A Journey of Mindfulness--the Remaking of Life in Midstream.

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IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

Ego wrote:
Tue Feb 28, 2023 6:24 pm

I've been doing HIIT classes on a Pelaton bike at the gym lately and I've noticed that a few of the instructors are wearing the monitors. Not sure if they are diabetic or are using them as a training tool. I have my eyes peeled for one for myself and will let you know how it goes if I get one.
That's interesting. It might be a worthwhile thing even for younger, outwardly healthy/fit individuals to start gathering information in that realm as it typically takes decades for issues to accumulate to a severity it will be detected by conventional medicine. At the risk of edging towards a rant, the whole topic is pretty frustrating the more I immerse myself in it--how stubborn conventional practitioners are in refusing to recognize they operate in a flawed paradigm that's allowing a huge societal cost both in healthcare spending (around $4T in the US annually) and many, many people enduring more years of morbidity than they need to. I've now become completely convinced that I essentially need to be my own primary care provider except for signing off on a couple in-case-of-emergency prescriptions related to environmental allergies. Without those I might just go it alone. It's good to see more people taking things into their own hands as knowledge is empowerment. The medical profession seems to just follow a flowchart to select a drug then on to the next patient.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

Sort of a follow-up on the whole health/wellness topic.

I mentioned I started reading Smarter not Harder recently. This is my first detailed exposure to Asprey even though I was aware of his Bulletproof stuff second-hand.

One thing this emphasizes is that when it comes to nutrition, if you get exposed to enough experts you'll quickly start to run into contradictory advice. I'm more inclined to get nutrition advice from enlightened MDs with clinical experience who are essentially functional medicine (think health from a systems perspective), so other than possibly rounding out my supplement regimen a little, this book isn't going to prompt me to make big changes to my nutrition regimen at this time.

But he's the original biohacker in the sense I think he coined the term, so I'm intrigued by some of his ideas about process outside of nutrition. Specifically today I've been thinking about goal-setting within his framework. He stressed serial single goals rather than multiple parallel goals, really just to keep it simple. One of his tenets is that our physiology (the MeatOS) is evolutionarily wired for laziness (meet whatever needs it has with the least energy expenditure), and when faced with complexity the MeatOS will subconsciously urge us to punt. However, since our physiology is a complex system, improvement of one type will tend to bolster other areas as well. He talks about 5 areas/domains of improvement. I'm paraphrasing a little but they are:

-strength
-cardio fitness
-Metabolism/Energy
-Mental Function
-Resilience (lower stress/improve recovery)

I've already selected Metabolism/Energy as my immediate top priority. Actually, if he is to be believed it is a good choice because it is the one that has the most collateral impact on the other domains. I am, however, guilty of explicitly working multiple goals in parallel as I'm also actively taking steps to improve cardio fitness and strength. I don't know if that is verboten.

I'm a little less comfortable in the areas of mental function and managing stress. Mostly that's because I tend to be data driven, and as far as I know at this point gauging improvement in mental function and stress reduction is based on how one feels versus having data that can be analyzed. Even with metabolic health there are a number of easy physiological metrics to get some sense on progress (weight, BP, various blood panel markers, etc.). Maybe later in the book he'll introduce some metrics that can be used to gauge progress, but for now I'm going to put those on the back burner. My intended progression is:

Metabolic health -> Strength -> Cardio -> (brain or resilience)

Since it seems dumb to turn sedentary while restoring metabolic health I'm going to continue on as I have been and consider the progression only when/if conflicts appear. I put strength ahead of cardio just because yak slinging season is coming up fast. Given the types of "workout" activities I can generally sustain, I expect gradual improvement in both.

Now it's time to delve into the hacking techniques. :)

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Ego
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by Ego »

I know that your father's condition has been a motivator for these major changes you are making. Rhonda Patrick just released a very interesting video with Axel Montagne from the dementia research institute in Edinburgh on solving Alzheimer’s and dementia with blood-brain barrier repair. It is a long video but the first minute gives a good overview.

https://www.youtube.com/watch?v=lChdNK0I8bw

I always wondered about the amyloid plaque hypothesis and the type-3 diabetes idea. Both are treatable with drugs so there is a financial motivation for those. It appears that those solutions are symptom-treatment rather than real treatment.

