Panem
1mo ago
The guy on dialysis was me, so I am doing this of course out of self-interest but also because I think this is a fairly atypical disease that doesn't get the spotlight much.
Panem
1mo ago
To add reference, my life expectancy on dialysis would be like 15 years. So the expected life-years for me doing this now (were I 100% healthy) is still fair bit longer than were I to go back to dialysis. I'll take the odds.
Panem
1mo ago
Training for a charity event I am organising, basically the prime aim is to help change the culture around dialysis. I think there are a lot of misconceptions that have made us converge on solution that is by far sub-optimal.
I will do 41 Alpine peaks above 4000m through hard routes. So it requires a whole season of just climbing and not dying (o1 calculated about 20 millimorts!, will have to check but sounds reasonable given my near misses).
Ramping up the training
So for the past month I have been at 4-5hrs of cardio. I do 1hr long run and a 5k interval session, going hard, per week. Then, most of the time is spent going up a 20 floor building with 12kg pack and taking the elevator down followed by some cycling. This needs to build to around 7hrs a week by May. Yesterday I did around 700m vert in an hour, today I am aiming for at least 400m. Though during the night I had very bad cramps. Every time I get them, I am scared for the kidney. Because leading up to my kidney failure cramps were a painful constant.
I am also climbing more and more outdoors now. There I really want to be able to onsight (sport) a couple of 6bs before May 15th. I also want to comfortably trad 5a/5b on limestone. Limestone is a traitorous mistress, gear that you would be bomber on any other rock can and will pull. My friends partner took a ground fall when two of his cams popped. You need deep placements and ideally nuts work best. Overall, I think this would put me in a good place to start the Climb Against Time.
Finding time for everything is a huge issue. So during the days there is obviously the daily lab stuff. On the weekends and nights there is the promotional stuff, improvements to the website, as well as attracting participants for their own challenge. I have to do these otherwise you are just 'Another fucker climbing' as per a mountain guide I met last September. Then there is finding the partners for the climbs I will be doing, which given the volume, is a bit of an ordeal of its own. All of this does strain my relationship with my wife, the time we can spend together is reduced by quiet a bit. Feeling a bit drawn.
Speaking of promotion the social media business is weird. I have now had some experience with Instagram and YouTube. I hugely favor Youtube. You need to spend a lot more effort, your reach is smaller, but you can actually post long-form content, saying somewhat meaningful things or actually being able to tell a story. And I also feel like with investment in to quality you can really take off. There are a crap tonne of accounts on instagram and the competition is fierce because the effort is less. On Instagram 3 second retention is like 30%. You can't really tell a story there, its more like, hey look at this thing real quick! Then bam on to the next thing. If I look at my own viewing habbits this all makes quiet a lot of sense. I think taking this brief foray in to the content creation world has made me a tiny bit more conscious of how I engage with it also.
Panem
2mo ago
Videos and reports! I want to document everything. The thing I really want to do is keep an alpine diary but its always hard to write while you are on 'tour' because you are one of: tired, eating, sleeping, or climbing and nothing else :D
Panem
2mo ago
A lot of things happening. So if some of you remember I was on dialysis (kidney failure) for like 10 months, decided to change career from vehicle engineering to basically finding a solution. Now I am in University Medical Center Utrecht, started a day after the transplant, trying to do just that. Its hard of course, creating a bio-artificial/engineered kidney. Harder still when you are so resource constrained, money being sprayed around in consortia with all sorts of other different ambitions and capabilities. But I feel like we are at a position to give a good crack at it. I say bio-engineered because there will always be some degree of bio-engineering, currently that might be simple, but in the future, maybe more extensive.
The current aim for me is an implantable hemodialyser, so something that can be implanted that will dialyse the patient without the need for an external blood circuit and so without the need for needles. This is like an intermediate point, half way line. If we can get this, patient mobility will increase, treatment quality also. More patients will be able to dialyse at home for instance, which is good given how pressed the nursing situation is!
