🎓 Doc Freemo 🇳🇱 @freemo@qoto.org

**I want to apologize to the whole #fediverse community, sincerely, for my recent behaviors over the last 4 months.**

If i have been rude or even short tempered with any of you my apologies you likely did not deserve it. Read on if you'd like to know the story and you can decide if I should be forgiven or not.

I know several months ago I made a similar apology, and this may fall on deaf ears, but I hope some of you will hear me out.

First off my last apology came at the face of an Israeli mob death threat on both me and my family. That added a lot of stress at the time and certainly led to me being a bit rude with some people, not an excuse but I do want to rehash it a bit for context. Many of you have noticed since then I do not go out without an open-carry weapon on my hip, this is why.

That said that is not the source of this apology but it is loose related.

I have been dealing with some health issues that, while not life threatening they have severely limited me in some ways. Specifically a very severe sleep disorder. The sleep disorder, and a brain fog that made it very hard for me to think and function normally. In and of itself these werent the root cause, there were underlying issues. But my attempt to treat the symptoms (since the underlying causes we unknown) actually led to a worsening of symptoms long term despite providing some help in the short term. I will explain.

Most of my life I had ADHD as a diagnosis, but it had never been a hindrance to me, in fact I saw it as something that improved my intellectual abilities overall. However this diagnosis allowed me to receive an adderall prescription to try to address the sleep disorder and brain fog, not to treat the ADHD directly, which I have been on for about the last 4 months. It was a low dose (20mg once a day in the morning to wake up). At first it addressed my symptoms with amazing results, but over time it led to a cure to my sleep issue but the brain fog got much much worse. In addition to that my irritability when interacting with people was worse and I have been quite dis-tempered with some of you, and I am deeply sorry for that if this describes you. It certainly continued to cure the sleep issue however and since normal sleep is needed for me to do my work i felt i needed to continue.

Recently however I decided to take matters into my own hands and stop relying on doctors. Instead I got labs through shady means to test for things doctors were dismissive of and wouldnt in the past let me get authorization to have tested. Namely my testosterone levels, thyroid hormone levels, and various blood sugar indicators. These tests revealed three underlying issues: 1) A severely low T-level (so low the tests couldn't even register trace amounts) 2) An extremely high Thyroid-stimulating hormone, 3x above the maximum normal range 3) metabolic disorder causing blood sugar and insulin irregularities (which likewise led to extreme runaway hunger).

At this point I found a doctor who was finally willing to listen to me, armed with a mountain of ill gotten blood tests and managed to convince her to test me properly for verification and finally treat my underlying diseases.

As of about a week ago I started treatment for my underlying diseases, needing to take injections of about 3 drugs, soon to be 4. Knowing that the root cause could finally be addressed I figured around the same time last week I could quit both the adderall and the sleeping medication entirely. Now that the underlying treatments are starting to work, and the old treatments out of my system I feel the best I've felt in years. I already lost 16 lbs, my brain fog has mostly evaporated, and while my sleep is still recovering it was quite improved last night... So while i have a ways to go to be 100% I am already back to my old self, how I used to be before the brain fog began. and certainly doing better than I was doing even 6 months ago.

I will do my best, going forward to treat you all with the respect and due consideration you deserve. Again my apologies.

So I finally figured it out.

I decide to buy a new birdwatching monocular. The one I picked is the same brand with my current 8x42 binocular. And I argued that purchasing a telephoto camera like nikon P950 or Canon SX70 HS is not worth. I generally use phone to take pictures and I'm fine with that. And I don't want to carry extra weight.

Also looks like Nikon and Canon are moving forward from telephoto cameras and now it's too late to go into that line of products. And the performace is relatively similar to my phone. So why don't I just use my phone?

The birdwatching monocular I'm planning to buy has 20x to 60x zoom with 82mm objective lens, combined with 3x telescope lens from my phone, I can get 180x zoom (I hope that's how physics works). And It saves money. That's the main point.

Now I'm looking forward to get my first month of salary 😋
----

And when I don't watch bird, I can use it to watch my neighboor. (jsut kidding)

Our newest paper has been published. Based on machine learning with k-medoids #clustering we identified three different signatures of #thyroid #homeostasis that predict the prognosis of patients with #Takotsubo syndrome.

https://pubmed.ncbi.nlm.nih.gov/38502972/
https://doi.org/10.1016/j.ebiom.2024.105063

@freemo You haven't been short tempered with me that I recall, but just to say sorry you've had all that and glad you're (from the sound of it) on the right track now

@freemo @mitexleo it's no different to a resistance group killing three nazi occupiers in France, and the whole village bring slaughtered in retaliation.

