josephinesotherman
No bio...
User ID: 1389
josephinesotherman
1mo ago
Also would be interested to see what works here, 33 and feel like I’m noticing a slightly recessed hairline, but unsure because I’ve always had a widow’s peak hairline.
josephinesotherman
1mo ago
Finally got an abdominal MRI to investigate exocrine pancreatic insufficiency and very fortunately my pancreas and other organs look and work fine, my ducts are completely open, no sign of any damage or pancreatitis or tumors or cysts. I'm going to my doctor to figure out next steps, but I somehow have found myself on square one again having no idea what is causing all of my joint pain, itchiness, discomfort, trouble sleeping, and digestive trouble and bloating. It seems probable that I'm dealing with SIBO, but it feels like it's in the same league as CFS or chronic lyme or a bunch of other disease states that are likely real but have a huge overlap with questionable practices and science.
... for example: my doctor put me on a "natural" SIBO treatment a month or two ago, which included allicin and oregano oil. They first caused some of the worst mood fluctuations of my life, then after a couple weeks of stability caused significant and severe bloating, stomach pain, acid reflux, discomfort. I stopped and told my doctor that I'd like real antibiotic treatment, and perhaps to back up and confirm the SIBO (though this is also apparently not extremely precise).
I feel like digestive trouble has been a constant source of trouble in my life, and it's at the core of a lot of health challenges I've been facing the past 5-10 years. I really want to solve it, but it's very much a one step forward two steps back kind of scenario.
josephinesotherman
2mo ago
I'm at a real low point in my life right now. In addition to all of the health issues I've been experiencing lately, I'm struggling a lot to find a new job.
Long story short, I work in tech as a SWE, worked in FAANG for 5 years, then worked at a VC-backed company I cofounded for 4. I left my last job to go start something with a friend, but he decided he didn't want to do it anymore after months of exploration. I really regret leaving my last gig:
- Getting interviews is rough. I'm easily getting 10x fewer responses than last time I was looking and often get form rejections.
- When I do get interviews, they're all FAANG-like now: either leetcodes and contrived systems interviews or long take homes. I'm prepping for leetcode, but it continually feels demoralizing and defeating that my experience is held secondary to the capacity to manipulate linked lists effectively, something I've never done once in my career.
I very much don't fit into a consistent bucket anymore, I'm much more of a jack-of-all-trades kind of person in a sea of specialists after doing most of the full stack, platform eng, frontend and backend eng for my startup and I enjoy that work.
I'm finding myself feeling awful about myself and my abilities. The rejections and non responses are starting to get to me too. We were unable to raise at my startup, after 4 years of hard work, and I'm starting to wonder whether these interviews are just accurate representations of my real abilities. I'm feeling like most of my life is characterized by intermediate beginner skills, from meditation to work and everything in between, and that I'm incapable of change or improving myself.
I spent most of my time at FAANG living very frugally and saving cash, and I'm very lucky to have a substantial moat to find the right gig, but I'm just so in a rut right now that it's hard to see the light at the end of the tunnel. This is all just multiplied by my health problems (pancreatic insufficiency out of the blue, joint pain) as a young guy. It feels like I'm staring into a void, I can't really visualize my future anymore.
josephinesotherman
2mo ago
Continuing my saga of trying to solve my chronic joint pain…
Got a ton of lab work done, including an ultrasound, pancreatic enzymes, H27BLA, stool test—all normal except extremely low pancreatic elastase in stool (32). Ultrasound was normal, but pancreas appeared heterogenous (non specific finding, suppose it could be gas or something). Stool test was weird because fat content was low/normal and protein was normal high but elastase was low regardless. Normal blood sugar but higher fasting insulin than I would like (7.9).
Doctor has me on oregano oil and allicin assuming SIBO and has ordered an MRI to rule out pancreatic etiology. These supplements are kicking my ass and causing not only a lot of bloating, but upper right abdominal pain I’ve had on and off the last 10 years of my life.
Needless to say, I’m struggling. The physical discomfort from the SIBO treatment is a huge anxiety trigger. I’ve started wondering whether I’m looking at something life changing like pancreatic cancer and I’m increasing feeling like I’m staring over this void. I’m trying to manage the anxiety through meditation and therapy but a physical trigger is extremely hard to ignore.
