liminality

I no longer have constant concussion-type symptoms (which I’ve had for 5 years, debilitating levels of symptoms) and my joints don’t go out of place as much because the inflammation has gone waaay down. Also pretty minimal side effects, and my weight just went down to the weight I was stable at for 10 years before a migraine med (that didn’t even help the migraines) made me temporarily hypothyroid a couple years ago. I basically fluctuated in a ten pound range for a decade without any conscious effort, and now I’m back to that point. (And my thyroid markers are back to what they were before the migraine med. Topiramate was terrible for me.) I’m not “skinny”, just kind of… vaguely average sized, but that’s my normal.

It’s been a miracle drug for me that’s given me my brain back, so I don’t want people to be discouraged from it for pain/chronic illness reasons!! An MCAS study found that no one in their (admittedly small/preliminary) n=30 study became underweight in it and suggested it’s more of a “weight normalizing” med than a “weight loss” med.

The weight loss hype is obscuring the medical benefits and also the weight loss dosage protocol is terrible (they go up in dose so fast!). If you stay on the lowest effective dose (or even microdose if that’s an option for you, tho that generally requires paying out of pocket), it has way fewer side effects. Tirzapetide (eg zepbound) also seems better tolerated and more effective for the chronic illnesses it helps (basically any condition that involves chronic inflammation) than semaglutide (eg ozempic).

Conditions it seems to help with:

Hashimoto’s and Graves’ disease (+ other thyroid issues) - this review goes a bit more in depth about GLP1’s immunomodulation and inflammation regulation effects

Rheumatoid arthritis (improved arthritis symptoms independent of weight loss)

Migraine

MCAS

PCOS / PMOS

Addiction and substance abuse

Multiple sclerosis (including remyelination - the remyelination study was on rodents, but I’ve seen a ton of MS patients talking on Reddit about how after being on a glp1 for a while, their imaging showed remyelination, which is wild to me), and here’s one on physical activity of MS patients on glp1. (There are a looot more studies on MS and glp1s, MS has had more research in this area for longer than a lot of others.)

Lupus

Long COVID (preliminary study, but there’s currently an n=1000 study in the works that should be out next year)

Neurodegenerative conditions (mostly neuroprotective, iirc it doesn’t reverse the effects of existing Alzheimer’s/dementia, but it has shown some evidence of improving cognition in Alzheimer’s patients)

Fibromyalgia

probably some I’m forgetting (eg anecdotal reports of it helping with OCD, PTSD, etc, which makes sense because of how trauma and inflammation and the immune system are linked). Basically any time I think of a condition that involves chronic inflammation, I do a search to see if someone’s studied it re glp1s yet, and usually the answer is yes.

ETA: I should probably mention the on-label/approved uses like liver disease, diabetes, sleep apnea, cardiovascular risks.

A lot of these studies were done before the pharmaceutical companies got involved, it’s a lot of practitioners (esp rheumatologists) seeing their patients’ symptoms drastically improve on a GLP1 another doctor (like a pcp) prescribed for diabetes or weight loss or the like, and doing case studies or collaborating with universities for small preliminary studies over the past 5+ years.

Larger studies will probably have more pharm funding, now that the pharm companies are aware of these possibilities. but if it gets us on-label approval for using these meds to treat the above conditions and have them covered by insurance, I’m not gonna complain.

There is a very abundant supply of such articles and a recent one especially annoyed the hell out of me because it (without actually mentioning the idea of disability) repeatedly alluded to accommodating a kid's sensory issues as example of parents being too permissive or failing to teach kids to tolerate discomfort.

That's bullshit because being in tune with your own needs and discomforts sensory wise is so fucking important for being able to adapt and function in the world.

Like, just an example, I got rid of almost every piece of clothing I own that was polyester or a polyester blend and just doing that dramatically improved my life and gave me more ability to cope with stressors, because I figured out that a lot of my sensory issues with clothes came from bad temperature regulation and the scratchy pills that polyester blends make.

"Discomfort tolerance" has never been super helpful as a concept for me. I have no problem tolerating discomfort in the sense of like, not doing anything about the thing that's hurting me. It's just that if I do it for too long, I can't think straight and process what's happening around me and I eventually become so fatigued it feels like I've got a fever, or else become uncontrollably angry.

I think "discomfort curiosity" is way better concept. You feel uncomfortable. What is the feeling like? Where in your body do you feel it? What does your body urge you to do about it? When does it start? What is it responding to? What about that thing makes you feel that way? Feel it...Experiment with it...Dabble in it...Play with it. I say curiosity because curiosity is so closely related to fear and to some extent, disgust. Curiosity is a frontier zone between repulsion and fascination.

