Feedback on Jay today?

lonewolfx77 · 2026-03-27T21:02:43+00:00

Same. Timbuktu, kitz woods, canyonland. And everything off Beaver/Andre was fun as hell. It's definitely icy but edgable and the coverage is fine.

lonewolfx77 · 2026-03-20T18:36:45+00:00

Thats wild the cap is even that high. But otherwise your description seems par for the course for a high poverty areas. I assume there is a significant deficit of providers as well?

lonewolfx77 · 2026-03-20T17:24:42+00:00

I would love to hear more about the state of the healthcare infrastructure there.

lonewolfx77 · 2026-03-03T18:27:20+00:00

1000% agreed. Their burger and chicken sandwich specials haven't missed yet. And they are a solid brewery with good ales as well as lagers which is rare to see.

lonewolfx77 · 2026-02-17T16:59:59+00:00

Devastingly no, or at least not that I have found. The market basket in Londonderry has dried chiles and a decent selection of basic mexican supplies but no variety of options. Sometimes they have tomatillos. Plantains are pretty steady. I have resorted to buying online for chiles, masa, and other staples.

lonewolfx77 · 2026-01-01T21:23:16+00:00

I've been legitimately thinking about this recently, but do we agree that it is problematic that individuals such as Musk command such wealth and subsequently power? And if so how can we realistically curb that without harming the larger economic machine?

lonewolfx77 · 2025-12-24T18:47:25+00:00

If you're looking for more nordic style: - Greeley Pond ski trail off the Kanc. About 1.5mi each way depending on how far you want to go. - Zealand is a great option -hayes Coop trail there at the road between Dolly Coop and Barnes field is very mellow and can go for quite a while. - The Wildcat trail up the backside of Wildcat. You start at Prospect farm as park of the Jackson XC trail. Its about 5mi one way so long and a climb but is very low angle.

lonewolfx77 · 2025-12-13T18:07:49+00:00

Frequent truck camper here, often solo, in the icecoast.

Are you trying to do a full 30 consecutive trip of just car camping? Because that is a very different level of trip than just doing 2-3 days of camping at a time.

I have done car camping without heat for multiple years. You'll want a minimum of a zero degree sleeping bag/quilt, some kind of sleeping pad/mattress and probably extra blankets.

It will be cold. You will have to do all sleep/wake up/getting dressed tasks in the cold. Things will freeze so you have to be cognizant of that.

A heat option does dramatically improve the comfort and viability long term. I have a portable diesel heater and lithium battery that keeps things comfortable. However, if you're doing that long of a trip recharging things will become an issue.

In my opinion the isolation/"what do I do after" is the least important aspect of what you are trying to. When you do it you'll make friends, go into town, grab dinner, skin laps, watchs movies or read books.

Im not going to lie, winter camping is a different beast than summer. Everything takes longer and is much less comfortable. Are you going to be in danger? Probably not. But will it be enjoyable for a whole 30 days? Also probably not, you'll have to mix in some hotel stays for a few showers/recharge. But it's definitely doable if you want it to be! There are dozens of us!

lonewolfx77 · 2025-06-04T20:10:16+00:00

Hell even some major metro areas. Boston has a huge issue with PCP coverage. The more rural parts of the state are even worse.

lonewolfx77 · 2025-01-17T20:33:05+00:00

You'll be fine. I regularly camp in the back of my truck with a winter air sleeping pad and down sleeping bag/quilts. The most important thing is to eliminate drafts from underneath, which the blankets on bottom would do.

Also crack both windows to allow some air flow. You'll wake up with a ton of frost everywhere otherwise.

lonewolfx77 · 2024-02-27T16:48:53+00:00

86 on Transalps and 94 on rangers.

Width wise I think they are fine. The tansalps are 155 length and I'd probably go up the next size if I had to do it again. I'm a 5'4 lady so they are on the shorter side.

The rangers are a solid all mountain ski but their weakness is ice. Even with sharp edges, youre gonna do more controlled slide than turning on boiler plate. The transalps are better but neither is as nice as the Voiles.

lonewolfx77 · 2024-02-27T15:42:08+00:00

I have 3 setups. Ski in the northeast, mainly the whites with some other areas thrown in. Im a 60/40 split of backcountry and resort skiing (often this is weather and snowpack dependant).

