmers stretches and banded propioception and neck and spine strengthening exercises, you will easily overdo it trust me. Try not to. Physios and exercise physiologists deal with alot of overtrained virally unlucky athletes and are probably your best source of guidance on this facet of recovery.
Sorry I misread kettle for kettle bell. But the load is irrelevant.
If you are that weak then start with fragmented swimmers stretches 1 limb at a time. I was in the same situation in 2018 but you do forget once you escape. Just do 1 rep on each limb every second day until you can do two. Or figure out the training periodicity for your body so that you can build up to 30 swimmers stretches. Then add in another exercise.
The feeling of muscular fatigue doesn’t matter - the not overtraining is the important bit.
There’s so many other things to get right also but getting physically stronger will only help. I’d talk with a sports physio first if I was in your situation.
I'm not "strong" by any means, but I wouldn't say I was weak either; the problem is that I'm not lacking the strength to lift the kettle (or my own arms, for that matter), rather that lactic acid doesn't allow me to use the strength I have for any length of time.
And after writing that I realised strength training is one of the recovery shortcuts for pacing. Smart people probably read this and think Doh, I'd be fatigued if I had that guy's problem solving ability.
There are plenty of other shortcuts.
I think this is the gist of what I'm whinging about regarding CFS treatment options.
More people would recover faster if Mindfullness wasn't the only tool available to shorten the process of pacing one's self to recovery. Being chill and treading carefully will work for less debilitated people. The really debilitated people are sensibly avoiding exertion, they aren't signing up for an underresourced olympic swim team .
Here's a simplification (that I experienced before I dealt with cfs) -
there is long series of stairways up a large hill that people run up.
You can run up the hill slowly every 5th day without it killing you, then every 4th,3rd 2nd then everyday. That process might take 4-6 months and takes grit.
Or you can strength train your legs with barbell squats once a a week for 8 weeks noticing yourself getting stronger each week and then just run up the hill.
I accept I'm a terrible athlete now so I strength train my legs with very amateurish pistol squats so I can walk up the hill without crossing over the lactate threshold.
If you are crossing the lactate threshold lifting a kettle then strength training should help. I know the exact feeling you are describing and used to deal with it. Gradual strengthening helped - with a strong emphasis on the gradual. Aim for fragmented single limb swimmers stretches. I still remember the pure exhaustion after doing 1 rep. Make sure your body has glucose before after and during any form of exertion. The steadier the glucose flow the better. Getting up and down off the floor is a form of strength training.
There's a balance between strength and endurance and I don't have the explanation off the top of my head but exercise physioloogists do.
Zone 2 exercise heals mitochondria. Zone 3 exercise stresses it and requires a recovery period. Exercise physiologists are having good success treating cfs as athletes are really just optimising their mitochondria so they can thrash it harder and longer than their competitors on race day. Exercise physiologists often work in with physio teams at sports academies at univerisities.
Dr Peter Attias stuff he is figuring out and sharing from helping wealthy intelligent people live long debilitation free lives is very useful for understanding lactate thresholds.
Just like athletes take performance enhancing drugs to reduce recovery times - so can we. There are plenty of supplements to play around with. So many people mess up their B vitamins by taking multi-vitamins but getting b vitamins in quanties your body is utilising is a low hanging fruit. Unfortunately it has no profit motive attached to it so you have to guess or work with a Complementary Medicine MD if you can afford one. A low inflammation, glucose goddess style diet with moderate cheating in the mix so you don't get food obsessed as the base helps also.
The supplement reccommendation page on www.perfecthealthdiet.com is a safe base to play around from for supplementation. If you adapt a soft version of the perfect health base diet to the glucose goddess method and gradually strength train I think you must increase the probability of escaping the fatigue trap. Some of it is mental but if you can get small wins you eventually beat the mental side back as well. Dopamine managment is a factor.
My frustration with some medical professions take is that they sometimes expect you to deal with it purely via mental resilience (which helps) without providing any tools to get any small wins which is impossible. If you think about it - an olympic athlete has a coaching team to ascend mount everest, what do we have?
The medical system treats the condition like someone's on a cave dive and provides the support encouragement, training and advice afforded Eric the eel. They are right that you can do it, panick won't help and that you do need to keep moving in some direction but until you run out of air you will be alright. The fact you can't work is irrelevant, lot's of people deal with debilitation. From the health systems perspective maybe they are right - who deserves saving vs who deserves training are different questions. There is alot of suffering out there - maybe placing the onus on the individual to figure their own path is the correct approach.