I’m 32 male, no family history of pancreas issues. I’m really struggling with all of this, I’m attempting to just keep moving forward but it’s really hard.
Thank you! This is really helpful.
So my update here is that a stool test came back with extremely low pancreatic elastaze 1 level (31) and a high amount of Klebsiella oxytosa, which is fairly correlated with ankolyzing spondylitis. Next steps are to essentially rule out some bad stuff like pancreatic cancer and chronic pancreatitis with an ultrasound or CAT scan and simultaneously treat the klebsiella and what looks like SIBO. Doc is checking HLA-B27, amylase and lipase, rheumatoid factor too, so I should have some answers soon.
I’m glad I found a doc to take my symptoms seriously, no one else would’ve ever detected that my exogenous pancreatic function was cratered. Most doctors make it clear they either don’t care or that trying to deal with chronic issues is like witchcraft. I feel like I was living with mild symptoms for years and all of a sudden they’re much larger, and if docs cared to take me seriously back then I wouldn’t be in this situation. I worry I’m about to cross the rubicon into chronic illness or serious acute illness and I just want to feel like I have agency to fix things.
josephinesotherman
3mo ago
Finally found a doctor who is taking my various intermittent symptoms seriously (joint & muscle pain, dry eyes, burning nerve sensation), and my ANA came back positive, though at a borderline titer (it was negative 3 years ago though, and I'm male, early 30s). I see her in a couple weeks, and while I'm not jumping to conclusions (under the understanding that autoimmune issues are much more complex than a mildly-positive ANA), I am worried about the realities of management of rheumatoid arthritis or lupus or another autoimmune issue.
Wondering if anyone else here has any experience in this kind of territory and has any advice?
josephinesotherman
3mo ago
To add a counterbalance here: I don't think anyone here has nearly enough information to clearly state that you've made a mistake. A life-long commitment with children is a huge one, and you have every right to feel a sense of security in your decision when you make it (I'm saying this as a married guy with a 2 year old). I also find it patently absurd that others are holding you accountable to robbing this girl of 6 years of child-bearing-years, it is not your responsibility to provide someone with children, and further, if you have doubts then you don't want those doubts materializing in your relationship later where they could affect your child.
josephinesotherman
5mo ago
I recently stumbled on this LessWrong post about self-love that piqued my interest: https://www.lesswrong.com/posts/BfTW9jmDzujYkhjAb/you-are-probably-underestimating-how-good-self-love-can-be
... I, like a lot of my peers, especially software folks, experience a lot of internal self-criticism and self-loathing. I would absolutely love to change this, but finding the right playbook for fundamentally changing your relationship with yourself is challenging, to put it lightly. I'm trying to figure out what an effective "30-days of self-love" would look like to go and change the direction of the ship.
Practices like metta or any of the other brahmaviharas are no panacea at all, as a lot of the western meditative footguns fundamentally block successful performance, particularly:
- Focusing on the intention of well-wishing over the feeling is quite difficult, intention is subtle compared to feeling. It's very easy to accidentally go and do mantra meditation on the phrases, or get overly focused on feeling or body sensation.
- It's quite easy to go and over effort metta compared to something like anapanasati. The effort, at least in my case, is difficult to actually debug since it feels like a fundamental belief issue ("you have to try for things that are worthwhile").
- Metta (and meditation broadly) can be extremely reinforcing of old patterns and of self-centeredness generally. I've seen several friends, independently into meditation [as seemingly everyone is nowadays], come back in these really self-centered states.
... that's not even mentioning the problems with certain courses (like Finder's course) and orgs (Dhamma Sukha, the TWIM camp, loves making false, and frankly delusional claims about their method).
I've tried therapy a couple times, but the expense is killer, and I have a lot of trouble with the whole "you need to do this for years or months to see any small tangible benefit" paradigm. In fact, a lot of the therapists I've seen seem like they're much more interested in keeping therapy going versus helping me and potentially losing my business. I've tried ACT/CBT/REBTs therapies, IFS, somatic therapy, and in our therapy-as-a-universal positive society tend to try again every several years, but I always get the ick from the experience every single time and eventually fizzle out. Last time I tried IFS, I did it for 9 months but couldn't say that any behavior was any different.