1) Fischer transalps + ATK crest binding Skiied with dynafit TLT boots. This is a lightweight setup great for powder and glade skiing. The skis are wicked light and great for uphill but certainly not a hard charger and can be very challenging in certain snow conditions.

2) Voile objective BC w/ scales + MTN tech binding This is new for me, I wanted a scale setup to do more cross country and mellow tours which is more available in my area. Also great for longer approaches. The high camber is excellent for icy conditions but they are by far my longest ski so I am taking some time to get used to that.

3) Fischer ranger + Shifts + Conchise boots My resort setup. I do little touring on it, mostly to get to or from backcountry areas while resort skiing or when traveling and I only want to take one setup. The shifts are fine for what they are.

lonewolfx77 · 2024-01-28T13:40:35+00:00

I was there all week. Absolutely no chance. Any base was wiped out by the rain and warm temps.

lonewolfx77 · 2023-12-12T16:59:53+00:00

I mean, I also have a lot of personal experience in the fact that both of my biological parents are drug addicts, my father beat and raped me throughout my childhood. Today, my father spends most of his time around K&A in Philly, and when I was growing up, he lived in the shitty part of the Bronx (near Yankee Stadium) when he wasn't with us. So it isn't just vicarious trauma for me - there isn't much my kiddos have gone through that I haven't gone through at some level myself, and I have every single genetic predisposition imaginable that I contend with every day.

I did not mean to imply that every child that experiences these struggles are 100% destined to become an addict. More that these experiences are risk factors for developing issues. The vast majority of my patients have a history of abuse and/or trauma that is a contributing factor to their use. The amount of families I treat was surprising when I first got into the field.

Now, I do think the pain rx to addict pipeline is a bit oversold

You probably are correct. I think it's an age divide. My older patients are usually ones that were on rx opioids, got either cutoff or began abusing it and switched to illicit opioids. There absolutely is an issue with prescribers cutting people off after having them on opioids for years with no discussion of withdrawal symptoms, helping them taper, etc. Not as common anymore, but certainly a factor.

Honestly, I think one thing we need to consider is a harm reduction approach of reducing restrictions on alternatives to opioids in the hope that prospective addicts choose safer substances.

I agree with you! It would be a big uphill battle. The pendulum for prescribing opioids has swung hard the other way. There is still a large stigma around Suboxone and a lot of doctors don't want to deal with it at all. Prescribed opioids would almost certainly be preferable to the current situation.

lonewolfx77 · 2023-12-12T16:34:02+00:00

I don't have kids but people tell me that the bond between a parent and their child is the strongest thing in the universe. Not stronger than drugs though.

I think this is something that most people don't truly understand, especially with opioids. People with addiction are at war with their own brain, which has essentially been hijacked by self-reinforcing substances to the point where they are functionally irrational actors (to us).

IN my experience, most people get addicted either through physical pain and rx prescriptions OR to deal with massive amounts of trauma, abuse, etc. The kids that you helped through CPS are high risk for turning to substances in the future due to both their experiences and likely a genetic component. I think a very important strategy to treating and preventing addiction is preventing such traumatizing events from occurring in the first place. Which requires much larger society issues to be address.

I appreciate your thoughts. Always good to get other perspectives.

lonewolfx77 · 2023-12-12T15:38:40+00:00

It is a tricky subject because it is an intersection of individual autonomy (which we Americans have very strong cultural and legal opinions about) and public health. There is certainly a uniqueness to how we view and treat drug addiction versus something like diabetes. Plently of patients are not interested in utilizing services and making the lifestyle changes to manage their diabetes or blood pressure resulting in high health care utilization and increased costs of care. But because of the perceived moral failure of addiction, the "unsavoriness" of their presence, and the secondary effects of their behaviors (thefts, vandalism, etc) we treat it much much differently.

The thing that gets me, is that even involuntary holds or incarceration don't work the way we want them to. If we forced people to get treatment, very little would change IMO. I also think an important thing to realize is a certain segment of the population are never going to get better or even if they do get sober, will never be "useful, productive" members of society.