7Wannabe5
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by 7Wannabe5 »

I measure my mental function by doing the NYT Wordle and Mini-Crossword every morning. Less than 4 guesses on Wordle and less than 1 minute on X word and it's probably going to be a low brain fog day. Oddly, I would say that tutoring kids in math actually does more towards keeping me sharp than working on M.S., because I'm better able to B.S. my way through the coursework.

I agree that metabolism/energy/vigor is overall most important towards quality of life, but it has been my experience that there can be some friction between self-directed muscle-beach lifestyle vs. self-directed brain-in-box lifestyle. Maybe just because I always feel like I have to choose whether to write a two page paper OR take a hike in the woods after my second cup of coffee in the morning. When I bring other humans into the mix that changes the dynamic.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

Ego wrote:
Wed Mar 01, 2023 10:07 am
... Rhonda Patrick just released a very interesting video with Axel Montagne from the dementia research institute in Edinburgh on solving Alzheimer’s and dementia with blood-brain barrier repair ...
Thanks, Ego, I'll check that out. I watched a podcast recently that talked about plasmalogens (I think they're involved in protecting neurons among other things) and when in short supply in the brain is when cognitive decline begins. For the most part plasmalogens are produced in the liver, suggesting dementia is actually linked to liver disease/decline. The blood/brain barrier is a place with a fairly high concentration of plasmalogens, and maybe the BBB is indeed a critical juncture. Another intriguing thing is that low plasmalogen levels in the blood precede manifestation of dementia by about 7 years on average, so if one monitors those levels you get somewhat of an early warning (good for making sure one has their affairs in order as it were) for the onset, if not a signal to do something about it. Goodenowe claims his supplement is the only biologically available method to increase plasmalogen to healthy and even "biochemical reserve" levels when the body/liver lose the ability to produce them.

The guy's name is Dr Goodenowe (and as alluded to he has supplements to sell)

I thought about getting some and trying to get my dad to take them along with a few other things that can goose brain health. Unfortunately his interest in learning about and upgrading nutrition based on science ended about the time he finished Jim Fixx's first book.
Last edited by IlliniDave on Wed Mar 01, 2023 2:47 pm, edited 2 times in total.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

7Wannabe5 wrote:
Wed Mar 01, 2023 10:41 am
...
I agree that metabolism/energy/vigor is overall most important towards quality of life, but it has been my experience that there can be some friction between self-directed muscle-beach lifestyle vs. self-directed brain-in-box lifestyle. Maybe just because I always feel like I have to choose whether to write a two page paper OR take a hike in the woods after my second cup of coffee in the morning. When I bring other humans into the mix that changes the dynamic.
To the best of my knowledge I don't think I've ever had "brain fog" except in the throes of a severe hangover. I'm mostly a de facto non-drinker now so it doesn't happen very often, and when it does the solution is quite obvious: put the tequila away. And I've never felt like I've had a hard time dealing with stress. It comes and goes as events warrant, but I can't put a finger on anything that convinces me there's anything chronic about it. Of course, improving stress management is probably an unqualified good thing, it's just in my not-urgent, only-somewhat-important quadrant at this time.

Exercise, especially so-called "resistance training", is actually one of the very best things a person can do in support of cognitive function. So increasing/maintaining muscle mass is one of the best low fruit things an aging person can do to extend their cognitive horizon, along with other obvious benefits it gives. That's the thing about truly complex systems--cause-and-effect is multidimensional and is not always obvious. So going uber librarian to the exclusion of keeping the Meat and the MeatOS running at a high level may actually hurt the pursuit of being the best uber librarian possible over the long haul.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

One thing I forgot to mention in my February update is the regimen's impact on my body temperature. Measuring with an oldschool oral thermometer, for most of my adult life my "normal" temperature has been in the range of 97.5-97.8 degF range. Back in 2020-2021 I was on an honor system of checking my temperature daily before reporting to work, so I know that range above is pretty accurate over an extended time at approximately the same stage of life, which is consistent with what I remember from older observations. Those ~15 mos included periods of restricted carbs and weight loss as well as my autumnal fattening periods.

