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Didn’t know about the rash thing. Looked it up along with some pics – seems unpleasant! Responses to keto seem to vary a ton.

I have felt way more energy and less of a need for sleep on keto, but some people say it makes them tired.

Oh also, the various lifestyle changes I’ve made have had the side effect of letting me take naps and get benefit from them. When I used to get migraines a lot, taking a nap was a big risk. My sleep schedule was extremely “fragile”, in that any minor deviation (getting up too early, going to bed too late, taking a nap) could trigger a migraine. So taking a nap was risky. That seems pretty awful in retrospect.

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Trying to practice the stoic† idea of negative visualization some.

One of the worst things I can imagine is being blind. It would interfere with so much and make so many things harder. A few short examples of stuff that immediately occurs to me:

  • Just getting around (even your apartment, forget about outside) is harder and you have to learn skills for doing that while blind.
  • Stuff like cooking seems a lot more perilous.
  • Obviously you can’t drive or even ride a bike normally (though re: bike-riding, there is this, which I didn’t know about before this exercise).
  • Needing to deal with some of the current technology/systems for reading would suck.
  • Can’t experience things like the beauty of a sunset, or the visual information in movies, or any art with a visual component really. Can’t even have direct awareness of what things like color mean.

†I saw a comment on reddit disputing whether negative visualization is a traditional stoic practice or whether it’s just the idiosyncratic practice of a particular modern stoic (William B. Irvine). I haven’t referred to the primary sources yet to sort this out.

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Sorry I think I totally missed this question.

Yeah, I think Levels is a reasonable and easy way to try a CGM. There are things that I’m not happy about with the app, but it is still usable and has some upsides. I have been using both the Levels app and the Sugarmate app at the same time, since neither one does everything that the other does.

The way Levels works is that if you get the FreeStyle Libre through them, you actually do get a prescription from them and can later transfer that prescription to a local pharmacy, where you might get a better price. But to get the Dexcom G6, you have to participate in their study (you don’t have to do anything special, but they will be using your data for a study, so you may or may not be comfortable with that), so you don’t actually get a prescription, so there is no way to transfer it to get it filled locally. If you aren’t getting insurance coverage, it’s not really any cheaper to fill the Dexcom at a pharmacy anyway though.

One benefit of getting the CGM’s through Levels is that they have their own customer service, so if you have any problems, they will help you. A lot of people online say they were able to easily get replacements if their sensor stopped working or fell off, and that Levels is easier to deal with than either manufacturer. So that a benefit.

Levels says they are currently not available in all states, but I think that may only apply if you are getting the FreeStyle Libre: the reason they give for is that some states do not allow telemedicine prescriptions, but Levels isn’t using prescriptions for the Dexcom, only for the FreeStyle. (Also, when you go to check out, it blocks out certain states if you have selected the FreeStyle, but allows you to put in any state for the Dexcom.)

I believe you said you wanted a bluetooth CGM (instead of manual scan), so right now the only options I know of for those are Dexcom G6, Dexcom G7, and FreeStyle Libre 3. The only one I know of that is available through an app is Dexcom G6, which you can get through either Levels or Signos.

I still haven’t been able to find any good comparisons of the Signos vs Levels apps. I chose Levels because of their pricing structure. Signos is cheaper for a single month (if you buy it on sale, and it seems to always be on sale), and it’s also cheaper if you want to use them continuously for 3 or 6 months, and commit beforehand to that. But Levels allows you to have them sent to you every 3 months (or more or less often than that), which seems like a more reasonable way to use them for most people – it allows you to experiment a bit, make some changes, and then check how you are doing again later. I think continuously using them is probably overkill for most people.

With the way Signos works, if you are on a 3 month plan, they will send you 3 months worth of sensors, but only 1 transmitter. The transmitter only lasts for 90 days, so you can’t just save some of the sensors for later.

With Levels, you can set it up to send you a kit every 3 months, which will give you 1 month worth of sensors and a new transmitter each time, since your old one will be expiring. (If you get the kits monthly, you won’t get a new transmitter each time, so don’t buy them early with the plan to save them for later – they only send you a transmitter if your current one is going to expire.)

So the Levels structure will easily allow you to use 1 CGM a month (10 days out of the month), or use CGMS for 1 month then skip 2 months, etc. That part of Levels seems really good to me. I think that is probably the most reasonable way for most people to use CGMs.

When you sign up with Levels, there is no commitment to actually get future shipments. Even if you sign up for 1 kit every 3 months, you can easily delay or cancel that in app later. So you could try it with the first months worth of CGMs, and then decide at that point if it is worth continuing for you or not.

For me personally, I think it is worth using them pretty regularly. I have learned a lot about my own response to sugars & carbs, and it does not match the standard glycemic index stuff, etc. I plan on continuing to monitor later, not just doing it as a one time thing. Your diet, habits, gut microbiome, etc, all change over time, and your glucose responses will change with that.

According to Level’s website:

Levels offers a no questions asked refund policy for the annual membership charge at any time during your membership period.

So if you aren’t happy with it and decide not to continue, you can get the membership portion refunded.

