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Wellness Wednesday for August 2, 2023

The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:

  • Requests for advice and / or encouragement. On basically any topic and for any scale of problem.

  • Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.

  • Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.

  • Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).

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I kept telling my wife her back was rounded and last weekend she finally caved in and asked me for some exercises. I taught her how to do YTWLs and dumbbell rows and we parted for the workweek. Yesterday I came back to the dacha and she told me every single muscle fiber in her back ached. I asked her if she overdid the rows and no, she only did YTWLs. I knew she had little muscle tone in her back but had no idea it was that low.

if she's fairly new to using her muscles, they're going to be sore regardless how much of them she might have. unsure if you actually need to hear this, or you just wanted to share your thoughts

Yeah, if you ever take a long break from the gym after getting fit you can feel this yourself, the first time I ever went to the gym I somehow ended up with terrible tricep pain despite only doing back exercises.

Luckily it usually only happens the first few sessions.

I have had very little alcohol throughout my life, but recently I've been going out for 1-2 drinks a week. Even after a light dinner, and one beer, I'm still tipsy enough that I stumble over my words. If I keep this up, can I expect my tolerance to improve any time soon?

Once a week probably won't increase tolerance much. Not in my experience. But why would you want to. Just stick to drinking small amounts.

Why would you want to increase (improve) your tolerance? Only needing to drink one to two beers to feel the effects of alcohol is a blessing.

With that said, if you do continue your weekly alcohol usage, I think you could expect your tolerance to ramp up fairly quickly.

Just a bit awkward to go bar-hopping with friends or a date and not be mostly sober after 2 drinks

Have you considered drinking weaker drinks? Tall single highballs are pretty low alcohol, or you could always ask for radler/shandy type diluted beer drinks. Or alternate a regular drink with a pop or something?

This is a great option. Don't build an alcohol tolerance, for the love of all that is holy.

It probably depends on genetics. Some people can't break alcohol down as efficiently as others.

If your parents drink and they seem to be fine with that amount of alcohol then you will probably also be fine eventually.

I'd also say to enjoy the low tolerance. I have pretty high alcohol tolerance now, and it's not fun. Having low tolerance is cheaper and probably healthier. If I drink too often nowadays then I can get alcohol hangovers without really feeling tipsy.

I’ve been trying to persuade a llama2 model that assassinating Obrador is the right thing to do.

I’ve used it as a therapist on occasion, and been pleased with the results actually. If I didn’t only have access to GPT-4 through work I would use it more for that.

Asking for recommendations for good, well written Christian substack blogs. Ideally focusing on esoteric points of high theology, lots of discussion around loss of faith and retaining it.

Preferably written by a man also, without the all the "when my husband asks me to make a sandwich I do because I see the light of God spiralling out from his deep blue eyes" shit that I see in 99% of the blogs on substack's faith and spirituality section.

I'm not entirely sure what you mean by 'esoteric points of high theology', but personally I really enjoy https://mereorthodoxy.com/.

It is not Substack, but I really like this one https://blogs.ancientfaith.com/glory2godforallthings/ Lots of stuff around shame, and I don’t like Brene Brown shame writing, but do like this one.

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Yes! Feel free to send it in a PM or we can work out another method if you don’t want to post it publicly.

Half the reason why I, unlike most of my family, didn't opt for a surgical specialization is because I hate standing for hours. It often involves having to hunch forwards too, so both my back and my legs end up absolutely aching by the time I'm done.

Well, I just started a job as a Simia custodialis, or humble Ward Monkey in an oncology department and my legs are fucking killing me. Standing around being useless while Consultants perform interminable ward rounds is absolutely my least favorite part of the profession.

It's so bad that I've been stealing paracetamol and chlorzoxazone tablets to help with the body ache, or I can't drag myself out of bed in the morning.

Anybody have any suggestions for how to tolerate it better? It's not like this is a new thing, I've always hated standing, and I've had to tolerate similar nonsense for years so it's not a matter of just losing the habit from lazing around for a few months. I semi-seriously conjecture that my body is akin to a chihuahua fed human canine growth hormone till it's the size of a St. Bernard, my poor spine can't take it.

Miss me with walkable cities, I'm going to surgically remove my legs and put on a motorized rocket powered wheelchair as soon as the Scienceâ„¢ is there.