> I’d say ability to sideplank and neck strength are probably two of the most important recovery metrics. Drs don’t understand the psycho-somatic balance of the illness. There is a psychological component but it is a minor component and is driven by physical constraints.
Can you explain/corroborate this? The rest of your post really paints a picture of it being about psychological/emotional stress (and suggests different coping techniques akin to avoidance). I was with you until "sideplank".
The physical problem is bigger than the mental problem. There is an underlying physical problem, it just isn’t understood. Because brain fog and pain are the defining symptons then emotional regulation (which is super important also ) gets overblown.
A convalescant event effectively transforms you into a really terrible athlete with shameful recovery periods.
Being physically injured like spraining an ankle is so mentally fatiguing because the brains autopilot modes get temporarily disrupted. It can’t use all its gpu bandwidth and has to switch on other processes to move about.
Proprioception is important, head stability is important, not aggravating the thoracic and cervical spine when moving is important. The stronger you are the more you can achieve without getting to the point of exertion.
There is alot of emotional management necessary for sure - your brain used to work and now it doesn’t. And it hurts to move.
There is also a lot of biochemical management needed to minimise inflammation.
But without a certain level of physical strength then emotional and biochemical management alone won’t allow you to recover.
And it takes grit (which is hard in the face of hopelessness) to get that physical strength back plus a smart diet and supplementation combined with effective emotional management.
If I didn’t have follinic acid in my recovery steps I probably wouldn’t have recovered. If someone hadn’t gifted me a decent bed I probably wouldn’t have recovered. The bed was to support the thoracic spine so I could sleep.
There is a definite physical component to recovery from cfs and this is poorly researched.
> Being physically injured like spraining an ankle is so mentally fatiguing because the brains autopilot modes get temporarily disrupted. It can’t use all its gpu bandwidth and has to switch on other processes to move about.
Ohhhh... this explains so much about why what are otherwise mild injuries can absolutely throw off my rhythm and disrupt my productivity. Having even a low-grade injury ties up cycles and is like a background task set to prevent going into power-save mode, because it's like a constant potential threat/alert.
When your CNS is at 0%, it's weirdly difficult to hold your spine and head straight against gravity. You start leaning on stuff, resting your head on your hand, etc.
Totally, interestingly they diagnose the illness with a tilt table in some countries.
I had an inversion table atempting to relieve my thoracic pain at the time of my diagnosis. Which was a diagnosis of exclusion. I was gutted by the chronic diagnosis.
I was lucky that the inversion table allowed me to accept that I had the condition post diagnosis because it definitely triggered fatigue after I’d rest at the tilt angles that trigger fatigue.
The awareness of the tilt test and that delayed fatigue onset were the 2 useful pieces of information I got from the cfs support group I attended 3 times. I accepted my diagnosis quickly as I’d accidentally been doing my own tilt table tests with the inversion table. I also quickly realised that regularly whinging about the condition in a support group of people who accepted that they weren’t going to recover from something that seemed treatable wouldn’t help me.
I see it slightly differently although his research is great. I think this could be one of those carrot problems.
I think there’s a possibility Mcdonald’s hates that they need to sell Ice-cream. There’s a probability Icecream’s an inescapaable loss leader and their lowest margin item and that it is a poor loss leader due to it’s substitution effect with probably their highest margin product - soft-drinks. Because neighbouring restaurants offer ice-cream - Mcdonald’s also needs to - because people often feel like an ice-cream. If they don’t provide ice-cream while BurgerKing does then they lose high margin Fries and Softdrink sales. By offering icecreams with the minimal tolerable 85% reliability (ice cream isn’t a deal breaker - few people cancel an order when they can’t get a sunday with it - but it is an enticer - they remember Mcdonald’s ice-cream is nicer than Burger King’s when they get it - it’s the equivalent of Wendy’s ice-cream but cheaper). So there’s a possibility they’ve figured out that 85% reliability maximises high margin sales and minimises low margin ones.
Maybe they’ve figured out how to offer low cost high-quality ice-cream just enough of the time to maximise gross profit. A second order effect of 15% reliability - is the lack of reliability also discourages ice-cream orders - because - people try to avoid disappointment and decision making in group situations under time pressure.
Markup on soft-drinks and fries are massive compared to ice-cream. As you mentioned Free flow ice-cream probably has the highest food safety management cost on top of the low gross margins. It also gives staff cold hands and melts quickly in summer. It’s not a great loss leader but an inescapable one. Their other option would be to raise ice-cream prices but wendy’s grade ice-cream is an enticer. It would possibly cost more profit than 85% reliability.