Curiosity is an instinct that encourages us toward unfamiliar things, not away from them. It is part of a large landscape of feelings where away-instincts and toward-instincts are blended together.

I think of the difference between curiosity and fear to be like the difference between solitude and loneliness, or like excitement and apprehension. Or, think of exploring an eerie abandoned place, one of the "liminal spaces" the internet speaks of. The place is "eerie" which is closely related to fear, but the "eerieness" shades into becoming a positive stimulus that our instincts are drawn toward. Liminal spaces, for those of us that enjoy them, are "creepy," but they are also "nice" at the same time. And the "creepiness" is part of the "niceness."

And curiosity is sensitivity. It allows for openness and playfulness toward the unknown.

Many humans' relationships with their own urges and instincts are based on domination and punishment. Tyranny over the body by the mind. The goal is to absorb without shock and endure without indulging the urge to seek relief, to reduce your attunement to your body.

But the ability to be "less controlled by" your body's urges is not positive, because your body is providing information about what your needs are. I find that the ability to make reasoned decisions about how and when and why to persist through something painful requires a deeper attunement to the body's instincts, not a greater ability to ignore them.

Stop treating your bodies like they're animals in a cruel experiment to be shocked with electricity until they lay on the floor whimpering in helplessness. It doesn't help.

I think sensory discomfort, pain, etc shrinks that window. I noticed with my youngest that, when he started on medication for ADHD, his window grew because he was no longer wrestling with his brain as much.

ID: A youtube comment with 11 likes by Niceone, it says "I've lived 46 years without knowing this. How nice of life to save some of the best bites for later." End ID.

This confirms that there is a civilization older than the Sumerians that we have yet to find

Some people get existential dread from this

Source (non Aboriginal)

And a quote I picked out from a longer interview with an Aboriginal local elder about the area where he touched on the history

Sean: .....yes. absolutely

Elijah: 100 percent.

The Shire is excellent farming country, with consistently good weather, and only one tough winter in living memory; hobbits like to produce large families; they’re resistant to disease, rarely violent, and encounter few dangers. It is usual for hobbits to produce many children, so that (for example) Bilbo and Frodo are unusual in both being only children, with no siblings, and not having children of their own. All of this should point to a population that increases every generation if not doubling outright. Young people (and their ideologies!) should rapidly outnumber the old with an ever-increasing effect and impact on society. However, the Shire has a surprisingly stable history; it never seems to increase or decrease greatly in population, and the bell curve of age seems… demographically balanced? There certainly isn’t a conflict from rising young bloods challenging the middle-aged reactionaries; there’s no unemployment; there are no housing crises or waves of emigration, or even a tendency for young people leaving home to marry. Meanwhile, not only does the Shire not suffer from internal pressures, but it remains obscure and hardly noticed in global politics.

What makes sense here is that adult hobbits form a loose group. Four parents in a polycule, between them all, may produce four children. All four parents claim to have four children. An outsider would assume this meant the adults had eight children.

Hobbits therefore are not especially fertile or fecund. They simply have large families. Much of their interest in genealogy is due to the complex relationships of blood-kin, hearth-kin, love-kin and pledge-kin, who must all be carefully tracked and measured - not just because you need to make sure that you don’t climb into bed with an un-permitted degree of blood-kin, but to track family alliances and carefully quantify the precise level of thoughtfulness to put into the proper present to gift your father’s lover’s lover (too much implies a degree of intimacy that might upset the polycule.)

Thus, while a hobbit matron may tell a startled dwarf that she has seven sons, she might only have borne five of them herself, and have one hearth-son by her wife, and a pledge-son of her first husband’s. There are between three and four fathers involved at various stages of production, from conception to pledge-duty, but there is debate about the precise number of fathers, as one child was festival-conceived and therefore provisionally pledged to the Brandybucks until more distinctive paternal traits should materialise. It’s expected that four of the sons will be uninterested in women, and their contribution to family life will be in raising hearth-children and pledge-duty. However, this level of detail is normally negotiated later in conversation, as a mutual overture of friendship. So she’s just clear and simple: yes, certainly, she has seven sons. Yes, they’re all hers. Yes, that’s fairly normal - yes, hobbits like big families. How big? That’s really hard to say! Well, about thirteen hobbits live in her house… er, she has forty-three nieces and nephews. Yes! She has nine siblings, that’s correct, but some of them are still babies themselves..