When I first started the new regimen at the end of January I checked my temp several consecutive days and all the readings were 97.6-97.7 degF. But over time that has crept up to now around 98.3F in recent days. I don't measure temp every day, and haven't been recording the data, just have that anecdotal observation.

The reason I decided to monitor temp is because of what I'll call Gundry's Keto Code Hypothesis. I call it that simply because I read it in his book and don't remember all his attributions to original researchers on the topic. The research comes from others and he primarily assembled and presented it in layman's terms. The premise in The Keto Code is that certain steps can be used to "decouple" mitochondria and achieve metabolic rejuvenation of a sort. In the framework he presents, one of the things decoupled mitochondria do is replicate. Another thing is the now larger population of mitochondria individually convert more energy into heat and less into ATP compared to the prior lesser "always coupled" population. So I decided to check and see if that additional heat would be detectable as a test of plausibility regarding whether I was achieving the uncoupling.

I was skeptical, tbh, and now am a bit surprised and encouraged. Correlation and causation having the relationship they do means I can't say anything with certainty, but at the same time I can't completely dismiss the observation. I also don't have much of a solid indication in the data I have that this has turned into noticeably higher metabolism of fat stores, but I haven't really looked for it. I can say that compared to last year (first year I had a way to measure) my breath ketones consistently measure higher than they did in 2022. But enough has changed year-over-year in the overall regimen that there are enough variables I can't pin anything on just one.

I should also note that Gundry never asserts in the book that the regimen will result in increased body temperature detectable by a simple thermometer, just that increased energy inbound to mitochondria will be shunted to heat.

Just tossing that out there for the morbidly curious.

7Wannabe5
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by 7Wannabe5 »

That's the thing about truly complex systems--cause-and-effect is multidimensional and is not always obvious. So going uber librarian to the exclusion of keeping the Meat and the MeatOS running at a high level may actually hurt the pursuit of being the best uber librarian possible over the long haul.
Two words. Stephen Hawking. I had to temporarily make him my new role model while I was feeling too sick to do much of anything physical last year. However, it is the case that Nassim Taleb, whose practice-towards-erudition of 30+ hours reading per week I could only hope to follow, does also engage in some kind of muscular workout regimen. At my age X current level of pudge, it probably would be best if I dropped out of the M.S. program I am currently pursuing and devoted those hours to renew my practices of Scavenger Walking and/or Water Aerobics/Swimming.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

7Wannabe5 wrote:
Thu Mar 02, 2023 9:34 am
Two words. Stephen Hawking. I had to temporarily make him my new role model while I was feeling too sick to do much of anything physical last year. However, it is the case that Nassim Taleb, whose practice-towards-erudition of 30+ hours reading per week I could only hope to follow, does also engage in some kind of muscular workout regimen. At my age X current level of pudge, it probably would be best if I dropped out of the M.S. program I am currently pursuing and devoted those hours to renew my practices of Scavenger Walking and/or Water Aerobics/Swimming.
I haven't heard any sort of argument that Hawking was brilliant because of ALS. He lived 55 years with it, which is remarkable and probably speaks to the underlying strength of his physiology. The only person I've had a connection to with ALS went from apparently perfectly healthy 40-something to funeral in 3 years.

I think your conflating my point, which is one of my standard ones just dressed up for a different domain. It's not an either/or dichotomy. Like most things, the optimum is found on the both/and continuum. And in regards to the Meat (of which the brain is a subset) it appears that "optimum" in any one dimension is often approached when attention is given to all dimensions since it's increasingly clear they all support each other. So an overall healthy physiology means an overall healthier brain in general, and in turn a healthier overall brain, especially the MeatOS aspects of the brain, promote a healthier overall physiology. There appears to be very little orthogonality in a human being.

