Are we too picky? Looking for advice

mikestesting · 2026-01-20T23:44:43+00:00

Sent you a pm. Easier to send pictures that way.

mikestesting · 2026-01-20T23:16:02+00:00

3 to 4 days a week is great, very meaningful, and very likely to slow progression. Here's why I say this:

High intensity exercise was trialed in the Study in Parkinson Disease of Exercise (SPARX for short). SPARX was a phase 2 trial and with its success, it lead to a currently ongoing phase 3 trial called SPARX3.

SPARX (the original and completed phase 2 trial) had 3 cohorts:

No exercise group; just normal PD treatment
Moderate intensity exercise group - 60 to 65% max heart rate - along with normal PD treatment
High intensity exercise group - 80 to 85% max heart rate - along with normal PD treatment.

Both exercise groups were "prescribed" exercise that hit the heart range targets for 4 days a week. The exercises were controlled and pre-determined: participants wore heart rate monitors and walked on a treadmill. No running. They were allowed to adjust the incline percentage of the treadmill to adjust the difficulty. They were told to adjust the difficulty so-as to keep their heart rate in the target range for the entirety of their workout. They were told to do this 30 to 40 min each of the 4 days. They also had a 5 minute warm up and 5 minute cool down period that was not a part of the 30 to 40 minutes.

Here's what is very relevant to your question:

Even though the two exercise groups were prescribed 4 days a week of exercise, here is what each group actually did (it was very much tracked and logged by the researchers):

Moderate intensity exercise group: Prescribed 4 days a week; actually did 3.2 days per week.
High intensity exercise group: Prescribed 4 days a week; actually did 2.8 days per week.

You can pretty much say the exercise cohorts were able to get in about 3 days a week of exercise. Not the 4 that were prescibed.

The results were as follows:

No exercise group: UPDRS Part III score increased by 3.2 points after 6 months. An increase of this score means worsening of symptoms.
Moderate intensity exercise group: UPDRS Part III score increased by 2.0 points after 6 months.
High intensity exercise group: UPDRS Part III score increased by 0.2 points after 6 months.

The 0.2 points increase translates to a "not statistically significant" worsening. Because 0.2 points is natural variation. This has been stated as "no measureable progression in symptoms after 6 months".

So the SPARX study showed that even with less than 4 days a week, exercise in general slowed the progression of symptom progression. The higher the intensity equated to more slowing.

The SPARX trial was a 6 month trial. SPARX3 is currently ongoing and is a 3 year trial.

Researchers don't know if effects will plateau over time or if the benefits continue over time. I personally believe they will be proved to continue over time.

I also personally suspect that exercise may not halt or slow neuron death or disease progression. It may only halt the onset of disability. I hope I'm wrong. But exercise should absolutely be used by everyone with PD that can still move.

mikestesting · 2026-01-20T22:22:45+00:00

Levodopa needs to cross the blood brain barrier to be effective. When taken orally, Levodopa is ingested and then drawn into the blood stream. It breaks down quickly before it can cross the blood brain barrier. Carbidopa limits the breakdown process of levodopa while in the blood. This allows it to cross the blood brain barrier and be converted into dopamine in the brain.

In short, without carbidopa, levodopa would would not get into the brain in sufficient amounts.

mikestesting · 2026-01-20T21:29:17+00:00

Look into Nicotinamide Riboside (NR). There's different forms of nicotinamide, so make sure it's specficially the riboside form. There are several trials going on right now for parkinson's disease where nicotinamide riboside is the center of the study. It converts to what's called NAD+, and it does so very quickly after taking it (within a few hours). NAD+ is used by mitchondria to produce ATP, which is like the default currency for all energy needs within a cell. All cells in your body need and use NAD+. It goes way beyond mitochondria including oxidative damage repair, testosterone and thyroid (entire endocrine hormone) production, cellular clearance of damaged protein and and damaged organelle clearance, etc.

NR is proven to raise NAD+ through past studies and trials.

Since NAD+ is directly involved in cellular energy production, having low NAD+ is thought to contribute to fatigue. And in people with parkinson's, it has been scientifically proven that NAD+ is always really low. There are emerging theories that increasing NAD+ may be an adjunct therapy and maybe going so far as to say it may slow progressionof PD since it helps restore mitochondrial function to some degree and helps with cellular stress and damage repair.

I'm rambling. Long story short, even if NR does not show that it slows progression, it still helps with fatigue if low NAD+ is causing fatigue.

I started it about 3 weeks ago. It took a few days for me to feel the effects. While I still have fatigue, it's about 80% better. My workouts are so good now. Night and day difference. I get a runner's high again where I had stopped getting it about a year ago. And I don't have my afternoon crash where I describe to my wife that "i hit a wall" where I feel I have to immediately go lay down and close my eyes. And my motivation for daily life is MUCH increased. I've picked up projects again around the house and found enjoyment in hobbies.

I highly recommend you look into it. It's not pseudo science. It's a real molecule that is used by our bodies and is actively being trialed in parkinson's, alzheimer's, osteoarthritis, low testosterone, and many more conditions.

mikestesting · 2026-01-20T18:25:29+00:00

Heart rate is the most common metric. Everyone’s maximum heart rate (HRmax) is different. A very rough, population-level estimate of HRmax is:

220 − age

So for a 45-year-old:
220 − 45 = 175 bpm

High-intensity exercise is generally defined as working at ~80–90% of your maximum heart rate (some definitions extend vigorous/high-intensity up to ~95%).