I honestly wonder whether, as an adult, it's possible for me to go and change something as fundamental as my relationship with myself, but if it is, I'd really love to go and try. I think others are much better at doing something without seeing the tangible benefits, I just can't go and do something every day without seeing some kind of improvement over weeks and months.
josephinesotherman
9mo ago
I’ve posted about before, but I’m constantly dealing with this issue on-and-off that feels vaguely autoimmune:
Joint pain Muscle cramps Muscle spasms Neck and shoulder pain and tension
I found some significant relief through LDN and going lite keto, but some days I’m really floored by it (and it feels like it’s getting a little worse again). I went to a neuro years ago and nothing from Lyme tests to antinuclear came back positive.
I’m pretty afraid I’m treading water with what is an autoimmune issue, but I have no faith in the medical establishment to figure out what this is. Any advice?
josephinesotherman
9mo ago
You could delay caffeine 1-2 hours so that it's not the first thing you do when you wake up. I'm not sure of the efficacy here, I've heard that this helps restore your natural cortisol response in the morning.
Maybe also keep a window cracked and your bedroom doors open while sleeping. Anecdata, but my air quality monitor reports fairly significant CO2 spikes at night if we don't do this.
I usually wake up extremely energetic, and I mostly attribute that to years of practicing free-running sleep (https://supermemo.guru/wiki/Formula_for_good_sleep:_free_running_sleep). I haven't woken up to an alarm in years, thanks to lifestyle changes from COVID, and I almost exclusively wake up around 7-7:30 am every day naturally. I'd argue that any unnatural wake-up like an alarm will often leave you groggy no matter what other changes you make.
Other ideas: you could try "artificial zeitgebers" like Nobiletin for a month, which will help normalize your circadian rhythm. In fact, the more zeitgebers (social activity, movement, sunshine, exercise, water) you can incorporate into your morning routine the better, as they'll potentially make an alarm-less or light lifestyle viable.
josephinesotherman
10mo ago
Sure! Radical works, I was merely trying to provide some shape for an answer, not necessarily to scope any suggestions to my own biases on change management.
josephinesotherman
10mo ago
If you had to construct a curriculum of developing radical self-reliance and independence as an adult, what would it look like? Think: the Jeffersonian ideal of the Democratic citizen, someone with the bravery to speak up, spontaneity, a great deal of flexibility, a love of free play and exploration, and competence in a variety of disciplines.
The curriculum would need to be gradual, in my opinion, gentle even, to establish new habits to displace those cultivated through years of compulsory schooling and hierarchy in the work force. It would also likely need to ultimately be multifaceted, taking on e.g personal spirituality and financial independence at the same time.
josephinesotherman
10mo ago
Get good quality meat, no spices except salt and maybe pepper, you’re making a burger, not meatloaf.
American cheese. No other cheese compares for a burger. Put it on after the flip and close the grill to get it to melt.
Make the grill spitting hot before putting anything on.
Don’t make a dad burger, make those puppies thin. It’s hard to control heat on a grill compared to a skillet, don’t risk a raw middle and a burnt outside.
Don’t worry about undercooking, so what if you eat some undercooked meat? You’ll survive just fine.
josephinesotherman
10mo ago
Unsourced, so take this with a grain of salt, but my impression has been that the significant utility of exercise in weight management is either:
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Body composition changes
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Metabolic disorder maintenance
On (2), a salient example is insulin resistance, which can be modulated through either cardio or strength training.
The reason for this, as far as I understand it, is that exercise increases caloric needs, and typically folks will increase caloric intake to compensate.
I think a reasonable weight loss routine incorporates both dietary changes and exercise to normalize metabolism.
josephinesotherman
1yr ago
Curious what kind of shoe you’d recommend running in? I do strike on the forefoot but I think I put a lot of stress on the ankle.