There’s potential for profiting from co-operation on the lack of machine reliability but the franchisees will also be maximising profits by offering the minimal amount of ice-cream possible to not cost big-mac + frys + soft-drink sales. Mcdonald’s could possibly be paying high machine fees for exclusivity so Burger King doesn’t get an option of higher quality Ice-cream.
The only person really missing out is someone wanting an ice-cream 15% of the time - who like the franchisee - may be disappointed in the reliability of the ice cream machine - but is also better off financially - even if they don’t realise it. A possible third order effect is it breaks food addictions to things like ordering thick shakes on the way to work - regular consumption of sugar + saturated fat is not a healthy combination. Health management is a large concern for Mcdonald’s.
I’m happy with low-cost high quality ice-cream 85% of the time. I prefer that option to more expensive Ice-cream. I think this is part of the magic of the market economy. The invisible hand.
Are carrot problems killed by their public disclosure? I hope not, I like the 85% probability of cheap delicious ice-cream.
An amazing thing would be if there was tech in the machines making failure rates non random. I wonder if they fail more in winter than summer for instance which would educate the consumer about the lack of reliability so when summer comes less ice-cream is ordered.
This just my 3 minute thought experiment (brain fart) but could be a great topic for a behavioural economist such as the freakonomics blog to cover.
I don't think you watched the video which provides a much more simple explanation (and more importantly simple to carry out) than "ice cream is a loss leader that a bean counter discovered 85% reliability minimizes losses".
For one, franchise owners decide when to do repairs that are prohibitively expensive. Two, the failures are not "random" and likely store based (one franchise down for 2 weeks rather than 10 franchises down a day) because it's owner discretion on when to fix it. Three, there is demonstrated profit in the McDonalds <-> Taylor collusion based monopoly.
There's no need for an elaborate spreadsheet conspiracy. Taylor is using a contract which enables them to charge exorbitant amounts for labor and prevent the free market (iFixIt and Kytch) from providing equivalent labor (theoretically under equivalent liability) at a much cheaper cost.
Mcdonalds is making a contractual obligation on behalf of the franchises and that contractual obligation benefits McDonalds at the cost of the Franchises.
If you understood how the brain creates pain and retains memory of the molecules that it interacts with you would understand that hyperchondria is a worse than useless diagnosis for anybody.
Certain people are going to recover faster from illness than other people. It isn’t because they have better mental hygiene.
They are fortunate. If you had long-covid you wouldn’t be able to type that because you would be mentally fatigued. Like Mike Tyson says, everyone’s got a plan until they get punched in the face. If your mitochondia locks up on you one day and your energy starts collapsing within 72hours of mild exertion I’d love seeing you blaming your own thinking to fix the situation while everyone else does.
I don’t feel vindicated. I am beating chronic fatigue syndrome anyway, I have to do spinal strenthening exercises, I have to get plenty of sleep, I have eat healthily, I have to not do too much physical exercise in a day, I can’t sit for too long or I end up with post-exertional malaise.
I think the people diagnosing other people with mental-disorders to explain what they couldn’t are going to get progressively more and more exposed as people find non-obvious ways to overcome their chronic multi-systemic health conditions. People are figuring it out.
There is a psycho-somatic component. There is a physical component. It is brought on by viral illnesses.
People with anxiety are prone to it but they are also prone to hypermobility(joint dislocation).
One of us is right. I’d hope I’m not a delusional hyperchondriac. When my fibula pops out of my knee joint and I pop it back in and carry on with my day is that hyperchondria? Or could that be in some way related to managing chronic fatigue syndrome of which long-covid appears to be a sub-set.
60% of people with hyper-mobility have anxiety disorders.
It doesn’t matter to me whether I’m right or you are right. All that matters to me is that I can sustain employment to rise up maslow’s hierarchy. I know that your approach would not have allowed me to do this because I tried it. Believe me I tried it.
Hypermobility (cartilage dysfunction) and anxiety disorders correlate.
Vitamin D and K interact with cartilage.
Vitamin D deficiency and severity of covid infection correlate. As does obesity. Obesity causes vitamin D deficiency.
Brainfog is a symptom of covid and causes some people to fall down levels of maslow’s hierarchy of needs.
Falling down maslow’s hierarchy of needs causes anxiety.
Anxiety depletes the body of B vitamins. B vitamin deficiencies can impact on glutathione production. Glutathione deficiency can impact immune function.