I think it's possible for nearly all people to find a physical improvement regimen that would have efficacy and not require abandonment of intellectual pursuits. I spend considerably more time the vast majority of days on intellectual and artistic pursuits than I do on "fitness", with admission that a significant minority of the intellectual pursuits are periodically directed towards education on the topics of health and fitness.

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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by jacob »

Nerd-alert: I wrote a 31 page essay on Hawking in 11th grade. About half-way in there's a comment from my teacher in the margin wondering "where I'm going with this?" (I spent the first 10+ pages talking about Newton and the basics of quantum physics. I guess I just got carried away finally getting an essay assignment that interested me instead of the feely-social topics that comprised almost all the regular writing assignments.)

Anyhoo, Hawking was certainly brilliant before getting diagnosed---the "passing the test after studying all afternoon" kind of brilliant. He started experiencing the ALS symptoms in grad school. He was already a theoretician and so was able to make it work. I don't know if he holds a record but ALS is usually a quick death sentence measured in years, not several decades. His specialization in black hole physics lent itself eminently to being mostly locked in [his head]. General relativity is very geometric (albeit 4D+) and so it's more vision-logic than rationalizing (more visually oriented than deductive). Had he gone into quantum field theory instead, he'd been SOL.

Thus ... it may be that ALS was able to focus 100% of his efforts for several decades on something he already has both a talent and a solid base for w/o getting distracted by humaning.

7Wannabe5
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by 7Wannabe5 »

@IllinDave: Oh, you're absolutely right in terms of general systems theory. Anyways, my true limiting factor is self-discipline, not time. I've lapsed into being far too much an overly-indulgent grandmother towards myself since I've been ill. The funny thing is that out of all the 7-year-plans and bucket list items that my illness was threatening to make impossible, I focused the most on the loss of my end-of-life plan for if I made it to Age 85-92, which was supposed to be something like- Eat all the pastry I want while constructing large erotic garden sculptures.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

7Wannabe5 wrote:
Thu Mar 02, 2023 11:17 am
@IllinDave: Oh, you're absolutely right in terms of general systems theory. Anyways, my true limiting factor is self-discipline, not time. I've lapsed into being far too much an overly-indulgent grandmother towards myself since I've been ill. The funny thing is that out of all the 7-year-plans and bucket list items that my illness was threatening to make impossible, I focused the most on the loss of my end-of-life plan for if I made it to Age 85-92, which was supposed to be something like- Eat all the pastry I want while constructing large erotic garden sculptures.
Yeah, consistency isn't my strong suit either. Irrespective of my age when the end comes, everything I'm focused on now is through the lens of trying to extend my healthy life span as close to my absolute life span as possible. Probably excludes unlimited pastries sadly. I don't know anything about the system theory that gets talked about here, just the mundane engineer's viewpoint that practicality necessitates.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

jacob wrote:
Thu Mar 02, 2023 11:00 am
... Thus ... it may be that ALS was able to focus 100% of his efforts for several decades on something he already has both a talent and a solid base for w/o getting distracted by humaning.
Seems plausible, although most of his peers didn't have the same "advantage". I'd guess a big part of the reason he fought it for 55+ years is that it didn't completely derail his passion in life, which as you point out was largely an internal thing. IMO, speaks to the importance of having some sort of a north star (to steal an unpopular idea from a different thread) to fight off entropy.

Many of the various authorities I've been delving into put a lot of emphasis on mental and emotional well being as central to any attempt to extend metabolic health and healthy lifespan, and the importance of solid metabolic health to maintaining mental/emotional well being. Seems like there are no single knobs or easy buttons in such an endeavor. Luckily it appears improvement in any single domain spills over into all the others as well.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