I have found Levels customer service to be friendly & responsive so far. I have a lot of complaints about the app itself, but their customer service has been good, they are easy to work with, they ship fast, etc. So overall I would recommend them, especially for someone who doesn’t have a prescription, insurance coverage for CGMs, etc.

If someone can easily get a prescription & insurance coverage, I would probably recommend just getting the Dexcom G7 + Sugarmate app, assuming their insurance would give them a better price than Levels or Signos.

I am curious about Signos. It is marketed towards weight loss, which isn’t what I am using it for, so I am not sure if the app would be a good fit for me. I really hate how hard it is to find walk-throughs of apps online. These places want you to sign up and give them $400 to even see the app, which seems ridiculous to me.

If you are going to want to use a CGM closer to continuously, then getting a Signos subscription on sale would be cheaper than Levels. But Signos does not offer any kind of pro-rated refunds if you change your mind part way through your subscription, so that is a major drawback.

The other thing I am curious about is using the FreeStyle Libre 3 with the Veri app. You’d need a prescription for that too though, and the Veri app is $25 a month if you sign up for 6 months upfront. And I have no idea what the Veri app is like either. (I really don’t understand why they don’t have app walk throughs available online for these apps that they want you to spend hundreds of dollars to even access.)

As far as I can tell, those are the only options for the bluetooth CGM with an app that lets you record & track stuff.

Also, I could give more detail about the Levels vs Sugarmate app and what I like/dislike about them, if you are curious.

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I found another option for this. You can get a prescription for the FreeStyle Libre 3 online from a company called Tastermonial. You can then use the FreeStyle with their app or with the Veri app. Tastermonial also sells food kits that you can use to test your glycemic response to different foods. And they have a waitlist beta program where they will send you free foods to test.

I still don’t know of any other apps (besides the FreeStyle app itself) that you would be able to use with FreeStyle Libre 3.

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I started experiencing a migraine earlier today for the first time in many weeks. I believe it was brought about by insufficient sleep due to the sleep disruption that typically accompanies traveling for me. I took my medication and felt a mild relief but still felt pain. I then tried my running “remedy”. It worked to cure the pain completely.

I tried to pay attention to how I felt while I was running. For the first mile, the migraine pain actually felt a bit worse. Around 1.6 or 1.7 miles in, though, the pain started to dissipate, and was completely gone in short order. Incidentally, my second mile was my fastest and most intense mile of the run.

If anyone sees any discussion online of people curing a migraine attack in progress with running or other cardiovascular activity, please let me know, as I’d be extremely interested. I’ve seen discussions of cardio reducing migraine frequency, and I’ve seen discussions of exercise potentially being a migraine trigger, but I haven’t seen anything about people trying running during an attack and having it provide relief. I wonder if anyone else has made this connection and discussed it.

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I was curious about this, so I searched a bit. I found this reddit thread on r/migraine.

Most of the commenters said they did not exercise during migraine, some said they have and it made it worse.

I did find one comment saying that exercise could help stop his facial pain (which is what he mostly experiences migraine as now).

And another comment saying that he has had some early migraines go away with exercise, but other times it got worse.

I didn’t read through all the comments. Thought you might be interested in the thread though.

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That same guy also said:

I do find it pretty extraordinary how variable headache disorders are between individuals. We end up being lumped in the same diagnostic bucket but the reality appears to be that migraine is a set of symptoms for which there are likely many distinct root causes.

I agree with that (and have thought along those lines for a while). We don’t have the understanding or diagnostic tools to know what’s going on in detail with people’s headaches so we group them together under very broad labels like “migraine” that I imagine we will drop (or at least qualify with more descriptive adjectives) once we actually know what’s going on.

I had my first visual migraine aura a few years ago. Never had them before despite getting migraines since I was 14. I had one more visual aura almost exactly a year later, and then haven’t had them since (thank goodness). Why’d I develop that symptom after years of having migraines, and why’d it just happen twice and then go away? Is it gonna come back? Nobody could really tell me. Our knowledge is really limited.

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I finished my Peikoff logic course project.

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This is a section of the three I made regarding this video:

I’m wonder if I should continue working on logic and made a tree about it. It’s just a quick “brainstorming tree” thinking through various issues, haven’t decided anything yet.

Deciding on Next Project
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Another example [EDIT: of a negative visualization exercise]: paraplegia