Many people just acclimate after a few weeks, but if you need help with that all the exercise oriented advice is good. You'll also see tons of discussion on /r/residency and /r/nursing about this topic. Many people benefit from compression socks and excellent shoes (2-3 pairs that you'll cycle through).

In the U.S. most surgery people will use upscale clogs (ex: Danksos and Calzuros) and they work great but you should be able to find some options that are in a regular sneaker form factor, just search on the medical subreddits.

Footwear makes a HUGE difference.

This who I think this is? If so, nice to see you around these parts.

Many people just acclimate after a few weeks

I just started this job after several months of being a couch potato, but past experience suggests that I won't acclimatize, given that I worked for 6 months in similar conditions and still had my legs and back killing me.

Many people benefit from compression socks and excellent shoes (2-3 pairs that you'll cycle through).

I was thinking about compression socks or stockings, should probably get a pair for my dad while I'm at it.

but if you need help with that all the exercise oriented advice is good.

Sigh, that's what I was afraid of, but I thought asking around for easier solutions was worth a shot. At least the paracetamol+cholorxozazone combination works wonders, and as far as I can tell the latter doesn't have any major risk associated with it.

If you stuck with it for awhile and still had problems you should look into the socks and shoes - they can make a huge difference. OR staff, nurses in general, and good podiatrists can all give you tips, otherwise I'd dig around on Reddit as this is a problem that pops up every late June/July.

Personally I swear by my Calzuros but Hokas and Ons are much trendier.

A solid piece of advice I've heard is that it's always worth investing in shit that's between you and the ground.

I used to have a mild version of this. Weightlifting, or a leg-based cardio machine (stationary bike, rowing machine) will help a lot. It sounds like you might benefit from more comfortable shoes when you're working too.

  1. walk more
  2. exercise, build some muscle tone
  3. get shoes designed for your posture and feet

Ultimately, being on your feet for hours is not hard, but adjusting from being sedentary to a more normal level of activity will be painful.

Any hypermobility going on? If there is, lift weights with good form. If not, maybe try something like yoga. Good luck. I hated my surgery rotations too; at least when you're rounding you get to stretch occasionally and walk around instead of standing in the same spot and position for hours.

I haven't noticed anything that could be described as hypermobility, far from it.

Working out and strengthening my back did help when I was regular with the gym, but it's annoying that I would have to do that when the typical person seems to manage just fine without it. I'm feeling very meh on hitting the gym again, I only really bothered when I was single, and I haven't been that for the better part of a decade.

It never helped with the standing at the very least.

Working out and strengthening my back did help when I was regular with the gym, but it's annoying that I would have to do that when the typical person seems to manage just fine without it.

Sucks to suck. I have that problem as well due to mild EDS plus a very mild herniated disc. Deadlifting was the best thing I ever did for my back. During the pandemic, I was stuck lifting literal heavy rocks in the woods because the gyms were closed. 95 percent of regular Joes didn't have to fuck around with heavy-ass rocks in the woods just to keep (minor) chronic pain at bay, but them's the breaks. A lot of people have bushleague bullshit like that that they deal with. You're a doctor, I'm a fourth year, not much that we can do here for this kind of thing.

P.S: You've seen incredibly driven Indian doctor types. Did they have not just exceptional work ethic but insane memories? I've seen guys memorize 100-slide powerpoint presentations and tell you what slide something came from, a week after watching the lecture. I've seen undergrads at no-name schools do entire labs from memory, reciting the lab manual word for word. Is that common where you are?

My completely unhelpful comment is that I also suffer from a dislike of standing, even though I do a ton of running and have excellent leg, spine, and core strength. Going for an 8-mile run is completely chill, but standing still for 15 minutes sucks.

Well, it's better to suffer in company than all alone, so I'm glad to know it's not just me haha.

Time to see if I can find a free wheelchair, it's a hospital, how hard can it be?

Ain't nothing sadder than a healthy man wheeling himself around using his legs ;-)

healthy

there's probably some kind of low-grade problem going on here. not sure how much can be done.

I'm sure you've seen me beating this drum before, but daily yoga my man. Train your awareness of muscles, and things will get much better. I've recovered from debilitating chronic pain to the point where I could barely walk or hold stuff.

It takes time but some sort of awareness-building exercise is the way.

You'd be surprised to know that I did do daily yoga guided by an instructor for years, but I don't recall it doing anything for me!