Sort of a random observation. I've getting near full-swing as far as adding bands to my resistance training regimen. I had my nephew help me put together an anchoring ladder (for lack of a better term) to facilitate variety in lines of push/pull. One thing I've found I didn't really anticipate due to lack of foresight on my part is that standing and pushing/pulling bands away from/towards the body puts a noticeable demand on ones core/balance since the force exerted by the stretched bands are often enough to rotate the body. Iow, say 100 lb of upward force is a much different mechanical situation than 100 lbs of sideways force (like a "standing" bench press or push up). So I feel like I'm getting a bit of a bonus in that regard in both muscle improvement and neurological stimulus/balance. I tried googling to see if that was a bona fide "thing" but couldn't really find anything except links to ab workout routines. I don't think I'll get a ripping 6-pack from what I'm doing, but my intuition tells me that when one of my end goals is hoisting and manhandling a moderately heavy cumbersome object the bands have some advantages compared to working with something a little more predictable and balanced like a bar or dumbbells.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

March Scorecard

I'm posting this a day early so it's likely some of the numbers will change slightly, but the gist of it should be accurate.

Rolling 12-month monthly expense < monthly annuity rate: 92% Good
Rolling 12-month monthly expense < instantaneous monthly equivalent 3% WR rate: 83% Good
Stash Assessment: Fair, trending slightly positive.

Stash still down around 7.7% since retirement but up a bit over 3% for year. February spending acceptable per my plan and still well below annuity income.

Nutrition and Health

iDave(3/1/2023)=iDave(2022)-17.8 lb.
iDave(3/31/2023)=iDave(2022)-26.2 lb.

My disappointed in weight loss rate at the end of February continued through all of March. To quantify:

Average Weekly Weight Loss by Month:

Jan: 2.27 lb/wk
Feb: 2.56 lb/wk
Mar: 1.40 lb/wk

I project to come in about 10 lbs above target on appointment day. It will still be my lightest body weight since 1999, so it wouldn't qualify as a fail but if things continue as they have the last few weeks it'll be a bit of a letdown.

I don't have an explanation for the substantial slowing of weight loss. My diet/nutrition was very consistent through the month and the prior 6 weeks going back to mid-January. My ketone levels through the month, measured twice per day, were about 25% higher in March than February. I'm not taking any exogenous ketones or things like MCT oil, so the ketone levels would be expected to indicate fat metabolism. I suppose it is possible I'm just processing dietary fat more efficiently into ketones. The things that did change were my weekly activity levels, which have increased by roughly 50%, mostly via more frequent/longer walks/hikes. Also my strength/resistance training increased 2 or 3-fold although the volume is low compared to what is typically practiced. I'm trying some of the hacks outlined by Asprey in his new book. I think offsetting maybe 0.25 lb/week of fat loss with lean tissue increases isn't out of the question, but that still leaves me 0.5-1.0 lb/week short. Unless Asprey's hacks are extraordinarily effective (something I doubt) that "extra" weight isn't going into increased muscle.

Per the belt notch test I've gone down 2 notches since January, which is a pretty reliable indication I'm shedding visceral fat which for me is a very good thing.

Per the eyeball test I do appear leaner and, with the caveat I'm pushing 59 years old, arguably more "defined" than I have in a while. No real indication of any more than subtle lean tissue increases from that admittedly subjective measure though.

FWIW, my BMI is now down into the high end of the "healthy" range, although that measure is not one that I put a whole lot of stock in.

Blood pressure and resting heart rate continue to improve. Comparing the last 10 days of February to the last 10 days of March:

-systolic ave from 110.5 (high 123) to 107.8 (high 119), -2.7 mmHg
-diastolic ave from 70.9 (high 75) to 65.2 (high 73), -5.7 mmHg

And ave resting heart rate went from 66.5 to 62.5, -3.9 bpm

I'm starting to occasionally get resting heart rates below 60 in the morning. Should note that I don't measure it immediately upon waking while still in bed, but usually after I'm up moving around for 15-30 minutes.

On balance, I'm starting to wonder how much lower my BP can go before it's an issue.

Implied V02 max from my rowing activity has improved almost 78% since my first benchmark in February although it is still nothing to brag about.

Heading into April

My focus in April will remain on health and fitness. Specifically I want to key in on "perfect consistency" of nutrition so I get a good data point on how avoiding poor nutrition decisions affects my blood work, which I'm hoping to get done late April or early May leading into my first appointment with my presumptive new primary care doc.