I want to develop a minimal prototype by May 1st. So a lot of hours in the lab, I feel like with the printers and resins we have, we are in a good place to do this. But it requires a shit tonne of optimization and bashing ones skull in to the printer casing I feel. Just the other day I moved the printers in to another room, and physics stopped working. I had prints come out good at first, then wonky later. Turns out that I was not in the grips of delirium, but the lights in this room were emitting too much UV and poisoning the resin. Took quiet a while to figure that one out, now I am mainly in the dark :D
This is all happening in the background of a fundraiser/awareness campaign I am planning for the summer (May 15- October 15). Where I will be doing 41, 4000m peaks through hard routes. I have also invited other people to do their own challenge, hike, climb, walk, cycle, whatever it may be. The idea is inspired by my own experiences in the mountains and the National Donor Monument, which is called 'The Climb' the website is www.climbagainsttime.org. In any case, naked advertising aside, it took quiet some time to knock this together, not on the code side (gpt helped a tonne), but the communication side. Its very hard to communicate things via the web form I find. Presentations I can do, but web, its hard to give enough information but not too much. In any case, now comes to hard part of getting people involved, networking, social media presence etc. So quiet a lot of stuff, because in the end, I at least want to make some noise, money is nice, but not essential.
And also, if I am putting my neck on the line (or spine in this case), I want it to have some pay off, high-risk low gain isn't too desirable. But I do remind myself of the Scottish song 'Will ye no come back again' from Alastair McDonald, he says 'although the cause was ill fated and hopeless, the sentiment is noble and chivalrous and self-sacrificing ' referencing the Jacobite uprising. So I take some solice in that!
I will try to keep updating here on the progress and other details. I said I would keep a dialysis diary here but only managed like 3 weeks, so lets see how far this one goes
Panem
5mo ago
Perhaps, depending on how the space capabilities are used. But space technology so far has given me very little to be suspicious. Spy satellites etc are of course a thing, but compared to the thing in your pocket, they almost seem like old technology. I fear more the cars of the glorified military contractor than I do his rockets right now.
Panem
5mo ago
nobody is calling for a return of Constantinople to the Christians
I honestly wouldn't say nobody. There are plenty of people larping as crusaders. Just mostly they aren't taken too seriously.
Panem
5mo ago
I am thinking about the aesthetics of technology. Certain technologies seem deeply aesthetic to me and really appeal to my soul. So for instance, SpaceX capturing the booster, that really speaks to me, to be honest pretty much anything space related does. I would class this as 'real' engineering, as would I class building a bridge for instance, but that doesn't have the same frontier pushing edge. Whereas anything related to sensors and artificial intelligence, though can be cool, doesn't evoke the same feelings. I am trying to pin down why this is. I think maybe because I see the electrical technologies as more homogenizing, or more liable to the centralization of power and control? Mobile phones during COVID come to mind for instance. Does anyone else get where I am coming from?
Panem
6mo ago
It depends whether it is a suicide pact or not. If you are climbing a long unprotectable hard snow at high angle for hundreds of meters, than perhaps its good to put away the rope. But most of the time it is not like this. You are moving through a very large amount of terrain of varying complexity. You do not have the time to mess around with the rope. You should move together when possible, using terrain belays when possible and soloing if you cannot. This is the only way to really move in the Alpine. Otherwise you get benighted. Just last week I was listening to some French mountain rescue guys talk about a pair of British climbers who were stranded enroute on the Peuterey Integral having made it just past the technical difficulties. Its an astounding route, very serious but most parties complete it 2-3 days. These guys were on it for 5 days. Likely because the terrain requires a lot of efficient moving together. The subsequent rescue was quiet legendary and put a hell lot of people at risk with a storm nipping at their heels (helicopter could not be used due to visibility).
As for the milli and micromort strategy I think its a function of ability. Ueli Steck could jog up the Matterhorn and down before you got to the Hornli. It would also mean that during an Alpine season your chances of dying should decrease. But I find the approach interesting and I will use it for my next year fundraiser which will be 41 Alpine Peaks above 4000m through technical routes. I am curious what my chances of dying is.
Yea I am always kind of at two places with 'safe' outdoor route climbing. I generally think there should be a variety. Because usually things that are too safe or too gym like also become like a gym where you lose a lot of the outdoor element and there is a lot of traffic. Some sort of gating based on ability and risk tolerance is I think nice, also gives an additional sense of progression and accomplishment. I generally don't think having bolts but coloring them etc makes sense, not having the bolt there, and experiencing the real sketch is what makes the route the route. So overall I think a variety of climbs of differing boldness is good.