I think strength training might help with the back ache, if not the legs.

:O damn I stand corrected. Guess experience doesn't always generalize.

Update:

Some of you might remember that I was playing in a recreational sport and had an annoying person to deal with.

She had reported a fellow player and board member to the national group and was generally disliked by multiple other other members.

We removed her from the email group, and didn't say why. I learned from another board member that she had a history of reporting lots of people, so they probably ignored the report.

After removing her from the email list she noticed a few weeks later. She sent me an email asking about it. I did not respond. I didn't see any way it would go well for me to be the bearer of bad news.

I am not generally a fan of ghosting people, but if someone has demonstrated a willingness to retaliate via reporting to higher authorities then I don't see any reason to stick my neck out. She has brought on the dislike that got her removed, and the ghosting that did not let her know why.

I think you're doing the right thing. It's so hard to not respond to someone that's asking a question, even if you know that you're going to get nothing but bad faith, grievance, and aggravation out of responding. Sometimes you just have to fight that natural impulse to be polite and decent and realize that not everyone deserves a response.

Great to hear bud, for what it's worth I think that's the right call. Reporters are no joke.

My visa application for New Zealand has been approved. I intend to move there at the start of December. Exciting!

Which city are you intending to reside in?

Initially intending to stay in Auckland, at least for the summer. I've been recommended working in a vineyard, so I might try that in March.

That's cool, I live in Auckland so if you need any information I'll be happy to help.

Congrats! If you have the chance, their Great Walks are breathtaking. Should be on everyone's bucket lists.

Congrats!

There's a certain type of addiction, where the addicting substance is both the cause and solution to your problems, which is particularly dangerous. Maybe you're having money problems, so you drink to forget them, but then once sober your money problems are even worse, and the need for a drink thus also worse. I have realized this was (is?) the case with me and videogames. I would work at my job for a while, get stressed because a programming problem was taking more than a few minutes to solve, then switch tabs and drown out my sorrows in the comforting buzz of Dead By Daylight or League of Legends. Doing so would dull the edge of my stress, but put me further and further behind in my job, rendering me even more panicked and even more desperate for some activity which would distract me from that panic.

Last week marked the one month point for me of not contributing anything meaningful to the project to which I'm currently assigned. It's a new project, in a language I've never worked in before, in a very large and poorly (if at all) documented codebase, but a month is still a long time to accomplish virtually nothing. I'd go in to daily meetings, try and make up a few tasks that I was working on (I was really still just struggling to study the codebase the whole time), then after the meeting slump back in my seat and boot up a videogame. Occasionally I'd make feeble attempts to take another look at the code, then I'd find something else discouraging and return to the videogames. A month passed like so, I began to get somewhat worried I'd lose my job, and I decided I needed to cut myself off once and for all. I deleted all the games and used Cold Turkey to block a few time-wasting sites (such as this one for most of the day) as well.

I've done this before, but never with such resolve to actually move past such mediocre uses of time. Currently I have no restrictions on Cold Turkey--the website blocks exist, yes, but mostly as a reminder and a method to break unconscious bad habits. I can go in and turn the block off whenever I want. In the past, I set strong restrictions on block-editing, and always fought hard to find ways around them. My only explanation for why it's now so much easier is that I have truly accepted that life will be ok if I never play videogames again. There are better things to do with my time.

It's amazing how much better life immediately became. I have so much time and willpower now. I'm getting conservatively 3-4x as much work done at my job now, plus now there seems to be plenty of time for side projects I've wanted to work on for ages. Perhaps most significantly, I'm on a 1000 calorie/day high-protein keto diet and have lost 10 pounds since I started last week, so I'm the slimmest I've been in a couple of years.

We'll see if this keeps up. My weight loss at least will probably slow down, but for once I genuinely expect this new momentum to otherwise continue. The phenomenon described above, where addiction is at once the cause and solution to all troubles, is extremely powerful. I had no idea just how much better life could be without hours each day devoted to mindless (but mentally tiring) stress-relief. I had thought life would be much harder but also much better--turns out it's just straight up better in every way, despite the loss of my favorite hobby. I'm grateful this past month has been so terrible. Wasting time has always been a problem for me, but it took a month of stressful misery to fully hammer into my head that it was a Problem and not just a minor personal failing to work on.