In this way, a bewildered dwarf might assume that hobbits are absurdly fertile, producing an average of seven children per couple, at an absurd pace.

When in fact, with about half of hobbits never bearing biological children, the population of hobbits is pretty much always the same.

Tl:dr, hobbit population works perfectly well, both internally and in the perceptions of outsiders, if the majority of the Shire is gay, they’re all polyamorous, and they all firmly claim to be parents of high numbers of children. Of course Frodo fathered Sam’s kids - he named them! They were pledge-kin but not hearth-kin, as Frodo needed a lot of quiet and stability in the home.

In short, all of the hobbits enjoyed achieving even larger families on their adventures, legally and without argument or debate. It’s free real estate. If nobody else is going to sibling these losers, we will. (The condensation of so many entanglements at once also legally made Pippin his own father-in-law.)

Gandalf never explained.

Inheritance follows parent-child pledge as the primary consideration, with matrilineal descent as the secondary. Pippin would have been bewildered to gradually understand that Denethor held his two sons in such odd and different standing :-/ hobbits don’t recognise kingship so it would’ve been very upsetting and disappointing to Pippin to understand how Denethor stood in position of sworn-father to a whole city of people without even being slightly fair to his younger hearth-son. Aragorn is demonstrably much better dad-material and therefore had Pippin’s vote. Pippin, by virtue of being an excellent father-in-law to a spectacularly promising young son-in-law, also considered himself a better candidate for king of Gondor than Denethor, by outranking him in Dad Competence - but was too busy by the time he realized this to point this out .

I think it's a vicious cycle; when people don't know something exists, they're not curious about it. Also, people use conceptual categories to think about things, and when a topic falls between or outside of conceptual categories, it can end up totally omitted from our awareness even though it very much exists and is important.

@icannotgetoverbirds It already is a maddening, bizarre research hole that I have been down for the past few weeks.

Basically, I learned that we have native bamboo, that it once formed an ecosystem called the canebrake that is now critically endangered. The Southeastern USA used to be full of these bamboo thickets that could stretch for miles, but now the bamboo only exists in isolated patches

And THEN.

I realized that there is a little fragment of a canebrake literally in my neighborhood.

HI I AM NOW OBSESSED WITH THIS.

I did not realize the significance until I showed a picture to the ecologist where i work and his reaction was "Whoa! That is BIG."

Apparently extant stands of river cane are mostly just...little sparse thickety patches in forest undergrowth. This patch is about a quarter acre monotypic stand, and about ten years old.

I dive down the Research Hole(tm). Everything new I learn is wilder. Giant river cane mainly reproduces asexually. It only flowers every few decades and the entire clonal colony often dies after it flowers. Seeds often aren't viable.

It's barely been studied enough to determine its ecological significance, but there are five butterfly species and SEVEN moth species dependent on river cane. Many of these should probably be listed as endangered but there's not enough research

There's a species of CRITICALLY ENDANGERED PITCHER PLANT found in canebrakes that only still remains in TWO SPECIFIC COUNTIES IN ALABAMA

Some gardening websites list its height as "over 6 feet" "Over 10 feet" There are living stands that are 30+ feet tall, historical records of it being over 40 feet tall or taller. COLONIAL WRITINGS TALK ABOUT CANES "AS THICK AS A MAN'S THIGH."

The interval between flowering is anyone's guess, and WHY it happens when it does is also anyone's guess. Some say 40-50 years, but there are records of it blooming in as little time as 3-15 years.

It is a miracle plant for filtering pollution. It absorbs 99% of groundwater nitrate contaminants. NINETY NINE PERCENT. It is also so ridiculously useful that it was a staple of Native American material culture everywhere it grew. Baskets! Fishing poles! Beds! Flutes! Mats! Blowguns! Arrows! You name it! You can even eat the young shoots and the seeds.

I took these pictures myself. This stuff in the bottom photo is ten feet tall if it's an inch.

Arundinaria itself is not currently listed as endangered, but I'm growing more and more convinced that it should be. The reports of seeds being usually unviable could suggest very low genetic diversity. You see, it grows in clonal colonies; every cane you see in that photo is probably a clone. The Southern Illinois University research project on it identified 140 individual sites in the surrounding region where it grows.

The question is, are those sites clonal colonies? If so, that's 140 individual PLANTS.

@motherfucking-dragons

it's called the Alabama Canebrake Pitcher Plant and there are, in total, 11 known sites where it still grows.

in general i'm feral over the carnivorous plant variety of the Southeastern USA. we have SO many super-rare carnivorous plants!!!