I also put in a call to a local "function medicine" doctor/facility. Nothing set up yet but I'm hoping to get in for a consultation to see if going that route versus a traditional primary care practitioner might be more suitable for me. The website for the practice implies it might be a little more focused on treating things like bad autoimmune problems and tough-to-treat maladies like Lyme disease, as opposed to my goals which are more attuned towards maintaining as optimal a state of health as possible and avoiding the conditions they tend to treat.

I've started staging and when necessary procuring items for the summer up at the hideout. I'm hoping to get the kayak on the water next week or the week after. The early spring has been pretty wintry so far (still have snow in the forecast over the next couple days) and since I put off purchasing a good dry suit I need to wait until both the air and water are a good bit warmer than they are now.

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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by Western Red Cedar »

IlliniDave wrote:
Fri Mar 31, 2023 6:46 am
Average Weekly Weight Loss by Month:

Jan: 2.27 lb/wk
Feb: 2.56 lb/wk
Mar: 1.40 lb/wk

I project to come in about 10 lbs above target on appointment day. It will still be my lightest body weight since 1999, so it wouldn't qualify as a fail but if things continue as they have the last few weeks it'll be a bit of a letdown.

I don't have an explanation for the substantial slowing of weight loss. My diet/nutrition was very consistent through the month and the prior 6 weeks going back to mid-January. My ketone levels through the month, measured twice per day, were about 25% higher in March than February.

Per the belt notch test I've gone down 2 notches since January, which is a pretty reliable indication I'm shedding visceral fat which for me is a very good thing.
Congratulations on the continued progress with your health!

I've refrained from chiming in over the past couple months as it is clear you've put a lot of thought towards this. Just keep in mind that the body adapts during the weight loss process and it gets harder to lose weight the leaner you get. I think 1.4 pounds a week is great for someone at a healthy BMI. It is probably a better balance in terms of fat loss and maintaining lean muscle IMO.

Your initial goal and timeline sounded extremely ambitious in terms of your ability to lose weight without losing too much muscle. You are making great progress, so celebrate the wins and don't worry too much about an arbitrary deadline. Make sure the new lifestyle is sustainable.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

Western Red Cedar wrote:
Fri Mar 31, 2023 12:20 pm
Congratulations on the continued progress with your health! ... Make sure the new lifestyle is sustainable.
WRC, you're welcome to chime in any time, of course. Thanks. That last thing you said is going to be the hardest part--figuring out how to wind this down and get into a regimen that avoids the dangerous derailments I'm prone to. Fortunately I have a lot of time to dedicate to it being out of the workforce. The first step is to work up a plan for the ~4 mos I'll be at the hideout with limited variety in what I can get in terms of groceries. The goal will mostly be to maintain weight, stay active, and avoid abusing my liver.

I agree that on balance things are going pretty well. I decided to eat enough berries (wild blueberries, raspberries, and blackberries...yum!) last night to kick myself out of meaningful ketosis just as a reset, so we'll see what that does. I might extend that to a high carb day today as well. And I'm also considering a supplement stack mod--one particular one I happened to have started right around the time I hit this recent stubborn plateau. Nothing I'm taking should have any sort of anabolic effect, everything is geared around mitochondrial health and metabolic efficiency. You're probably correct in that I'm probably moving asymptotically towards some physical size/composition near what my body thinks is ideal for itself. The main thing going into my appointment next month is to continue the good nutrition and activity levels and take stock/reevaluate if necessary when the new blood work is available. Last check I was around 186.5 lb @ 6-1ish which isn't terrible and if I can get 6-8lb off before I head to the hideout I'll feel pretty good about it.

IlliniDave
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by IlliniDave »

Couple add-ons to yesterday's monthly.

