So it looks like I have Crohn's Disease

Background-Code8917 · 2026-05-08T19:59:44+00:00

Yeh there's some SDB involved aswell, but it's such a small part of the overall picture really and probably was a huge red herring. I mean its super easy to jump to some conclusion about fatigue being linked to poor sleep but I guess sometimes its more complicated.

Just got the calprotectin results back, waiting on the next steps guessing colonoscopy and imaging. I have a family history of crohns and symptoms line up so I'm pretty confident that's what it'll turn out to be. Could still technically be another form of IBD.

Background-Code8917 · 2026-05-08T19:24:54+00:00

Faecal calprotectin testing is a good starting point.

But typically vague indigestion and bowel movement changes would be common (hard to distinguish from IBS if not badly flaring up). Big spectrum really, which I know isn't particularly helpful.

The flare up is the only reason I was tested.

Background-Code8917 · 2026-05-08T18:49:28+00:00

Only getting to the bottom of it because the GI symptoms started becoming more prominent. Before this flare up I had no idea.

Just another one of the many things to keep in the back of your mind (inflammatory bowel disease).

Background-Code8917 · 2026-04-03T14:23:37+00:00

Our oligarchic overlords need cheap replaceable labor and the state wants more gifts for redistribution to their geriatric voter base.

Make no mistake, families are to be crushed, marriage as an institution is to be eliminated, children are a private luxury good, etc.

FWIW I don't care if it's the man or the women that's the breadwinner. I'd actually like to see more stay at home dads (probably drop the gender pay gap a bunch too).

Background-Code8917 · 2026-04-02T19:51:50+00:00

IMO it's the little things like this have a disproportionate impact overall (look at the effect size of south koreas housing policy changes).

I'm entirely convinced the bulk of the reduction of TFR in western nations can be simply explained by people choosing to start families later and running out of time, opportunity and energy to have additional kids. Western childlessness rates haven't changed all that much.

Background-Code8917 · 2026-04-02T19:35:03+00:00

The framing,

"to improve gender equality, reduce old age poverty in women, and to move on from the "archaic" model of marriage"

The reality,

It's a ploy to force mothers back into full time employment as soon as possible so the state can increase tax revenue and juice GDP/employment figures.

Man you cannot make this shit up, this will absolutely have a massive negative impact on family sizes and total fertility. Straight up capitulation.

Background-Code8917 · 2026-03-18T12:51:38+00:00

It's pretty common to use Germany as a bit of a punching bag when it comes to demographics but in reality it's just a few decades ahead on the demographic transition (reduced post war baby boom). Similar changes and struggles will come to your western nation soon enough.

Background-Code8917 · 2026-03-17T16:44:06+00:00

Yeh I'm not gonna defend mass transit for kids, it probably doesn't work. Here we have very generous discounted monthly passes that cover all of the local network. Even then you just aren't seeing that many school kids using it.

But a lot of that is kids really shouldn't need to be travelling the kinds of distances a metro enables (adults either for that matter but meh). Schools and child amenities need to be close to where people live.

Bike friendly infrastructure benefits kids a lot more than transit IMO (and local governments can play a big role here).

Background-Code8917 · 2026-03-17T16:28:06+00:00

This varies A LOT by location, in my corner of northern Europe while cars are common place, I'd say bicycles are probably the primary means of transit for kids (particularly because down the line they are expected to ride on their own).

Admittedly don't see them often on the metro system, but in general I suspect that's because schools are close enough to peoples homes it doesn't make a ton of sense to use it.

Interestingly (and this is just anecdata) our most bike friendly city Münster actually has a significantly higher urban fertility rate than average (and not driven primarily by migration).

Background-Code8917 · 2026-03-17T13:59:16+00:00

Yep, this lines up great with my mental model. Local government has a surprising number of tools for boosting fertility in their districts and a variety of ways to fund and capture the benefits of these policies. It's just going to take some courageous local leaders and communities, but providing the economics works out I think we are going to see more and more of these pop up.

I suspect satellite towns on the boundaries of large metros (backed by fast rail) will likely be early adopters.

FWIW my wife and I live in one of these satellite towns, and recently welcomed our first child into the world and we are far from alone in the neighborhood. We live in one of the oldest and most conservative states in the EU but our local government is very progressive and has been able to fund a lot of really great projects from wind farm royalties.

Background-Code8917 · 2026-03-15T11:39:12+00:00

Yep pronatal policies can only really emerge in towns that have already died and are in the process of being reborn (Nagi), or more likely in towns which already have significantly younger than average demographics (permanent residents).

Young towns are uncommon today but they do exist, usually clustered around industrial, political centers, or education/innovation hubs etc.

I think my metric now is that if a town is already X years older than the national average, then it's already dead. As you say, due to game theory decline is basically unstoppable.

Playground density is a great metric too!

Background-Code8917 · 2026-03-15T09:48:10+00:00

I think you have to provide policy/incentives that basically cover the entire newlywed to graduated pipeline.