I was in the canebrake near my house again this morning, and river cane is extraordinarily good at completely blocking the view of anything beyond it. It is bushier and leafier than Asian bamboos, and birds like to build nests in it. It would make a fantastic privacy barrier.

The cane near my house is around 10-12 feet tall. This species can reach 30 feet or more, but I think it needs ideal conditions or to be part of a large colony with a robust system of rhizomes or something.

Well, several reasons. As y'all may know, bamboo is stronger than any wood, and therefore it makes a fantastic building material.

The Cherokee used, and still use, river cane to make fishing poles, fish traps, arrows, frames for structures, musical instruments, mats, pipes, and absolutely gorgeous double-woven baskets that can even hold water.

Here's some distinguishing traits I've observed myself:

River cane has a really full, bushy, leafy look that makes it really hard to recognize as bamboo from a distance, because the stems are harder to see. The shape of the individual cane with its branches and leaves is narrow, because the branches spread out very little, but the foliage is DENSE. It's like a plume.

River cane is stronger, denser and heavier than invasive bamboos I've seen.

River cane stems are always green all the way around, no yellow (unless the plant's been dead for a good long time)

River cane stems feel smooth like plastic to the touch. The common invasive bamboo I've seen here, when you run your hand upwards along it, the stem feels awful like sandpaper.

The biggest way to distinguish them: River cane grows 6-4 feet tall when it's in little patches, and up to 10-12 feet when it's in a large size patch (like, the size of a backyard) It is known to reach up to 15 feet tall nowadays and historical records claim heights of 30 feet or more in fertile river valleys. I really want to stress that it's RARE for it to get big. A canebrake will almost always be many times wider than it is tall (sometimes they grow in very long strips along fence rows)

The best time to look for it is in winter before things leaf out, because it's evergreen and grows in dense masses, making it easy to spot.

Some more cool stuff i've found out—River cane was a common food of bison! Earliest European settlers reported canebrakes so big that "100 bison could graze on a single canebrake." Apparently it used to make extremely high quality forage for livestock, before it was mostly destroyed.

European settlers apparently set their pigs loose in the canebrakes purposefully to destroy them, because the pigs would root up the nutritious rhizomes and kill the plant. Thinking of the relationship between Bison and Canebrakes, and the relationship between Eastern Native Americans and Canebrakes, and the relationship between Plains Native Americans and Bison...it seems like a pattern, huh?

In the case of both bison and canebrakes, they were a fundamental part of their ecosystem, and fundamental part of the indigenous cultures that used them for every material, their musical instruments, their homes, their most advanced arts, and even food (Rivercane shoots are edible just like other bamboo, and supposedly the seeds are edible too!) but European settlers purposefully destroyed the species almost completely. I can't help but wonder if there was a similar motivation.

Books that talk about Rivercane:

Weaving New Worlds: Southeastern Cherokee Women and Their Basketry by Sarah H. Hill talks about rivercane a LOT and gives tons of details of its uses and history.

Saving the Wild South: The Fight for Native Plants on the Brink of Extinction by Georgann Eubanks has a whole chapter about Rivercane.

Venerable Trees: History, Biology and Conservation in the Bluegrass is a book about Kentucky, but it talks about rivercane's importance including its relationship with bison. It's only a couple pages out of the whole book but it's still great information.

By the way, though, if you read any very early European account of Kentucky, the word "cane" is everywhere. It's just such a nondescript word it's hard to realize its significance.

On a more personal note...god, I love this plant. Here's another photo I took. When you're in the canebrake, it feels so cut off from the rest of the world; it's shaded, quiet, cool, and someone 10 yards away couldn't even see you.

i actually talked to my neighbor that I learned owns the canebrake. She had no idea what it was but she was excited to learn about it! It was a lovely conversation.

Apparently, she knew I had been down there a bunch of times and thought nothing of it. She said "Yeah I told my husband, If you see her down there, just leave her alone she's doing her thing." In the most sincere way possible, God bless this woman

She said I could transplant all I wanted, too. This was great! ...but I quickly learned how RIDICULOUSLY HARD it is to transplant from a canebrake of this size. The rhizomes are so big and tough, a shovel can hardly get through them, and unless you're at the edge of the canebrake, there's a thick mat of them going every which way. I was driving my whole weight down on this shovel and it kept just denting the rhizome and glancing off.

I did get some transplants but each one took like half an hour because I was fighting for my life!