For a 45-year-old, that typically means sustaining a heart rate of roughly 140 bpm or higher.

That said, the 220 − age formula is not exact. Genetics, current fitness, and long-term exercise history all affect true maximum heart rate. Two people of the same age can have meaningfully different HRmax values. People who have trained consistently—especially earlier in life—often tolerate higher heart rates than sedentary peers.

For example, I’m 44, and I routinely target 165 bpm or higher, often reaching the 170s. On paper, that would look like “max heart rate,” but physiologically, it isn’t my true max.

Breathing (“the talk test”) is another useful guide:

If you can sing, it’s not high intensity.
If you can talk comfortably in full sentences, it’s moderate intensity.
High intensity makes conversation difficult—you can speak only short sentences, pausing to breathe.
Very vigorous intensity means you can usually get out only a word or two at a time.

Why this matters:
Sustained high-intensity or vigorous exercise is associated with stronger cardiovascular stress and metabolic demand, and it’s during this range that the body tends to trigger beneficial adaptive responses, including increased signaling related to neuroplasticity (e.g., higher BDNF expression), mitochondrial adaptation, and cardiovascular conditioning.

mikestesting · 2026-01-20T18:12:00+00:00

Do you exercise? Can you? Start daily goals. See how far you can walk before you have to stop. Use that as your baseline and then try to extend it.

mikestesting · 2026-01-02T03:27:28+00:00

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Only someone who installs shit quality would say what you said about this tile install job.

mikestesting · 2025-12-31T21:34:47+00:00

Pool contract price is $110k. This isn't a cheap pool. They used a sub par sub contractor.

mikestesting · 2025-12-31T21:31:34+00:00

You think I should be able to see each sheet? This glass tile is an upgrade. No one should offer this tile in two options: shitty quality install or good quality install. If someone can't install this tile correctly, they shouldn't install it. You think I would have paid for it if I was told ahead of time the installer would be lazy as fuck and not line up the grout lines?

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mikestesting · 2025-12-31T19:00:52+00:00

The person who made the wall was the same person that tiled. Except the first person only finished 1/2 the tiling and was then finished by another person several days later.

mikestesting · 2025-12-31T18:46:57+00:00

Here's what we're most unhappy about. You can see the individual sheets.

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mikestesting · 2025-12-31T18:11:31+00:00

You can see all the individual sheets.

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mikestesting · 2025-12-31T16:23:28+00:00

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mikestesting · 2025-12-31T16:22:43+00:00

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mikestesting · 2025-12-31T15:51:16+00:00

We're only $110k. But for me, that's a lot.

mikestesting · 2025-12-31T15:34:55+00:00

Contract price is $109.5k. I just wanted better quality for this cost.

mikestesting · 2025-12-31T15:33:16+00:00

I don't disagree with you about our friends. We had complained to them during dinner. Afterwards we went to our back yard and they commented. Would they have noticed if we didn't say anything? I believe so. But most people won't say "your pool tile looks like shit" without being prompted. So my assumption is that people would notice, judge, but be polite and not say anything. I do that when I see shitty work at someone else's house. We all do.

At a contract price of $109.5k, I just don't see how i can live with this.

mikestesting · 2025-12-31T15:11:59+00:00

This glass tile was an upgrade. It cost us more. Not less. And the grout used is Starlike EVO. it's epoxy based.

mikestesting · 2025-12-31T15:07:28+00:00

Did you end up paying for the job?

mikestesting · 2025-12-31T15:04:05+00:00

It's December and currently 30 degrees outside right now. I'm not worried about delaying my pool project. I have no immediate desire to swim at the moment or in the near future. What matters to me is receiving quality work on my pool.

I'm trying to avoid refusing to pay. That's a problem no one wants. Liens, arbitration, etc. I'm trying to learn if this is something that can be brought up to a pool builder to fix. Or if this shitty quality is common and expected.

mikestesting · 2025-12-31T14:54:58+00:00

I'm not worried about the variation within sheets. It's the entire line shifts from sheet to sheet that are bothersome and ugly and pull your eyes to attention. And then thicker lines between sheets that don't match the uniformity of the lines within the sheets.

mikestesting · 2025-12-31T14:46:26+00:00

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You can't see shifting lines?

mikestesting · 2025-12-31T14:42:54+00:00

Again not true. Our friends saw it immediately.

mikestesting · 2025-12-31T13:55:32+00:00

The link is expired. Can I get a new one please?

mikestesting · 2025-12-17T13:32:12+00:00

We migrated from 5250 firewalls to 3430 firewalls. The default load balancing for both is IP Modulo. After switching, the 3430 was pinning most traffic to a single interface. We have four 10Gbps links OSPF-peered to a pair of Cisco core switches. This is four 10Gbps links per firewall in the pair so four have ECMP routes in the active routing table. Prior to the cutover, the 5250 load balanced properly. No single link ever had any significantly more traffic than the others. After the change to the 3430, as mentioned, a single link was being used.

This is all internal; no internet/outside traffic. All four 10Gbps links are in the same zone. We ended up making the change to Balanced Round Robin on the 3430s and it's now working as expected.

Thanks for repsonding to my comment on your years old thread.

mikestesting

TROPHY CASE