Spinal alignment/stability helps one maintain focus. Poor spinal alignment causes the brain to burn energy on proprioception. Causing mental fatigue, ie brainfog.
When the body is under stress the cellular membranes become less functional. I think this an immune protective mechanism (speculative). I think you can control cellular permeability with lipid ratio ingestion and calorie management. Cellular permeability affects the mitochondrial energy production and immunity. It makes sense that cellular protection is optimised over energy production when recuperating from a viral illness.
The brain impacts the immune system, there is immune memory stored in the brain.
I was diagnosed with chronic fatigue syndrome 4 years ago after contracting a chinese flu.
I am writing this because when people write the word psychosomatic I think the same thing. I just think no-one in medicine has a comprehensive understanding of what psychosomatic is.
I also think long-covid is worse than chronic-fatigue. The base damage is worse, then there is the same viral borne psychosomatic condition layered over the top of it.
What the people safely ensconsed up maslow’s needs hierarchy often fail to understand is the immense stress felt by the people sliding down it.
Incremental motivation and autonomy is hugely important to mental health. The homeless and mentally discounted don’t get much. So there’s this often unarrestable downward spiral.
When you land literally on the floor. The way back up is swimmers stretchers an arm, then a leg, then a leg, then an arm. Build up that spinal strength and propioception with whatever spare energy the body has available to it. It takes at least six months and there are numerous crashes.
You need to eat really simple foods because the brain goes into ptsd mode and hypersensitivities emerge.
You need a really comfortable bed because you are in constant pain and can’t sleep.
You need to know you won’t be homeless because the anxiety will wipe out the b-vitamins faster than the you can ingest them.
The support groups will tell you you have a 5% chance of recovery.
I think it is a psychosomatic illness as well but medication won’t help. I also think some people’s immune systems end up in such a state of depletion that it is just a pure untreatable illness for them.
If you try and communicate any of this in the midst of brain-fog the natural assumption is that you are whinging and crazy. Forgiveness helps, anger management helps.
I think permeability of the membrane inner ear is the underlying causitive mechanism of long-covid chronic fatigue syndrome. You need really good potassium concentration in the inner ear for proprioception to work effectively. Lying down plus the cellular stress permeability response depletes this concentration. Hypermobility exacerbates the problem, the membrane is partially cartilagenous.
This leads to brainfog and fatigue when moving. You have to build yourself up really slowly and there are alot of critics. Outwardly you don’t look that terrible.
I spent time figuring this out to get better. Now I work in telesales because a failure mode of the prefrontal cortex (requiring the most brain energy kind of) is that you tend to talk alot.
I’m getting better, slowly crawling back up Maslow’s hierrarchy. No doctor told me any of this.
I got lucky, didn’t believe my diagnosis initially. (Takes the average person 7 years to be disgnosed with chronic fatigue syndrome). I asked for the most alternative physio at the practice I went to for the constant pain. He wouldn’t discuss the condition at all but he got me doing swimmers stretches and propioception exercises.
I can do sideplanks now. What people don’t understand is that your energy doesn’t collapse immediately. It takes up to 72 hours post exertion for the mitochondria to be overwhelmed and the fatigue and brainfog to kick in.
It is very easy for people to arrive at a place of learned helplessness. It is very easy for family members to question your behaviours from the perspective of mental illness. When you yourself don’t understand why your own energy is collapsing.
You can’t differentiate psycho-somatic from the physical. All that will help it is treatment plans that assume there isn’t a psychological cure in and of itself. Physical therapy is hugely important. More research is required into the base damage of the corona-virus. Then the treatment plan needs to regularly tweaked till it gets to the point of basic health maintenance.
No-one’s getting rich of this so I can’t see it happening soon.
My dream is a better collaborative information system for treating chronic illness. I think people are overly focused on causative mechanisms. Body’s heal themselves given the right conditions.
I wish a company existed where people report their pre-existing conditions, symptoms and medical test and diagnostic result then get given a best-practice treatment plans. The results of the treatment plans are monitored using fitbits. Then incremental adjustments are made to the treatment plan using machine learning to search for symptom dopplegangers and discover what worked and what didn’t for other health dopplegangers.
I don’t know why this doesn’t exist. I think the returns on medical research are getting less and less. The body is multisystemic and everybody is unique. But with 8 billion people there are loads of symptom dopplegangers. We don’t need to know why something works to know that it works. The search for why has diminishing return with each level of complexity. A smaller and smaller percentage of the population can afford the latest medical treatments. Medical research is expensive and wasteful. The top of maslow’s hierarchy is really saying that there is no need for why just being.