Also, with a canebrake this size, it doesn't grow little canes that will later become bigger—it shoots up tall canes in a single season. The youngest canes, more accessible and toward the edge of the canebrake, were significantly taller than I was. I cut the top off of one transplant for ease of handling—I had a pair of hand pruners with me that were usually perfectly useful for small limbs, but I could barely get these things through the cane, it's just so strong and dense.

Here is some YouTube videos that talk about river cane!

Roger Cain of Keetoowah/Western Band Cherokee shows and talks about Rivercane. This video has a BIG canebrake, the mature canes look as if they could be 15ft tall, but he says it's only a fragment of what they used to be!

Stan the River Man visits a Canebrake in Northern Kentucky. This channel only has 22 subscribers, I feel like I've discovered a rare and priceless treasure

River Cane Renaissance, Episode 1. This guy has devoted a large part of his life to studying Rivercane and now works with the eastern band Cherokee to try and bring it back.

Chattooga river conservancy video on Rivercane, haven't watched the whole thing myself but it looks really good and detailed

This is exactly what you think it is.

For privacy reasons, I share details online of my real world activities only reluctantly, and not very often. But don't be bamboozled into thinking I have forgotten the Canebrakes. It's exactly the opposite.

I have done a lot of networking and made a lot of contacts. I am not alone. There are other people with a story exactly like mine: first, they heard an offhanded mention of forests of American bamboo, which shattered everything they thought they knew about their environment. Next, they became crazed with fascination, searching for knowledge with insane ferocity. Then, they realized that river cane is not only a plant, it is a keystone species symbiotic with indigenous cultures for thousands of years, and it was almost destroyed due to the subjugation of its habitat and the genocide of its caretakers.

The canebrakes' devotees have been working tirelessly to compile every single scrap of information on canebrakes that exists in writing. Every record, every primary source, every historical mention, every comment and conjecture. I have been given access to some of this priceless treasure trove. The wealth of information is amazing, but even more amazing is how much is still unknown.

The history, properties, and ecological importance of the canebrakes is so much more than I imagined.

For example, the massive amounts of seeds produced by huge canebrakes in flowering events fed the passenger pigeon flocks. Likewise the Carolina parakeet was also dependent on canebrakes, and the extinct Bachman's warbler was a canebrake specialist. The destruction of canebrakes could be responsible for why these birds went extinct.

Canebrakes were absolutely fundamental to the indigenous peoples of the Southeast, providing for their every need. Food, shelter, containers, tools, music and art. The settlers foolishly thought the indigenous peoples were not "advanced" enough for metal tools, but in truth, they already had a material superior to metal. River cane by weight is stronger than steel. You can make knives and blades out of it.

I am excited for the future. It seems like momentum is building to save the river cane and bring back the canebrakes, and I am hoping to join together with all the other like-minded people to accomplish this task.

Holy shit okay i looked it up and HOLY SHIT. Published 2 months ago.

1700 years old.

And it says A. appalachiana, (the Appalachian species of native rivercane), has actually NEVER been observed to flower, which means ???? i dont even know what the fuck that means.

THIRTY hectares. THIRTY. That's HUGE.

Does this mean that???? Most canebrakes are so small now because they're babies????

However, the "well, someone's gotta do it, and this idiot won't, so I will" mentality secretly betrays that they have extremely strong values about caring for a community. If people can't take care of themselves, someone else has to do it, and if you're the one seeing it happen, that someone is you.

Through this process, there is a random chance that the angry Bostonian will adopt you like you are a helpless puppy. This is especially true if they see you make the same mistake on a routine: every day, this person does not take the bus even though a reasonable person would; they don't know how to care for themselves, I must watch out for them. If every day at 8pm you drop your bag, you may be an idiot, but you're an incurable idiot. You can’t help it, you need ongoing assistance, so they will show up at 8pm every day and insist that they carry your bag whether you like it or not. They'll give you a hard time, because you've given them a new job, but it evolves into a secret affection and extremely strong protective instinct. They will not let anyone fuck with you. They will throw down for you. They will be sad if they don't get to see you anymore, but they will never admit that or even that they like you. They will give you a $100 gift card to dunkin instead.

This response is much more likely if they realize you're not an idiot, you are just physically unable to Do The Thing. In this case, they have nothing to berate you for, but The Job Still Has To Be Done, so they silently carry your suitcase up the stairs. This also happens with moving heavy stuff on and off the train. They will not ask permission and they probably won't speak to you or even look at you. And they'll shovel the snow out of the 80 yr old neighbor's front yard because someone's gotta do it, and grandma can't. Unless you look out your window at the right time, you may never know who plowed your driveway. They may even outright deny it because they don’t know how to accept affection.

