Coriell has been the most satisfying for me personally, since they occasionally email a PDF of a manuscript that is based on analysis using data derived from my (and many other\u2019s) saliva. For me, at least, getting to read science papers and think, \u201cI helped!\u201d is much more motivating than cryptocurrency based micropayments<\/a>.<\/p>\n While it\u2019s all been fun and interesting, I haven\u2019t learned very much that was terribly actionable. Without putting too fine a point on it, I have basically re-verified that I don\u2019t have any of the major genomic disorders that would have already shown up by middle age. My standard line describing what I learned is I\u2019m most likely male, almost certainly of northern European descent, likely brown hair, likely brown eyes, etc.<\/p>\n One way this shows up for me is that I don\u2019t really know where to focus my health and lifestyle efforts. Sight unseen, one might tell a person like me that I should work out a little more, mix it up with cardeo and weight bearing exercise, eat a mostly vegetarian diet, don\u2019t smoke, drink in moderation if at all, maintain a regular sleep schedule, use sunblock, floss, don\u2019t sit too long at work, meditate, never read re-tweets, practice test driven development, etc, etc, etc.<\/p>\n None of it appeals and more or less because I know<\/b> that all this advice is generic. I.e: It doesn\u2019t really apply to me. I\u2019m pretty healthy, so who cares, right?<\/p>\n On the opposite side, I\u2019ve written before<\/a> about my frustrations in convincing my physicians to screen me for colorectal cancer. I have a family history on both sides, genetic markers, and a medical history that all point in the same direction: Elevated risk. The current state of clinical practice is that men don\u2019t need screening before age 50. I\u2019ve been getting screened since my late 20\u2019s, and I persist in thinking that it\u2019s a really good idea. This is one of those cancers that is easily treatable with early detection and lethal without it.<\/p>\n So there we have it: Advice is either so generic that I ignore it, or else when I do have actionable information it\u2019s a challenge to convince my physician to act on it.<\/p>\n Enter Arivale<\/a>. They are a relatively recent addition in the direct to consumer health and lifestyle offerings that are cropping up this year. I heard about them through professional connections (thanks Dave!<\/a>), and I\u2019ve been excitedly waiting for them to offer services in Massachusetts.<\/p>\n The Arivale process involves a battery of bloodwork, genetic testing, and a gut microbiome (which is a novel experience if you haven\u2019t provided a laboratory with a stool sample before). They combine this with coaching from people trained in nutrition, genetic counseling, and behavioral modification.<\/p>\n Because of the niceties of paying for lab work, I had to leave Massachusetts in order to reach a lab who could actually accept my money to draw the blood. Bright and early on a morning in the middle of February, I made a pre-breakfast, pre-coffee commute into New Hampshire to be stuck with needles.<\/p>\n Let me pause and say that again: Our health care system is so screwed up that I had to cross state lines to get bog-standard bloodwork done, entirely because I was paying out of pocket for it.<\/em><\/p>\n I also filled out a battery of health and family history questionnaires, as well as some about personality and lifestyle.<\/p>\n A couple of weeks later, I got an email and logged into a slick web dashboard. I went ahead and did the integration with my Fitbit account. I disabled GPS location sharing but enabled the rest. Let\u2019s hear it for granular access control. Because Fitbit connects to my wireless scale, my Arivale coach was suddenly able to access five years of weight data on top of the four years of info on my pulse, sleep, and walking habits that my Fitbit devices have accumulated.<\/p>\n Let me pause and say that again: I logged into a slick web dashboard and integrated years worth of data about myself in the context of a new battery of lab tests. At no point did I have to write down my previous physician\u2019s FAX number on a piece of paper.<\/em><\/p>\n It felt normal and ordinary, because I\u2019m used to these integrations everywhere except<\/em> health care. I do this sort of thing with my bank, my utilities, my news feed, and all sorts of other places.<\/p>\n That is a different rant, but come on!<\/em><\/p>\n Ahem.<\/p>\n Anyway, I logged in and saw (among other things), this:<\/p>\n It honestly gave me pause. I\u2019m pretty robustly healthy. I don\u2019t expect to see any of my biological metrics \u201cin the red,\u201d but there it was.<\/p>\n So I did a quick Google search, top hit, I feel lucky: A bit of refinement:<\/p>\n Which led me to look at my last few Grubhub orders.<\/p>\n Yeah, every time I order, I bolt on that mackerel. That\u2019s for me. That\u2019s my treat. It\u2019s worth noting that February 15 was the night before I made that hungry, grouchy drive. I know that mercury accumulates in tissue and lingers there over time, your milage may vary, but it\u2019s a pretty clear signal in my book.<\/p>\n And it showed up in my lab work.<\/p>\n So there you have it. All of a sudden, I\u2019ve picked something actionable to do for my health \u2013 out of the incredible variety of good advice at my fingertips. Because, well:<\/p>\n I just had a personal experience with how timely, personal measurements can drive better health and lifestyle decisions. Unfortunately, it wasn\u2019t related to any of the times that I\u2019ve been genotyped, nor was it in the context of care by any physician. In fact, I…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[37],"tags":[],"class_list":["post-415","post","type-post","status-publish","format-standard","hentry","category-genomics"],"_links":{"self":[{"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/posts\/415","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/comments?post=415"}],"version-history":[{"count":9,"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/posts\/415\/revisions"}],"predecessor-version":[{"id":1140,"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/posts\/415\/revisions\/1140"}],"wp:attachment":[{"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/media?parent=415"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/categories?post=415"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/dwan.org\/index.php\/wp-json\/wp\/v2\/tags?post=415"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}A question of focus<\/h1>\n
Personalized bloodwork<\/h1>\n
Show me the data<\/h1>\n
Retrograde<\/h1>\n
![\"\"](\"https:\/\/dwan.org\/wp-content\/uploads\/2018\/03\/mercury.png\")
<\/p>\n
\n![\"\"](\"https:\/\/dwan.org\/wp-content\/uploads\/2018\/03\/mercury-4.png\")
<\/p>\n![\"\"](\"https:\/\/dwan.org\/wp-content\/uploads\/2018\/03\/mercury-2-1.png\")
<\/p>\n![\"\"](\"https:\/\/dwan.org\/wp-content\/uploads\/2018\/03\/mercury-3.png\")
<\/p>\nFallout<\/h1>\n
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<\/p>\n","protected":false},"excerpt":{"rendered":"