#oradoursurglane

@Vincarsi

Difficult to discuss solutions, if the problem can't be properly defined.

@freemo @aeleoglyphic @Radical_EgoCom

@freemo

Hang in there. You definitely do not want to be cycling with uppers and downers. You will not get good sleep and you do not want to tax your liver because your liver has to work well when you sleep.

Your liver is what re-charges your brain to prepare for the next day, so no surprise you were dealing with the brain fog.

@randahl I feel like the judge should have made it a point to make this day fall on christmas.

Wait isnt it ramadan! Even better, its a gift to the Muslims, Trump is going to love that :)

Moin Europe! 🌤️

We are one day away from the fire sale of Trump's assets. 🔥

Have an excellent day! ♥️

@brouhaha

> [You likely know all this better than I do. I'm not trying to mansplain it to you, but explaining for the benefit of other readers.]

I am not upset with you, but if i were to get upset I'd be far more likely to be upset of the use of the sexist term "mansplain" than I would from the actual desire to explain. That said, your good :)

> Did you urinate more than usual?

Nope, less than usual in fact. I think all day I peed once, maybe twice at most.

> If it's not water loss from sweating

I actually was quite cold all day, just turned the heat on a moment ago.. if there was any sweat it certainly wasnt noticable.

> the main way you lose body weight is by fat broken down into ketones (lipolysis, ketosis)

Actually this part is partly true (there is glycogenesis and glycolysis cycles too). But yea the bulk of fat winds up as ketones for energy.

> excreted by urination.

This is the part where your mostly wrong. ketones, once broken down for energy, result in the byproducts that are mostly water and carbon dioxide. While you are correct that the part you break down into water is exreted by your kidneys (or sweat) you are incorrect in your assertion that this is the route the majority of your weight is lost.

When breaking down ketones or sugar the resulting water is only 16% of the weight loss by mass. 84% of your weight loss is actually expelled in the form of CO2. When you loose weight you literally loose the overwhelming amount of your weight through your lungs.

> The other alternative is muscle tissue being broken down (ketoacidosis), which is very bad, but shouldn't normally happen.

While ketoacidosis is bad it is **not** the normal route a healthy person undergoes to convert protein into energy. Ketoacidosis is an unhealthy state, usually unique to diabetics, where you have both high glucose, and high ketone count leading to Ph imbalance and potentially death.

Typically proteins (dietary and muscle) are converted through protein metabolism, which starts with protein catabolism. Derriving energy from protein is actually quite normal if you consume more protein than your body needs.

@freemo
[You likely know all this better than I do. I'm not trying to mansplain it to you, but explaining for the benefit of other readers.]
Did you urinate more than usual? If it's not water loss from sweating, the main way you lose body weight is by fat broken down into ketones (lipolysis, ketosis), excreted by urination.
The other alternative is muscle tissue being broken down (ketoacidosis), which is very bad, but shouldn't notmally happen.

@mxtthxw

So my first question is, how solid of a diagnosis is your apnea? was it borderline? Was it confirmed with a follow up?

It seems sleep apnea is the go to for a lot of things because its easy. A true diagnosis is nuanced and requires a high quality doctor and equipment. It also is distorted by the fact that the equipment and/or location of the study means your sleep will not be typical and thus you may demonstrate some symptoms that you wouldnt otherwise present at home when well rested.

The best sort of sleep study is one where they do the full study in the hospital, and then send you home with a light weight monitor for you to sleep with for a week or more at home. If your sleep study didnt include both of these aspects I would be a bit suspect of that part.

> I get periods of hypersomnia where I can sleep for 14 hours plus.

Hypersomnia is slight counter to apnea. Apnea usually makes it hard to get deep sleep, so I'd be a little suspect (not too much) by this property. I too have this pattern. My sleep disorder is delayed sleep phase disorder, but it manifests as going to bed every night 1 hour later and then having hypersomnia once I fall asleep (10 - 14 hours is quite normal for me). For me this appeared to be cost first and foremost by the low-t, that treatment alone is improving it already, and secondarily by my hypothyroidism. If you havent been checked for both of those that would be my first suggestion, with or without the apnea.

> I’ve been putting that down to autistic burnout.
>
> However, I’m still not 100% sure about the autism diagnosis. Most of the time I don’t feel any real problems but other times I’m like no I feel autistic af.