  • Paralysis of the legs (Paraplegia). What problems would this cause?
    • Problems
      • Obviously can’t go for walks or get around easily. Need a wheelchair.
        • Walking is a major activity for me. I live in a city and so walking is a practical way to get places.
        • I also walk for exercise and enjoyment. E.g. I just took a trip and walked approximately 42 miles over the course of 5 days.
      • Can’t do various other physical activities (running, biking, rowing). Exercise and physical is still possible but the scope of activities you can do would be severely limited
      • Navigating spaces would be a lot more difficult in a wheelchair.
        • E.g. lots of stores, especially smaller stores, don’t have ramps or entrances very suitable for wheelchairs.
        • Transit, especially older systems (like in NYC) lack accessible stations at many smaller stations (no elevator, only steps), meaning that lots of trips would involve a bus connection.
        • Getting onto a bus and getting situated can be a bit of a pain from my observations of paralyzed people on buses.
      • Paraplegia has various potential complications depending on the details of the injury. It can be a lot worse than “just” losing the ability to walk/move your legs. Complications include:
        • Pressure sores - skin breakdown caused by placing too much pressure on the same area of the body for prolonged periods.
        • Abnormal muscle tone as a result of disrupted communication between the brain and muscles.
        • Chronic pain.
        • Inefficient circulation due to lack of movement.
        • Balance problems due to lack of motor control
        • Bladder and bowel dysfunction occur due to loss of motor control over the bowel and bladder muscles.
        • Thrombosis.
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One indirect benefit regarding negative visualization that I’ve noticed: when you practice imagine dealing with the struggles that would come from losing things you already have (and take for granted), it becomes much harder to be stuck in the past with woe-is-me, if-only-things-had-turned-out-differently sort of thinking. Psychologically, there’s too much direct clash between appreciating your present circumstances and bemoaning the past for both to be sustainable at the same time.

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Completing/continuing this thought a bit:
A major reason people bemoan mistakes in the past is because of imagining ways the present would be better if they’d acted differently. If you’re focused on all the ways the present is good compared to potential worse situations, though, that shifts your perspective and clashes with getting upset by the fact that things aren’t even better than they are.

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Potential podcast question for @Elliot : You’ve written about inadequate civilizations and insufficient caution by our society regarding drugs. I was wondering how you apply the inadequate civilizations idea to the development of the Covid vaccines and their potential risks, and whether your thinking has changed over time.

Personally, I used to be very pro Covid vaccine and thought the speed of development was a great technological achievement. But I’ve gradually become more skeptical and less certain.

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Some notes on Chapter 8 of the A Guide to the Good Life book on stoicism I’ve mentioned a few times. I’ve been reflecting on these for a few days

  • Bedtime Meditation - Reflect on the events of daily living
    • Questions to think about
      • How did you respond to those events?
        • How should you have responded to those events?
      • Did something disrupt your tranquility?
        • Did you get upset, and could you have avoided getting upset?
      • Were you governed by reason or something else? If something else, what governs you?
      • Did you engage in negative visualization?
      • Did you distinguish between those things over which we have complete, some, or no control?
      • Have you refrained from dwelling on the past and instead focused on the future?
      • Have you intentionally suffered mild voluntary hardships?
    • Observer Techniques
      • Create within ourselves a stoic observer who comments on our attempts to practice Stoicism
    • Indicators of Stoic Progress
      • We will be less reactive to external slights or even to praise
      • We will have fewer desires
      • We will experience fewer negative emotions
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Continuing the discussion from Is The World Good?:

I worked a “government job” years ago as a law clerk for a judge (was on a standardized government pay schedule, got govt benefits, whole nine yards). Relatively low level but not a janitorial position either. I actually gave a lot of thought to the issue of what government jobs would be acceptable at the time (I was more “libertarian” then) and decided that it was okay. That’s somewhat of a special case though, since 1) if you’re working basically a single person, you can vet out how much they’re aligned with you in terms of job-relevant values much much more than if you’re working for, say, a Department, 2) the context of the job was reviewing claims people had against the government, 3) it was max 1 year anyways.

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I’ve been experimenting with more “moderate” low carb this week and had a very tentative/early initial impression.

On “full” Keto (for me, like 25-50 net carbs but trending towards the lower side) I have difficulty sleeping normally. I can get like 6-7 hours and feel fairly rested but that’s pretty much all I can sleep and I feel more at 80% charge than 100% charge (to use a mobile phone metaphor). For full Keto, on my sleep app, I generally have 4 periods of deep sleep. I’ve seen comments on line of people having a similarly reduced need for/ability to sleep when doing full keto.

I’ve been trying carbs at closer to a 70 to 100 net carbs level, and I’ve noticed that I’m getting more like 8-9 hours sleep, with 5 periods of deep sleep. That’s the level of sleep I tend to associate with more of a “full night’s rest”, and I do feel more rested. The higher level of rest seems to matter to how able I feel to exercise.

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Just an FYI to @anonymous71 that I’m going to follow up about the CGM stuff but probably not for a month or so.

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Continuing the discussion from Moderators Editing Post Introductions, Titles, Tags, Categories, etc:

I didn’t mind the edits. I was initially mildly surprised at the editing of the body of the post, but I looked at the actual edits and they were minor and unobjectionable. I would not have made any comment at all if @MetaCreation hadn’t raised the issue.

Yes.

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Xanthan gum gets used in lots of store-bought tortillas. I got some almond flour low carb tortillas I’ve been using lately (they’re still too high carb for keto but okay for more moderate low carb diet) and noticed they use xanthan gum. And I checked a bunch of labels, including for “regular” (not low carb) tortillas and it’s a really common ingredient. I don’t know how problematic xanthan gum is but I’m concerned by it being another super common “invisible” ingredient I was previously unaware of. I found some corn tortillas that don’t have it but I’m not a big fan of corn tortillas.

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What brand? All the tortillas I have found have gums, etc, in them.