My siblings and I are starting to think more urgently about some long-term care options for my dad. My sisters seem to favor having him move to an assisted living-type place (which in the past he's refused to consider). My brother and I tend to favor an in-home healthcare-type option as the next step. We just passed the 5-yr anniversary of my mom's passing Friday, and Dad's still not fully embraced all that goes into taking care of oneself. And after 5 years and him coming up on 84-years-old it's pretty clear he's never going to "get it". Truth be told, some of it is due to his sort-term memory struggles, but it's not all due to incompetence--he just doesn't give two shits about a lot of stuff and without Mom around to keep on him, nothing happens. IHHC options apparently include someone going over multiple times per week, do/help him with a number of household chores, make sure his prescriptions are in order, and do some top-level health monitoring. Or at least that's my understanding. Seems like there's room for that within his means and it would provide some added peace of mind at least for me--means I will fret less when I'm away for four months at the hideout. Other options are a lesser degree of IHHC and hiring a cleaning service to come over a couple times a week to keep some of the entropy at bay.

And we're going to present him the option of assisted living along with it--but sadly are going to try to strong-arm him one way of the other this time. If he opts for assisted-living that's fine. A potential benefit of it is having a ready-made community of sorts to replace his dwindling circle of friends. Potential downside if he's forced into it is that being forced out of the home he's had for the last 56 years might sever whatever connections to the past that are holding his mind together and accelerate his decline. I think hiring replacements for my mom is the likely near-term route we'll take. I've said all along that I'm willing to help him with household chores and the like, but that I am not going to do it all for him since he's still capable of considerably more than he actually does. Maybe that makes me a bad son, dunno.

On a more somber note, one of my cousins who is basically the same age as me went into the ER because he thought he was having a heart attack and wound up diagnosed with lung cancer (not sure which stage) and right out of the gate hit some complications with the chemo/radiation. Brings to mind the question: if not now, when?

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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by 7Wannabe5 »

Another possibility which is slowly growing in popularity would be to find another senior to move in with him, and then split the home health aide/cleaning person expenses between them. My mother is right around the same age as your father, but probably at least a level more into decrepitude. She is still getting by with cleaning service and health aides coming in to her apartment in a senior complex, but her visits to the ER followed by weeks long stays at short-term nursing facilities are becoming quite frequent. Also, her mobility issues combined with the fact that it's harder to keep her medicated for bi-polar disease with all the other medications she needs causes her apartment to become a very bizarre hamster cage sort of mess very quickly. She has items from the grocery store delivered as frequently as 3x per day, so all the people who gig for the delivery service know her, which in a weird way turns out to be helpful, because she just tips them a bit extra, and they help her out with other tasks. They also check in on her when they're making deliveries to other seniors in her building. "Active" senior complexes are quite a bit less expensive than assisted living, but some provide a number of the same benefits. For instance, all the community services available to seniors, such as meals on wheels, will be more readily available to seniors who are clustered together with other seniors, rather than living in their own homes or apartments surrounded by mostly younger people.

ffj
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Re: A Journey of Mindfulness--the Remaking of Life in Midstream.

Post by ffj »

We have very similar circumstances other than having to force action just yet. My father is slightly younger than yours and is still highly independent and just as much stubborn. If he goes to the doctor something is truly wrong and he sure as hell won't tell you about it. Even when my mother was still with us all of us kids never were made completely aware of the extent of some issues. The same goes for finances as I truly have no idea where his financial situation stands. If you ask him about anything he'll shut you down fairly quickly as he feels it's none of your business.

As in all families with multiple children there is probably going to be some complications once he's gone and most likely before if he lives long enough and as a planner I would like to help him address some of these issues before the inevitable but I have no clue on the status of anything and he's not offering information. If you bring the subject up he'll tell you it's under control and not to worry about it. If I didn't have snooping sisters I wouldn't be aware of anything really.

Thankfully he is doing well in most regards so nothing is imminent but I can easily see my situation morphing into yours several years in the future. We do have the benefit of having a sibling that lives right next to him so that helps greatly.

Regarding the bad son self-reflection, I wouldn't give it much thought. People choose how they want to live, even parents, and imposing your standard when he doesn't care just frustrates the both of you. Now obviously if the situation became really bad then action is warranted but I wouldn't sweat the small stuff.

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