All things rucking
OK, I did it. I forked over the cash for my boyfriend and I to get the rucksacks and weight plates from GoRuck. We've started rucking together with 30 lbs each (so romantic!!) and I'm about to spring for a few more weight plates. How do we know the right "dose" for rucking? I started with 20 lbs and then 30 lbs was a push. But now 30 lbs is much more comfortable, is it time to move up? Is it time instead to try some hills? What's the danger to my back? What are some techniques to make sure I don't damage my spine? If you can help unpack the weighted backpack, that would be amazing!!
Nuts and Bolts for Sirolimus
I would love to have your input on a Nuts and Bolts for Sirolimus. I don’t know if that is too granular and you have shied away from it because it would be interpreted as giving medical advice on an area where the data is not entirely ready for even pre prime time. But I am about to pull the trigger on Ziggy and Zara (my two amazing big standard poodles and training partners) and thinking of myself and limited use in my practice. Here are the questions: How much Sirolimus are you taking ? (I have gleamed from your podcasts that it is 5 mg a week and currently not cycling on and off 8/4 week cycle). What are the safety signals of concern? You have compared safety in this dosing better than statins, and we are full guns on statins (btw, your recent pragmatic reasoning for aggressive statin use- small risk and big benefits- has been a practice changing argument for my patients, thank you). Are there people you would avoid prescribing to? Cancer survivors, HIV, patients on DMARD for autoimmune. Not suggesting to prescribe cart blanc but who to avoid giving this med. How good is the human data? Which tacrolimus do you use? A specific generic, do you buy it in bulk? Given that it has to be enteric coated, I don’t want to waste years, money and opportunity by using a generic that is not absorbed and the low dose doesn’t make monitoring levels practical. Do you see where I am going with this? What percentage of your practice over 50,60, and 70 are being prescribed Tacrolimus? How big of a deal is this in your practice? I am 62, healthy but one ball of arthritis, calcium score Zero on Rosuvastatin, have macular degeneration, some data suggest in animal model that this could be of benefit.
Protein - how to get enough
It is becoming quite obvious that one has to be more cognizant of protein intake, so I have been. The issue is getting enough protein! It is harder than I expected and was wondering if we could have a discussion on how to do this, without adding the calories, which I certainly do not need.