My issue is that I tend to get tenderness and pain around the outer edge of my ankles around the bone after running regularly for a while. My weeks are usually 10-15 miles right now, but I can get up to 30-40 in the summer.
josephinesotherman
1yr ago
Just did three finger tests (since they’re occurring right now, have a kit for this from my keto days) and blood sugar is roughly 85-90 about an hour or so after a meal with a cookie afterward.
josephinesotherman
1yr ago
I’ve been dealing with on-and-off twitches and body cramps for the past couple years—went to a bunch neuros, eventually got diagnosed with cramp fascilation syndrome after scans, EMGs, etc.
…it’s largely calmed down since 1-2 years ago, but it sometimes really ramps up (right now my hands are cramping, knees hurt, and I have some twitching in my legs).
An acquaintance in med school mentioned I should get checked out for metabolic disorders, but I have no idea where I’d even start. I have some feeling that there’s a food sensitivity component that I can’t quite nail down [stomach discomfort tends to occur with the rest of the symptoms].
Any avenues anyone recommends I explore?
josephinesotherman
1yr ago
Dietary science is garbage, even the notion that red meat is inflammatory or unhealthy is heavily suspect nowadays. Ancient humans also had vastly different microbiomes than we do, so even the question of what we evolved to eat is highly suspect in a modern context.
I think around diet it’s best to just use the most blunt force weapons at your disposal: avoid refined sugars, processed meats, alcohol, otherwise just live your life. If you’re enterprising, my guess is that use of CGMs to minimize your insulin response might be fruitful.
josephinesotherman
1yr ago
Anecdatally I’d say Aubrey Plaza: all of the women I know find her very attractive, but not a single man.
josephinesotherman
1yr ago
From Greg Nuckols' guide on squatting:
What do I do about buttwink?
Buttwink is the nemesis of many. If you aren’t aware, buttwink occurs when the lumbar spine rounds and the pelvis tilts posteriorly a bit at the bottom of the squat. As previous mentioned, this increases shear forces on the spine, and should be avoided as much as possible.
The first thing you should figure out: Is it buttwink, or is it simply your spine going back to neutral? If you squat with a hard arch, your lumbar spine is hyperextended and your pelvis is anteriorly tilted throughout the descent. When you reach the bottom of the squat, what looks like buttwink at first glance may simply be your lumbar spine and pelvis moving from hyperextension and anterior tilt back toward neutral. Get a video of your squat from the side, and see whether your back looks like it’s going from a big arch to a smaller arch, or whether it’s going from a slight arch to being rounded.
If it is buttwink, the first thing you should do is test whether you can actually squat to depth without buttwink. Some people’s hip anatomy simply won’t allow them to. You can use this assessment to find out:
The one little thing I’d change about the assessment the way it’s presented in this video: drop your chest a little closer to the floor so that the assessment more closely mimics a horizontal squat.
If you pass this test and you can reach the required level of hip flexion without buttwink (your hip crease can get behind your knee without buttwink), then it’s not a mobility issue – it’s a control issue.
There are two strategies you can use to try to address this problem:
- Remember the difference between squats and deadlifts: most people naturally brace better for anteriorly loaded movements.
Start with a goblet squat. See if you can squat without buttwink when goblet squatting. If you can, add load each session until it simply becomes challenging to get the dumbbell or kettlebell in position to keep goblet squatting. After that, move on to front squats, which are still anteriorly loaded, but more challenging than goblet squats. You should be able to front squat without buttwink after really mastering the goblet squat. After 4-6 weeks of front squats, move on to high bar back squats, which you should be able to control well at this point. If that goes well, then give low bar back squats a shot (if you want to low bar back squat).
- Use progressive range of motion. See how deep you can squat without your butt starting to tuck under. Set the safety pins to that height, and squat to the pins, starting with a slightly lighter load than you were squatting before (since it’s a little hard to squat to pins). Squat down to the pins, let the bar rest on them for a second (don’t bounce the bar off the pins), and come up. Every week or two, lower the pins one position. Keep going until you’re squatting to depth.
josephinesotherman
1yr ago
I'm de-facto jobless as-of this month, as my company I cofounded ceases operations. I realized I rushed too quickly into job seeking (potentially because I was seeking some validation I have value as I watch 4-5 years of work disappear into nothing), and I'm trying to back up and work a little on myself (+ spend more time with my daughter) before I start looking again.