Panem
6mo ago
I am working on a membrane testing system for blood contact. Basically when blood makes contact starts to foul the surface and may start to coagulate. This is something I don't want. So we need a fast way of optimising surface coatings/membranes that prevent this from happening. All current systems are kinda shit and not meant for this purpose. We have animal experiments but these are costly and time consuming and not well controlled.
So I have currently a small fluidic loop that contains all the blood needed for the experiment, a peristaltic pump and a syringe pump. The peristaltic pump moves the blood around at the right rate so it doesn't aggregate or get damaged by excessive shear forces. The syringe pump keeps the system pressurised at a certain level. This is the neat part because then you don't need small diameter resistive tubing to do the pressure, which means blood gets less damaged.
I built the 3 syringe pumps from an old ender 3 printer. You should be able to control the pumps through the electronics of the ender but its super clunky. Especially if you want to interface with a pressure sensor and keep the pressure at a set point, via PID control. So I now bought an Uno and a CNC shield so I can do it low level via this. The syringe pump also means I can measure exactly how much flow is going through my membrane which is neat. But lets see if the interface works out, especially on the talking with the pressure sensor. Because the sensor is connected to a different arduino, so I think the simplest way is to send signals from my computer to the Uno based on this. But the nicest would probably be to integrate the control and the sensing together. But I think that would take a bit too long.
Panem
7mo ago
Isn't the problem here mass marketing? The same regulations basically seem to apply across the board, irrespective of the amount of data, nature of the data , or the usage of the data (non-commercial, research). The nature of the data in our case is very clear. Data obtained during human experiment, under informed consent, with a very real physical signature of said consent document.
Panem
8mo ago
I agree that cowboy in this regard can be both good and bad. There is a book called 'How to make a killing' which looks in to the flip side of the coin. Where basically doctors were the first ones to commercialize dialysis, and attempt to maximize profits from it. Of course, different cowboys at Seattle were the first to have a dialysis ward for chronic dialysis patients that would otherwise die, using the shunt invented by them, without the intent of profit maximization but maintenance instead.
Its obviously a mixed bag but I feel like we are sliding more and more towards things being harder to develop. I think this is a shame and potentially, in the long term, dangerous. There must be a way of reducing the regulatory burden and safetyism without producing these negative effects. Or the system is basically unstable and you will slide to one extreme or the other.
I am unsure about the animal research part. I think things that could be done without it, should be. This is what I am trying to do to some degree with in-vitro blood testing setup for the blood filtration membranes (its hard, blood is weird and weirder outside the body :D). I think in-vitro is always going to be cheaper and likely better controlled, if you are clever about it.
But I do wonder if the authors thought the work was unnecessary prior to their results. If so, why did the work happen in the first place. Goodness knows there are a lot of bullshit proposals out there. I generally think a lot of science is muddling around in the dark and sometimes something works. Thats for the majority of the mortals. Therefore most of the time the tools we use for this (animals perhaps) were 'wasted' if we hit a wall, atleast on the individual level. But on a macro-level it seems like a part of the process.
Panem
8mo ago
If you know how to fight standing then I think it goes without saying strength matters a lot. But I also did a few weeks of MMA (Friday was like sparring from standing with strikes allowed) I remember going against a person who was vastly superior striker (with my 2x MMA striking, you can imagine my state). But I shot quiet fast and took him down and there it was quiet easy. I imagine, given that she was so good at judo (coming from that background), etc, unless I got lucky or for some reason she just couldn't deal with striking being a part of the game, she would similarly take me down and go to town. As I replied to faceh, similar weight + huge skill imbalance is where you would get a woman absolutely dominate. If she was 20kg lighter (as is usual) I think it would be a very different story.
Panem
8mo ago
We always started standing. I mean she was a judoka so, it wasn't that hard for her to get me to the ground. If you are so heavily out skilled and you have the same weight, the strength makes very little difference. She isn't going to let you body slam her and might do the same herself. Most women are very much NOT the same weight as me, indeed majority in the sparing sessions were about 20kg lighter. Which means it would probably go down as you are proposing, weight + large strength difference. But this was the only big Dutch woman there hence the result.