What just happened in Hungary has a huge positive impact far beyond Hungary. For Ukraine, for the EU, for the future of authoritarianism internationally......

I just hyper focused on a project for a few hours for the first time in almost two years.

And yesterday, I realized partway through a client session that I was clear-headed, not fighting through brain fog, and was able to hold the client’s whole history in my head while working with them. I haven’t been able to do that in … I don’t know how long. Years.

I haven’t had brain fog for the past three days. I haven’t had a migraine for the last two days. I haven’t had to take a triptan / migraine rescue med all week.

My face is noticeably, dramatically less puffy with inflammation. My ears haven’t turned bright red with vascular pressure in three days, when that has been a near-daily occurrence since late 2021.

I can think. My mind is moving fast like it used to instead of sluggishly churning. I haven’t lost words partway through a sentence in three days. I’ve been able to access words reliably instead of groping for super common language and failing to find it.

My joints don’t hurt nearly as much, and don’t feel nearly so “floppy”/“loose”. A few days ago, my physical therapist confirmed that the inflammation around my joints is remarkably reduced, less swollen to the touch. My head isn’t hot to the touch. I slept on my side for a little bit last night and it didn’t immediately mess up my neck. The tinnitus isn’t quite gone, but it’s definitely less intense.

I had given up on ever being my old self or having my brain back. This is… this is wildly hopeful.

I started on 2.5mg zepbound. (I wanted vials to microdose with, buuuut insurance only covered the 2.5mg auto injectors. Hopefully this is tolerable. If the side effects are too much, I’ll resort to paying out of pocket for vials.) I was already frighteningly, intimidatingly hopeful about it before starting it, from the research papers and case studies and personal stories I’d read.

Here’s the paper that started me down this rabbit hole: Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.

“Among 47 cases (mean age 39, range 15–71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.”

Some more resources:

The 1 month before starting tirzepatide:

4 severe migraine days

9 moderate migraine days

14 mild migraine days

3 migraine free days

The past two weeks on tirzepatide:

1 moderate migraine days (had the migraine before taking the first shot so this might not count)

6 mild migraine days (concentrated around the couple days before the next dose, and/or the couple days before my menstrual cycle began)

7 migraine free days

All while maintaining a fairly stable weight. (Been hyper-vigilant about getting enough protein and hydration as neglecting those are the biggest pitfalls people fall into with this medication.) Actively trying to maintain a stable weight for now just to make sure I can manage caloric needs on this med; I dont want to lose muscle, that would be bad on so many levels.

And my neck was pretty badly misaligned for a good portion of the last week, which historically would mean severe migraine time… but instead I just had the neck discomfort without hardly any migraine. And minimal fluid backup/inflammation. (Confirmed by my physical therapist who was very surprised by how bad my neck was yet how low my pressure/inflammation was.)

But also my joints are more stable overall, and go back into place easier, and stay there for longer once they’re where they should be. Everything is less wobbly since there isn’t so much swelling. AndI mean everything - neck, wrists, fingers, hips, knees, ankles.

Haven’t noticed any worsening in POTS symptoms either. Haven’t noticed POTS symptoms at all, now that I think about it. Haven’t been tracking those like I’ve been tracking inflammatory symptoms / migraine / mast cell stuff though.

Also I haven’t taken an antihistamine in two weeks??? and barely taken any anti-inflammatories / NSAIDs, and only one dose a day when I do take an NSAID???? I was taking waaay too many NSAID’s prior to this just to function. (and in the past few months I started feeling fairly prompt, sharp negative reactions to NSAID’s - cramping and abdominal pain - so I knew the 15+ years of 600-800mg ibuprofen, sometimes multiple times a day, was finally catching up to me and something needed to change.)

My body feels better. I feel better in my body. My brain feels better, I don’t feel like I’m walking with a concussion all the time. I haven’t lost words partway through a sentence in 2 weeks. I’m in less pain.

My mood has improved. I’m down to my pre-quarantine summer dose of my antidepressants do the first time since 2020 (and realizing I may have been using the higher dose to brute force my way through the cranial pressure brain fog). There’s bit of extra somatic anxiety, but I’m not sure if that’s situational/environmental/related to deadline stresses, or if it’s chemical. Will have more clarity on that in a week or so.)