There are a couple dimensions of my life and my health I'd like to improve, and I'm wondering if anyone here has any insight on any of them:
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I've found myself masturbating and watching too much porn lately, probably because of more free time. I've always wanted to kick the porn habit (since I was a teenager), but have never found anything outside of momentary success. Does anyone have any advice on reasonable strategies here? I have no issues with masturbation, don't conform at all to the whole nofap nonsense, but instead have had an internally sourced (i.e. my wife knows about it and is fine with it) guilt-based relationship with porn most of my life that I think I ought to address.
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I stopped meditating after a particularly bad retreat experience (+ increasingly painful daily sits before that), and I'd like to start-up again, but I sense a lot of inertia present as I attempt to establish a habit again.
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Years ago, I had a really bad case of norovirus followed (a couple months later) by a skin infection that required fairly hardcore antibiotics. My gut has never been the same, I've had intermittent fatigue and diarrhea for years from it. Every single doctor I went to, early on, was judgy, unempathetic, and ultimately quite unhelpful, so I've not been back to doctors for a long time to try to figure things out. I've tried a lot of things personally but nothing has worked for longer than a couple weeks.
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Anything anyone recommends I invest my time into with a bunch of free time? I'm running and going to the gym to lift 5-6 days a week nowadays, so I have a good exercise routine going.
josephinesotherman
1yr ago
Two questions come to mind here when considering CBT/REBT or any of the third-wave behaviorist therapies (ACT, DBT):
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What is the effect size? To me, the cost of undergoing any therapy (>$200+ out of pocket per session, much more in the city I live in) means that the effect has to be quite large.
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Researchers studying these therapies probably practice them incredibly well compared to baseline--how well does the average person fair when an average therapist is performing these techniques with them?
I'd guess that the top 10-1% of therapists achieve great outcomes for their patients regardless of methodology (talk vs ACT vs something else), and the bottom 90+% do either nothing or worse.
josephinesotherman
1yr ago
Echoing a thread from /r/slatestarcodex:
How are you optimizing your home for health and wellness? What initiatives constitute the best bang for your buck?
I particularly feel curious about peoples' thoughts on HEPA air filters and water filters: do you think the current research supports the purchase and continued operation of a HEPA filter at home? Does a HEPA filter's operation become more viable with infants or small children in the house?
It's the terminal state in the eventual capital-ization of everything. No one can do anything for pleasure anymore and share openly, all activities eventually must turn into a money generating scheme or they're ultimately not productive.
The open source software world feels like a peek into an alternate dimension of what the world could've been like: in few other places do people share so much toil and effort so openly with others.
I'm in my early thirties, dad of a 2 year old, and I want to start really shifting my habits to establish a real enduring sense of contentment, happiness, health, agency and the like to define the rest of my thirties. What physical and mental activities are worth pursuing, what to purchase or do to pursue those things against an NYC upper-middle class budget? I'd like to explore outside of the baseline of diet and exercise as those are no-brainers.
I've spent some time over the past couple months getting back into meditation (after fizzling out with TMI-based meditation, which I think is honestly poor instruction for westerners in retrospect), particularly into the development of the brahmaviharas (this lesswrong post really convinced me of the power of these efforts: https://www.lesswrong.com/posts/BfTW9jmDzujYkhjAb/you-are-probably-underestimating-how-good-self-love-can-be)
I've been doing a couple meditations a day, one walking and one formal sit, alongside some more casual attempts at cultivation of brahmavihara cofactors. I just sort of say the phrases internally with some kind of intention, and I've coalesced around something like:
... these have been generally good, though I'm setting a very light intention when internally saying the phrases, as overefforting was a big problem in the past. I do not concern myself with whether any feelings arise, sometimes they do and sometimes they don't.
I'm looking to really pile onto this and my exercise habits with a bunch else to make my life fuller, richer, more mystical, to make time move slower, to increase my perceptive skills patience and kindness, and prevent health issues from developing as best as I can.
I realize I'm being a bit vague here, and that's partially on purpose: I want to discover what I can do for myself to make life better if I'm willing to put in time and money and effort to do so.
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