I think collaborative sympton doppleganger machine learning optimised treatment plans should be the future of medicine. It is what computer innovation should be about.
There should also be a whole lot more research into vitamin-d vitamin k and cholesterol metabolism. This is an intersection of multi-systemic conditions where membrane permeability, hyper-mobility and anxiety correlate.
You can test for hypermobility by straightening your elbow. If it goes backward even a bit, delve further, you are bendy and may need to manage that bendiness proactively.
A variable is the water temperature and it’s oxygenation level.
Shading the feeder waterways with 20 m belts of trees, using carbon credits to offset the establishment costs then compensating farmers for the lost area should help.
Everyone is winning. The higher oxygenated cooler water will utilise nitrogen and phosphate more effectively, less nitrogen and phosphate will get into the water as it’s absorbed by trees and less fertiliser will be required because soil hydrology will improve, reducing the amount that runs off instead of turning into plants.
Every 2km of waterway bank planted would hold 1500 tonne of carbon eventually. Erosion would decrease so some local bridge and road infrastructure budgets could go towards more planting. And everywhere you saw corridors of trees in paddocks you would think of native animals traisping along their natural highways.
Humans won’t cooperate and go backwards financially and or reputationally. This would potentially avoid that. It’s not the optimum but would have a positive impact for all involved and a chance of success.
I'm interested in what people with greater knowledge/insight/intellect than myself think of the following.
I think total reforestation is implausible but the native reforestation of most of the earths fresh waterways is plausible using the Miyawaki forest establishment method ( that achieves 10x growth rates and natural strata levels) and localised cuttings. By staggering the establishment of native plantings 20 meters either sides of creek and river beds so there is effectively a 50m wide native forest over most waterways you can delay the capital outlay which causes a positive net present value for existing landholders to finance the planting and enhance their balance sheet. By setting aside the planting corridor to regenerate while the miyawaki plots are gradually planted the soil regenerates so the the forest establishment can be sped up over a period of time.
Because there is a positive ROI with carbon credits at current prices and the work is fairly interesting and healthy the planting projects work economically and ecologically.
The ecological benefits are that native forests have a five degree celsius cooling effect. Cooler streams mean higher oxygenisation levels which means higher nitrogen utilisation levels and a healthier pH. Cooler streams also means cooler rivers which means cooler estuaries with more sealife means and sea grasses and colder coastal sea surface temperatures and less algal blooms. Native flora corridors along fresh waterways allows native fauna highways so that biodiversity is more resilient.
The economic benefits are improved hydro-logical flow through pasture and cropland so less phosphates and nitrogen flow through the soil and the soil retains moisture better as the 20 m rich native humus barrier either side of the fresh waterway slows the hydro-logical water flow into the creek. Native forests negatively ionise the air so the growth rate of the pastures and crops along the waterways should be higher with less fertiliser applied. Also rural employment opportunities are retreating globally as wealth accumulates with knowledge into cities and the localised forest design and planting employment funded via carbon credits would provide interesting educative yet non-stressful employment opportunities and achieve a higher return on investment for most landholders than commodity production. We have 10 billion people coming on board to feed, population growth slows with great nutrition so great nutrition is the anti-dote to long-term pollution. People won't go backwards so planting fresh waterways in locally designed fast growing native forestry using the Miyawaki method or better wherever there is a positive ROI at current carbon credits prices makes intuitive sense to me.
If I die unrespected and socially isolated I like the thought of donating my body to medicine while providing a funeral for poets to crash and get their words out. It is an absurd concept, it would be nice if they connected socially before I died and provided the respect they are concerned about. But given the constraints of their own lives it is nice knowing my lonely death could provide social support to probably introverted intelligent thoughtful people who are likely at risk of social isolation themself.
What is the purpose of a funeral is an interesting question. I think it is to help the living to socialise and forge ahead with a cohesive story of the deceased ‘s contribution to their own lives and to navigate the gap and hierarchy left in the modified social network. I’m guessing this process reduces grief and conflict as people feel loved and supported through the process.
If you die alone you leave no gap. I think it’s brilliant that Poets seized this opportunity to get a reading in and strengthen their own social network. They are also attributing value and respect to life, no matter how meaningless, which is another positive. The futility and absurdity of the human condition is a beautiful thing we all wrestle with whether socially connected or not and I think this is the point they are getting across while having someone listen to their poetry.