Oh and the digestive side effects have improved dramatically. Whew. That’s the one I was most nervous about. I can tolerate a lot of side effects if it means I get to be *me* again, but my understanding is that certain severe levels of slowed gut motility are as debilitating and life-interfering as the kind of migraine stuff I was dealing with. I’d rather not just trade one problem for another of equal severity. But it’s looking like I’m gonna be okay on that front. (Keeping fingers crossed but overall relieved there.)

0 severe migraine days

3-4 moderate migraine days (1 was the day of the first shot, beginning before taking the first shot, so I don’t know if it counts) - usually in the day before taking next dose, or the day before menstrual cycle began. Or in one case, the day after eating multiple migraine trigger foods as an experiment.

11 mild migraine days

14 migraine-free days

As a comparison point, the 30 days before beginning tirzepatide, I had:

4 severe migraine days

9 moderate migraine days

14 mild migraine days

3 migraine-free days

I just hyper focused on a project for a few hours for the first time in almost two years.

And yesterday, I realized partway through a client session that I was clear-headed, not fighting through brain fog, and was able to hold the client’s whole history in my head while working with them. I haven’t been able to do that in … I don’t know how long. Years.

I haven’t had brain fog for the past three days. I haven’t had a migraine for the last two days. I haven’t had to take a triptan / migraine rescue med all week.

My face is noticeably, dramatically less puffy with inflammation. My ears haven’t turned bright red with vascular pressure in three days, when that has been a near-daily occurrence since late 2021.

I can think. My mind is moving fast like it used to instead of sluggishly churning. I haven’t lost words partway through a sentence in three days. I’ve been able to access words reliably instead of groping for super common language and failing to find it.

My joints don’t hurt nearly as much, and don’t feel nearly so “floppy”/“loose”. A few days ago, my physical therapist confirmed that the inflammation around my joints is remarkably reduced, less swollen to the touch. My head isn’t hot to the touch. I slept on my side for a little bit last night and it didn’t immediately mess up my neck. The tinnitus isn’t quite gone, but it’s definitely less intense.

I had given up on ever being my old self or having my brain back. This is… this is wildly hopeful.

I started on 2.5mg zepbound. (I wanted vials to microdose with, buuuut insurance only covered the 2.5mg auto injectors. Hopefully this is tolerable. If the side effects are too much, I’ll resort to paying out of pocket for vials.) I was already frighteningly, intimidatingly hopeful about it before starting it, from the research papers and case studies and personal stories I’d read.

Here’s the paper that started me down this rabbit hole: Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.

“Among 47 cases (mean age 39, range 15–71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.”

Some more resources:

The 1 month before starting tirzepatide:

4 severe migraine days

9 moderate migraine days

14 mild migraine days

3 migraine free days

The past two weeks on tirzepatide:

1 moderate migraine days (had the migraine before taking the first shot so this might not count)

6 mild migraine days (concentrated around the couple days before the next dose, and/or the couple days before my menstrual cycle began)

7 migraine free days

All while maintaining a fairly stable weight. (Been hyper-vigilant about getting enough protein and hydration as neglecting those are the biggest pitfalls people fall into with this medication.) Actively trying to maintain a stable weight for now just to make sure I can manage caloric needs on this med; I dont want to lose muscle, that would be bad on so many levels.

And my neck was pretty badly misaligned for a good portion of the last week, which historically would mean severe migraine time… but instead I just had the neck discomfort without hardly any migraine. And minimal fluid backup/inflammation. (Confirmed by my physical therapist who was very surprised by how bad my neck was yet how low my pressure/inflammation was.)

But also my joints are more stable overall, and go back into place easier, and stay there for longer once they’re where they should be. Everything is less wobbly since there isn’t so much swelling. AndI mean everything - neck, wrists, fingers, hips, knees, ankles.

Haven’t noticed any worsening in POTS symptoms either. Haven’t noticed POTS symptoms at all, now that I think about it. Haven’t been tracking those like I’ve been tracking inflammatory symptoms / migraine / mast cell stuff though.

Also I haven’t taken an antihistamine in two weeks??? and barely taken any anti-inflammatories / NSAIDs, and only one dose a day when I do take an NSAID???? I was taking waaay too many NSAID’s prior to this just to function. (and in the past few months I started feeling fairly prompt, sharp negative reactions to NSAID’s - cramping and abdominal pain - so I knew the 15+ years of 600-800mg ibuprofen, sometimes multiple times a day, was finally catching up to me and something needed to change.)

My body feels better. I feel better in my body. My brain feels better, I don’t feel like I’m walking with a concussion all the time. I haven’t lost words partway through a sentence in 2 weeks. I’m in less pain.