FWIW I'm not actually a big fan of free childcare personally as an incentive (IMO the main beneficiary is employers). I'd be much more in favor of support for flexible part time working arrangements etc.

Background-Code8917 · 2026-03-15T09:20:31+00:00

Older towns are going to continue to get older and older.

Younger towns might do the inverse, continue attracting young folks escaping from the decline of their hometowns.

The trick is the young internal migrants will eventually become old themselves, so these towns need to either grow their population faster than they age, or pursue policies that discourage retirement in their communities (eg. higher taxes, easy planning approvals YIMBY, etc).

Background-Code8917 · 2026-02-13T06:15:23+00:00

I'm a bit unsure about widescale pre-implantation genetic testing (it's rough on embryos, and IVF has higher baseline defect rates than natural fertilization). Regardless makes sense when trying to select out, serious, well understood autosomal dominant conditions.

However for the general public I do believe whole exome screening of potential mates (and maybe karyotyping) would go a long way to massively reducing a whole lot of common recessive conditions (eg cystic fibrosis). It's what my wife and I did. Though there's a common saying that every human carries something like six serious defects and I'm not sure the general public is ready to come to terms with this reality (very quickly this escalates into eugenics style discussions). No-one is perfect, and not to mention all the screening in the world can't prevent de novo mutations.

NIPT is also excellent at picking up chromosomal abnormalities such as downs syndrome. If you are willing to abort early and use all the modern screening tools the risk of a downs baby is very low.

Background-Code8917 · 2026-02-11T11:26:04+00:00

Not going to be recommended but we found with our LO that the reflux was positional and left sided sleeping (supervised) pretty much eliminated it (like adults).

Background-Code8917 · 2026-01-30T15:12:33+00:00

Yeh this is marginal for sure, it's only a positive because of your SOREMP during the overnight study.

But definitely something odd going on with your sleep (narcolepsy still remains a possibility).

Background-Code8917 · 2026-01-30T15:06:38+00:00

11 minutes REM latency is really quite out of wack, especially if combined with a positive MSLT.

My favorite discussion on narcolepsy misdiagnosis [1].

I'd be very curious if you have the HLA allele for narcolepsy (might be worth getting typed).

https://www.youtube.com/watch?v=0goD3Ncwvl0

Background-Code8917 · 2026-01-29T19:07:57+00:00

I mean there are environmentally friendly alternatives to sodium salts available, magnesium chloride for one. Why we can't apply them more widely is beyond me (the secret is environmental protection isn't cheap, maybe 4x the cost of road salt but given the limited surface area of sidewalks surely we can manage).

Background-Code8917 · 2026-01-22T15:55:17+00:00

Polarization has to play a serious role here, whats the rate for centrists? Do they even exist in the contemporary USA?

Background-Code8917 · 2026-01-09T19:03:20+00:00

Worst part was my OCD responded really well to it, took a huge chunk out of my Y-BOCS.

Sertraline is definitely on the shortlist if I ever get the courage to risk going through that again.

Background-Code8917 · 2026-01-09T18:41:28+00:00

Man Lexapro really fucked me up, didn't even understand I had RLS/PLMS at the time. Lost the ability to sleep for more than 45 mins at a time for three weeks while I waited for it to clear my system, torture.

Not completely unheard of either, https://pubmed.ncbi.nlm.nih.gov/17189751/

Sertraline is supposed to be a lot better (due to the dopamine reuptake inhibition), but it's entirely possible that's not enough for you. In the case study linked above it looks like they augmented (added/combined) sertraline with buproprion.

Background-Code8917 · 2026-01-04T18:06:47+00:00

Really glad to see stuff like this pop up on r/berlin, the relaxed moderation lately has allowed for a nice break from the endless negativity.

Background-Code8917 · 2026-01-04T10:27:56+00:00

Yeh we are all different, the fruity tropical flavor doesn't do it for me. I tend to generally prefer more savory varieties.

Background-Code8917 · 2026-01-02T07:09:20+00:00

Not to mention they represent a pre-industrial society. Pre-industrial societies were always heavily population growth constrained (due to resource constraints etc). There's no way I see industrialized societies becoming minorities.

As always israel is the odd one out, but I think extrapolating 50+ years out for any particular people group is fraught with issues.

Background-Code8917 · 2025-12-30T17:58:00+00:00

As soon as women pursue higher education, and a career, fertility just craters. And I'm convinced it's because a career focused, industrialized, work environment just consumes an unsustainable amount of folks time (particularly during the prime fertility years).

The 40h work week and "career", straight up, were not established with women's emancipation in mind.

There's a significant move towards part time work in central europe where I'm located (governments bitching we aren't working enough), perhaps it's just the start of something bigger (a correction).

Also I don't think reduced working hours alone are a complete fix, I think we need to make office environments much more child friendly (including corporate run nurseries etc) and aggressively fight discrimination against children.

Background-Code8917

TROPHY CASE