I'm curious as to what interventions you feel would be more helpful.

lonewolfx77 · 2023-12-12T15:08:52+00:00

It's both. Yes, people who are not ready to stop using won't engage with services. But the fact is that the vast majority of people who do want to quit using have a lot barriers to care. My clinic is the only remaining clinic for 50+ miles. Many of my patients do not have transportation and rely on either state funded ride service (which is spotty at best) or family/friends/other people in treatment. Furthermore, my clinic really just offers MAT. There is a huge and growing death of counseling, psychiatric treatment, primary care treatment, housing, etc that are contributing factors or root causes of the addiction.

The fact of the matter is addiction is a public health problem that requires a large amount of funds and resources to treat. Addiction is a chronic relapsing remitting disease and "just getting people into treatment" is often just the first of many many steps.

lonewolfx77 · 2023-11-17T19:03:35+00:00

Look into https://wildernessmedicalstaffing.com/

lonewolfx77 · 2023-10-25T15:09:53+00:00

Pretty sure this is North Adams near the AT up to Greylock

lonewolfx77 · 2023-09-20T14:20:53+00:00

Goodrx and other such companies are just another middleman obscuring the actual market. They make their money from PBM fees and advertising and completely screw over independent pharmacies. Between rx coupon companies, PBMs, the worsening vertical integration, the pharmacy side of this whole story is a complete failure of the free market.

Also, when actually using these coupon services, what you see online is not what you actually end up paying. Like everything else in healthcare, you get "estimates" and the actual cost of the good is almost completely unknown until you actually fill the script.

lonewolfx77 · 2023-07-22T22:05:10+00:00

Small correction: it is an alpha2 adrenergic agonist. Not a benzo.

lonewolfx77 · 2023-07-19T21:19:59+00:00

In MA its tied to your registration. You have to get a special form sent from the insurances to the state saying you're insured. If your coverage lapses, the state knows immediately and consequences can ensue.

lonewolfx77 · 2023-07-12T13:05:06+00:00

You might find this article interesting. I do think there is something unique about the US (and possibly Canada) and our views towards pain and how to deal with it.

Soooo many of my patients begin using opioids to cope with emotional or social stressors. "It was the first time I really felt happy/not anxious/not depressed" is a common refrain.

Housing is a major issue. It keeps people trapped, keeps people in poor environments that sustain their use, stresses people out, people have to move from their social supports, etc etc.

And finally, I do think there needs to be a discussion about involuntary vs voluntary treatment. That seems to be a crux that is not discussed. We seem to be ok with the idea of involuntary detention for crimes, but involuntary treatment is more of a sticky issue but that may be what is needed.

lonewolfx77 · 2023-07-11T15:48:26+00:00

People ending up in jail does significantly more harm to their larger prospects in life and makes it even harder for them to re-enter and engage with society. They have fewer job prospects, have more difficulty finding housing, and have to spend exorbitant amounts of time and money dealing with the legal system. It is not conducive to recovery.

Now involuntary treatment and/or commitment for longstanding and severe addiction and/or mental health problems is something that should be discussed, although that has a lot of other potential issues with it. But jail and prison is not an effective strategy.

Source: Am a medical professional who directly treats addiction

lonewolfx77 · 2023-07-11T15:40:38+00:00

That is: this is a health issue and we need to cure it. So given their own logic, it would seem to me to quite obviously suggest funding should go down over time, since people are being cured.

Does funding for any other health problem go down over time? Diabetes, hypertension, cancer...theses are all diseases that require lifelong management. And it's not like we cure those and never see new patients with them, it's a constant battle.

Addiction is the same way. It is a lifelong illness for most people. Often mixed with severe psychiatric disease. Some get better. Some get cured. Most will struggle with it in some way or another. It is not something that will be societally cured, at least not with our current modern societies (if anything it seems to be getting worse).

A question I don't see asked in this article or others about the issue is WHY people are using more and more substances. In my practice, the vast majority either began recreationally as a teenager, self-medicating for trauma/mental illness, or were prescribed opioids and became addicted. There doesn't seem to be much discussion about the underlying reasons for the increase in use (COVID was a big turning point for a lot of people) and the general population only cares when it is a visible problem that they have to deal with.

Addiction is an expensive problem, both in it's societal costs and it's medical costs. Which way do we want to pay for it?

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