My mood has improved. I’m down to my pre-quarantine summer dose of my antidepressants do the first time since 2020 (and realizing I may have been using the higher dose to brute force my way through the cranial pressure brain fog). There’s bit of extra somatic anxiety, but I’m not sure if that’s situational/environmental/related to deadline stresses, or if it’s chemical. Will have more clarity on that in a week or so.)

Oh and the digestive side effects have improved dramatically. Whew. That’s the one I was most nervous about. I can tolerate a lot of side effects if it means I get to be *me* again, but my understanding is that certain severe levels of slowed gut motility are as debilitating and life-interfering as the kind of migraine stuff I was dealing with. I’d rather not just trade one problem for another of equal severity. But it’s looking like I’m gonna be okay on that front. (Keeping fingers crossed but overall relieved there.)

I just hyper focused on a project for a few hours for the first time in almost two years.

And yesterday, I realized partway through a client session that I was clear-headed, not fighting through brain fog, and was able to hold the client’s whole history in my head while working with them. I haven’t been able to do that in … I don’t know how long. Years.

I haven’t had brain fog for the past three days. I haven’t had a migraine for the last two days. I haven’t had to take a triptan / migraine rescue med all week.

My face is noticeably, dramatically less puffy with inflammation. My ears haven’t turned bright red with vascular pressure in three days, when that has been a near-daily occurrence since late 2021.

I can think. My mind is moving fast like it used to instead of sluggishly churning. I haven’t lost words partway through a sentence in three days. I’ve been able to access words reliably instead of groping for super common language and failing to find it.

My joints don’t hurt nearly as much, and don’t feel nearly so “floppy”/“loose”. A few days ago, my physical therapist confirmed that the inflammation around my joints is remarkably reduced, less swollen to the touch. My head isn’t hot to the touch. I slept on my side for a little bit last night and it didn’t immediately mess up my neck. The tinnitus isn’t quite gone, but it’s definitely less intense.

I had given up on ever being my old self or having my brain back. This is… this is wildly hopeful.

I started on 2.5mg zepbound. (I wanted vials to microdose with, buuuut insurance only covered the 2.5mg auto injectors. Hopefully this is tolerable. If the side effects are too much, I’ll resort to paying out of pocket for vials.) I was already frighteningly, intimidatingly hopeful about it before starting it, from the research papers and case studies and personal stories I’d read.

Here’s the paper that started me down this rabbit hole: Utility of glucagon-like-peptide-1-receptor agonists in mast cell activation syndrome.

“Among 47 cases (mean age 39, range 15–71, 89 % female), 89 % demonstrated clinical benefit with GLP-1RAs for a broad range of problems associated with MCAS.”

Some more resources:

Their mom notices, at the dinner table. She sees no nagging children, no stupid fights. She sees Lucy eating and speaking with perfect manners, Edmund analysing the economy and war with concerning skill, Susan being gracious but poised, like a diplomat.

Their father sees it in Peters eyes the first time they get into a fight. When he moves to punish Edmund for speaking out of turn, Peter calls him out on it. When his gaze meet his eldest son's, he's leveled by the war he sees behind it, the tensed muscle in his arm, the knuckles white around his knife. He's seen that before, in other soldiers. He doesn't know how to react.

Other children notice, too. Talking to all the Pevensie kids at the same time is like being the only one left out of a secret, and the way they touch and tease each other speaks of a history far deeper than their polite demeneor lets on. And when they walk they fall in line, as if there is a natural hierarchy between them.

The first time anyone picks a fight with Edmund, Peter comes home with a three week suspension and blood around his mouth. He looks more alive than you've seen him in weeks.

When Susan gets back in the pool after Narnia, she wins all the contests. Coaches can't explain how to beat her, because they don't understand how she's doing it, either. She seems to almost disappear when underwater.

Lucy, always gay and golden-haired, starts dancing, and never misses a step. She moves with an elegance that no 10 year old should have, and all the girls want to be friends with her

Edmund soon becomes the best student in his faculty. He always seems to know the right thing to say, and teachers laud his ability to think through complex problems. His mouth does get him in trouble sometimes, but the boy seems uncatchable, always talking his way through the cracks. And if not?

No one actively fears Peter, but everyone is a little scared of him sometimes. He's tall for his age, sure, but there is something else, some other air that seems to give him an authority far beyond what's normal for a teenage boy. He's nice enough, but teachers can't stand it, and bullies learn very quickly that pissing him off means missing teeth and black eyes.