Panem
8mo ago
A biological male who goes through male puberty has an insurmountable advantage over any person whatsoever who hasn't gone through male puberty. Unironically, If I were forced to bet on a no-holds barred brawl between a barely-trained 70 year old male and a heavily trained mid-twenties female in the same weight class, I am picking gramps for the win. Cardio will 100% be a factor here, but also, old man strength is REAL. (Oh I'm prepared to lose my money, but absent actual medical problems a 70 year old is not as fragile as you think.) I wonder why such a matchup hasn't been done before. Hmmmm.
I honestly don't agree with this. I went to BJJ for a couple of months just prior to starting dialysis. I was strong, not super strong but pulling 1 rep-max of 50kg over my 75kg body weight on a pullup kind of strong. I had no technique just strength and the technique was developing, but only enough to resist tapping to white belts for the 5 minute hard sparing periods. And for some of the novice white belts I was pretty comfortably in top position against (just had no idea how to submit anyone). I went up against a judo girl about the same size and weight as me. Absolute utter domination. She had been doing this since she was very young. I think I got tapped out like 3 times in the span of 3 minutes. This was in the first week of my short bjj bout, but still.
Panem
9mo ago
Going under the knife, is never good. There are reports of prolonged chronic pain after vasectomy, both in the literature and on reddit.
https://old.reddit.com/r/postvasectomypain/
Now of course, any surgery can have bad side-effets. Which is why going under the knife should be last resort. Use condoms.
Panem
1yr ago
Do you reckon Zafer Party will be able to come to some kind of agreement with KK?
Panem
1yr ago
I am not so certain that school itself is the cause of our woes here.
I think even without school, if you take the type of demographic that attend them and put them in to some sort of a job, they will still
delay children until their late 20s early 30s just because the responsibility of having a child would detract from the benefits incurred from having disposable income to travel to world and consume things.
Panem
2yr ago
I view plans of giving humans GOD mode (but not really) via AI as fundamentally removing all sort of meaning from life.
Things are easier now than they were, yes, but we still suffer. Suffering is, in my opinion, a core pillar of what it means to be human.
Panem
2yr ago
Does your significant other know about your use of The motte, and if so, what do they think about it?
Panem
2yr ago
Dialysis diaries week 5:
Well this week has been a pretty good week, aside from a small incident. I went to a boulder competition and bashed my catheder exit site in to an overhanging boulder. It started bleeding. Thankfully my girl friend took control over the situation there and patched it up so I was able to continue bouldering. But I felt absolutely disgusting, the thing makes my skin crawl and an incident like this really puts me on edge. But aside from this the week was good!
I had my first appointment at the transplant clinic with my mother. Everything so far is good. One issue was that the ct scan could take up to a month to book, which is crazy to me, but they managed to book it in for next week. After this it's just meeting the surgeon and the anesthesiologist. Then it's a 3 month wait for the surgery. This kind of gets under my skin a bit, 3 months feels like a long time and I don't want to endure any more than I have to. But hopefully everything works out, I can wait another 3 months, its already been 6.
The day after I went to the same hospital but this time to speak with a professor doing research on kidney regeneration and organoid technology. I want to first do an internship there and quit my current job in academia as an engineer then progress further for a paid position. Despite the fact that I don't have a biological background he was very encouraging. He is pretty positive an internship is a strong possibility, he was worried about me not getting salary for a while and quiting my job. He said we could write some joint proposals after a while to try to get money to fund me. He will contact me in 2 weeks time. Overall I enjoyed the vibes coming from the group and I feel like it is a really good opportunity to get in to the field and try to fight back against the disease.
Panem
2yr ago
Yes, the poster that prompted my thought had a much more "extreme" tuning curve which is why I thought they weren't considering potential medical advances in their calculus.
I also often think to myself how close would a friend need to be for me to be cool with a donation of this sort. And I am not sure myself. I would probably consider it for anyone I was already interacting strongly prior to their diagnosis. But that's because I know the disease, making me more sympathetic than I otherwise would have been.
I am not at the point of muscular failure. The cramps happen nocturnally after the training, honestly in this case I think I sweated a bit too much and not enough electrolyte to counter balance. But this tight rope between injury and gain is a fine one to balance. I find that given the nature of the challenge 72,000m cumulative vertical, long days etc I need to push now, but not too much.
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