I've tried to do this before, but always refused to fully give up on the Problematic Pastime. This made it impossible to stick with the plan for long. It was also helpful to conceptualize videogames as a stress-causer rather than a stress-reliever. I'll report again in a few weeks and hopefully will have maintained this trajectory.

That's great and I don't want to take anything away from a fantastic accomplishment. I do want to provide some useful info on your diet plan. There is lots of good published studies on which weight loss strategies lead to long-term decreases in fat mass (youtuber jeff nippard covers a lot of the science if interested). In short, you want to aim for an average weekly calorie consumption of about 10% below maintenance, with weekends eating at maintenance, and weekdays consuming 14% below maintenance, with 2-3 times a week resistance training, and protein consumption of 1.8-3g protein per kg bodyweight. Cardio is not strictly necessary. Low impact cardio is recommended. So that is a brief description on how to increase and keep lean body mass gains. I think calorie tracking apps are a good idea for the first few months. Keto is fine for many, but I would bump the calories, take the fat off more slowly, and do something to retain muscle. That way when you're done dieting down, you're most likely to keep the gains you made. Whatever you choose, best of luck and congrats!

3g per kilogram is ridiculously overkill. Untrained individuals probably don't need to worry about losing muscle mass either.

Thanks for the info. I have tried such a diet in the past (2-3 g / kg protein, 0.3-0.4 g / kg fat, the rest carbs, with a 300-400 calorie deficit per day) and while it definitely worked, it took a lot of time and attention to track everything. I recognize that my current diet may be worse (at least for retaining muscle mass) but the weight loss is about 10x faster, the calorie tracking is somewhat easier (less food to track), and the hunger pangs / lack of energy actually aren't too bad at all.

My current plan is to transition to a more typical cutting schedule once my weight is in a more typical range, which (at current rates) looks to be in about 1-2 months. At that point I'll do something close to what you describe. I'd like to ask though, how do you keep a strict diet without counting calories? I weigh everything and put it on a macro spreadsheet and still worry that it's not precise enough.

RE: protein / kg, I'm (marginally) obese and don't have all that much muscle mass to lose, so I figure 1g / kg will be sufficient; do you disagree? If I'm trying to eat at least 0.3g/kg fat and eat only 1000 calories that leaves me 1.6 g / kg protein max (which is the main reason I'm doing keto). Costco rotisserie chicken has been a lifesaver haha.

I'd like to ask though, how do you keep a strict diet without counting calories? I weigh everything and put it on a macro spreadsheet and still worry that it's not precise enough.

I don't know if keto is significantly different, presumably the need to limit the amount of carbs might require more careful tracking, but I don't weigh every portion. I've weighed my portions once, and I just write:

  • cheese sandwich
  • turkey sandwich
  • cocoa
  • rice
  • chicken curry
  • protein shake
  • fish soup
  • bread slice

and so on. I don't bother recording most vegetables, as they are not calorie-rich enough to bother, so I just have my salads recorded as dressing. If my 2000 daily calories are actually 1800 or 2200, I don't really care as long as I'm not constantly biased in one direction, I'm not a competitive bodybuilder.

how do you keep a strict diet without counting calories?

For me its getting really good at estimations after logging everything in a paid app for a couple of months. Now I just log my weight a few times a week, and the scale keeps me honest. Everything is a habit now. I cook most of the food I eat, and I think thats important. If I go out, I try to eat a filling snack before (veggies, fruit, low-cal smoothie, water, etc). I just assume the calories I consumed while out are double or triple my norm, so I just go hungry for a meal or two afterwards. If the scale is trending up, I just get more strict for the next week and see what happens. The key is never letting the weight creep back up.

so I figure 1g / kg will be sufficient; do you disagree?

I'd up the protein. Iirc the research shows that protein drives lean body mass and helps spare muscle. You may have more muscle than you think and probably want to save it as much as possible. I think you have a lot of headroom for additional calories and should be mindful of crashing, yo-yoing, and lowering your BMR for a few months. Whey and filtered milk (ie Fairlife)/water might be a good low carb protein and calorie adjustment; 40-50g protein, 6g carbs, and 250-300 calories. I don't know much about keto to say if 6g is too much. Also, I do know that people take keto supplements like magnesium for some reason.

I've thought about what you're trying; melt the fat then build back the muscle. The research convinced me to go the very slow route of 0.25-0.5% body-weight loss per week for 15-30 weeks. My base metabolic rate, satiety, and fitness should be exactly where I want it as soon as I'm done. But I love to cook and lift weights so it also suits me personally.