So this is where my opinion may get a bit divisive. I am of the opinion that in the UK and the USA (and maybe canada) that autism is massively over-diagnosed, by atleast 90%+ in high-functioning cases. Not to say there arent high-functioning autists, there are. But they are far more rare than the diagnosis suggests.

What i think is happening is a bit of an underlying flaw in psychiatry in how it reasons about disease and a bit of a runaway effect in the societies of those countries. Psychiatry assumes the majority of a population is "normal" and as such any of those in the minority struggle to cope with society are the ones experiencing disorder. Psychiatry utterly fails once 51%+ of a society enters into psychosis because the tools stop working. What I think has happened is our societies have become so overwhelming toxic and bad for mental health that an overwhelming majority of these populations have developed one of the many forms of personality disorders, leaving a small minority of healthy "normal" people. Since psychiatry operates on the fundamental assumption of normality in a society psychiatry unfortunately tries to find a reason why normal people in the minority are struggling to function and thus assigns them as the person with the disorder, and deems the larger majority with the personality disorder as the "normal ones"... this causes huge amounts of false autism diagnosis instead of addressing the real cause, the personality disorders the other half of people have.

This only became extremely obvious to me once I started living among European people and seeing how I went from feeling "what is wrong with me" to "wow literally all of america is diseased"

@freemo Thank you for your honesty and humbleness.

I've never noticed any rude behaviour so I'll skip that part.

What I do know is that Medical Doctors are overall conservative and unwilling to think out of the box.
They were lectured that Testosterone is evil and need to be avoided, while the opposite is true.

Brain fog is often the result of low testosterone. But many more symptoms are caused by low T, like Ostoperosis (lack of bone density), lack of energy, sleeping problems. loss of muscle tissue (Atrophy) and off course a low Libido.

For many years doctors thought that Testosterone caused Prostate Cancer while more and more evidence learns that men with low Testosterone levels are more likely to develop Prostate Cancer. Young men, who are walking Testosterone bombs don't develop Prostate Cancer, whil aging men with declining T-levels do.

Long story, but what I mean is that your gut-feeling was right. You were right to circumvent the 'normal' pathways to discover what was going on in your body.

Testosterone is life! Men and even women cannot do without it. Low T-levels will cause ilness and possibly severe risks.

I'd like to commend you on your quest en encourage you to proceed. You will ad years and quality to your life.´

I predict that maybe in about 10 yrs or so, the medical world will take a complete other stance toward Testosterone and TRT will become a regular treatment, which is a lot cheaper than battling symptoms and fight off Prostate Cancer.

@magitweeter

> Those are all practical policy recommendations which may or may not help make utility the determiner of profit. I can even grant that they do. My question is about something different.

I am glad we agree, at least, so far as we can with such a limited scope.

> Is it wrong of me to assume that you're taking for granted that production and distribution are organized around markets as they're typically understood?

Yes I would say thats a wrong assumption. I am not taking it for granted. At no point did I say that current governments are healthy governments. Therefore how they are currently organized has little bearing on how I claim a healthy government should be organized.

The disconnect, as I see it, is that I am arguing that such dysfunction arises in the nuance between the extremely complex facets of government systems that ultimately fail to deliver healthy markets, as well as quite a few other unhealthy byproducts (like starving poor people). The solution is not and never will be a dogmatic and ideologically pure system like pure blind redistribution of wealth (everything is free and equal) or pure unregulated wealth (everyone has whatever they can kills steal and rob and its theirs). A healthy solution can only arise from the careful nuance and interplay of various ideologies and an understanding of where and how they should be applied in such as system.

On the flip side it would appear your argument is that the very tenant of capitalism as an element int he more complex systems of governement is the factor that is to blame and will rot it away (never mind the fact that we have counter proof of that since governments that are anti-capitalist have likewise failed). One might presume your argument would be one for communism as an idealized principle, but that is just speculation. and I argue that any idealized dogmatic principle applied tot he formation of a government is in fact what leads them to fail, and not any one principle in isolation.

@aeleoglyphic@mastodon.social @Radical_EgoCom @Vincarsi

@freemo

Those are all practical policy recommendations which may or may not help make utility the determiner of profit. I can even grant that they do. My question is about something different.

Is it wrong of me to assume that you're taking for granted that production and distribution are organized around markets as they're typically understood? Markets in goods and services, markets in labor and capital, supply and demand—that sort of context?

@aeleoglyphic @Radical_EgoCom @Vincarsi