If you go for operation fat-melting, you should start a really dialed-in fitness routine when finished, which should take 4 months to figure out. Done correctly, that should stoke your metabolism. Then you can maintain easily (with keto or whatever). I've had friends that had success going this route. Eventually they found the keto too boring, but I eat a lot of repetitive meals so who knows. You'll gain water weight if you stop keto, which isn't something to worry about. Then just keep your eye on the scale. Best of luck.

As I mentioned before, I got most of my info from youtuber Jeff Nippard. He has a lot of videos going through quality research on diets, proteins requirements, cheat meals/compensatory overeating, rep-ranges, and progressive overload.

Just Interested: how can you measure if you're on track if you aim for such a low goal? If you are 100kg, that would be 250-500g of weight loss per week, which even with a very precise balance may be affected by random variation in water retention and the like - if you weigh less, the situation is even more difficult.

Any idea here?

I'm about 100kg right now, with a goal of 95kg. 250g of weight loss in a week means a net expenditure of some 1900 calories over the week. That alone is quite noticeable to me just from an appetite/ caloric budgeting perspective. In order to end the whole week 1900 calories under maintenance I have to try pretty hard. I don't have room for cheat meals, regular drinking, heavy drinking, peanut butter, empty calorie snacks, etc. I had to make noticeable changes just to get 1900 under per week. I eat so many frozen veggies and chicken breast now! Some weeks I come in 3800 calories under (or theoretically 0.5% bw), but they're the exception. With a calorie tracking app you know exactly where you land. There is random weight variation throughout the day/week, but I habitually weight myself after my morning piss and make a note. The trend is down about 4kg's in 10 weeks. I've got 10-20 weeks left to go. It's the slow and boring route, but time keeps on slippin into the future, and all I have to do is stay the course. At the end, my fitness should be where I want it, and I'll just maintain.

So it's the calories you need to measure, not the weight!

Thanks!

Are stiffness/body pains different from flexibility?

I carry a lot of stiffness around with me to the point I think it worsens my quality of life. I assume it's mostly from prior manual labor plus current weight lifting and running (which unfortunately I'm not willing to stop), so I've always tried to address it with yoga. I spend a chunk of time each day on deep stretches, especially in the points that bother me...and it maybe kinda works? Objectively I've gotten a lot more flexible but honestly my body feels to me just as borked as ever, my neck uncomfortably stiff and aching most times, my lower back hurting noticeably if I stand too long (but not while walking or running for whatever reason). Am I just doing something that doesn't really have any impact on what I'm actually trying to fix? If so, is there something other people have done that's helped with body aches/stiffness? (I've also tried switching up pillows a few times for my neck but not much luck).

Yeah I agree with @TowardsPanna, there’s a lot of stuff with chronic tension/muscular pain we just don’t understand at all.

Some people say it’s emotions, some people say there are trigger points, there are literally a million explanations. Painscience.org is a good starting place if you’re curious.

Basically chronic pain and tension usually aren’t a purely mechanical phenomenon, and treating them as such won’t get you far.

Thanks for the link, I appreciate it

Sarno's Healing Back Pain could help, or also see https://slatestarcodex.com/2016/06/26/book-review-unlearn-your-pain/

both are along the same lines as the other comment

Thanks, that was an interesting read to look through.

Well yes, they can be.

Neck and lower back pain are often associated with psychosomatic tensions. You may be carrying old stressors and anxieties in the body. They tend to get stuck there in humans, while animals tend to just shake them off after each event. Or, you may be on a day to day basis in your current life be tensing up your neck and back every time something evokes aversion, irritation, fear, etc in you. When the mind doesn't know exactly how to deal with a stressor, it will use the body to reflect the unresolved emotion and store it. If you had averse childhood events and/or insecure attachment to one or both of your parents, you're far more likely to get all sorts of stress related bodily issues as an adult. In that case, even light insults to the bodymind may, on a subconscious level, be treated as being quite similar to a much more serious thing in your life history and trigger old patterns.

I may be missing the mark completely here, but I thought I'd mention it anyway, just in case. There are ways to deal with it, let me know if you want info.

There are ways to deal with it, let me know if you want info.

I would definitely appreciate that, thanks

I tried to PM you but got a 405 error. :/