Blessed by the Potato

It’s rare disease day, so let’s look back on TTP, the rare disease that Wayfare had/has.

Thrombotic Thrombocytopenia Purpura

The tense is hard with TTP. It’s a sudden, short-term, life-threatening blood disorder. But even once the antibodies retreat as mysteriously as they appeared and the platelet count goes back to normal, it’s never really gone. There’s a good chance a survivor received organ damage from the clots or bleeding during a TTP attack, which may manifest as brain, kidney, liver, or heart damage — or just about anything else.

But beyond that, there’s the fear that it will come back. Roughly half of patients will at some point have another TTP attack, each of which carries with it a risk of dying during the episode, and accumulating more permanent organ damage and disabilities.

Wayfare essentially has PTSD from her rare disease. It took over a week and several visits to urgent care and the hospital before her TTP was finally diagnosed correctly and treatment started. By that point, she had so few platelets remaining that they had to call a vascular surgeon in to the ICU to do a cut-down on her leg to access a vein. They couldn’t run a central line because if it happened to bleed, she’d bleed out before they could stop it. In the leg at least they had the option of sacrificing the leg and tourniquetting it if the line went poorly.

We can’t afford to wait that long if she has a relapse, but the first signs of a potential relapse are fairly every-day occurrences. So any headache, any mysterious bruise (or one with a known cause that doesn’t look to be healing fast enough), any splotching on the skin, any time she feels maybe more tired than normal… these are all potential medical emergencies and we have to get her blood taken. Every few months we are off to the blood lab on short notice, or sometimes straight to the hospital to check.

Fortunately, there’s a new drug available that can help. She was part of the clinical trial, and was out of the hospital weeks sooner than they had predicted when she went in. Who knows how bad the strokes may have been if she hadn’t got it?

In Which Potato Learns How Drugs are Approved

Being in medical research, but not drug development itself, I thought I had an above-average idea of how drugs get to patients: Someone has an idea, it goes through pre-clinical testing, then clinical trials (Phases 1, 2, and 3) then reviewed by Health Canada, then ta-da, new drug on the market!

Caplacizumab went through all that. It’s safe and effective. Health Canada approved it. But TTP patients in Canada still can’t get it.

We can’t even choose to pay out of pocket for it.

There’s one more critical step: the drug has to make it onto a provincial formulary, the listing of drugs available for purchase somewhere in the province.

A big influence there is CADTH, which makes a cost-benefit analysis. In our case, they decided to recommend against caplacizumab, which as someone with expertise in a related field, who’s done a lot of reading into TTP for obvious reasons, I cannot understand why. Nearly every other nation that’s completed their equivalent review has approved it — if Wayfare gets sick again, we may be best served by putting her on a flight to the US or UK, ’cause their patients can get caplacizumab.

Reading their report, they seem to have mis-understood the feedback patients sent in, saying that we were concerned about the risk of a relapse but the clinical trial didn’t address that question. The subtext is that the company is welcome to fund another clinical trial to answer that question, after which CADTH may re-visit the decision. But that’s insane, no company is going to do that for a rare disease, especially for a tiny country like Canada if the big countries have already approved it!

And that isn’t the point we were making! The point is that caplacizumab works. It works to stop the early disease process where the platelets are forming tiny clots just fucking everywhere and ruining your very best brain tissue and nephrons. It gives you time for the conventional therapy (plasma exchange) to do its job and clear the bad antibodies that kicked the whole cascade off. It gets people out of hospital sooner and with fewer long-term disabilities.

And not just the first time. Half of TTP patients will have a relapse. Some of them have multiple relapses per year. Every time they relapse, they run that permanent organ damage and disability gauntlet: will it be a stroke this time? Will they lose a kidney? Will it affect their energy levels a little, or will everything get all scrambled so much they put the sugar in the coffee maker and the coffee in the cup in the mornings and just cry about how awful their coffee is, unable to make the connection about how to fix the problem?

We wanted them to consider that these risks don’t hit TTP patients just once, they’re a risk every relapse. Cutting those risks down by some significant percentage (the exact number would need more trials but the anecdotal evidence suggests it’s somewhere in the 50+% range) is huge if you have to face that risk over and over again — it compounds. A 10% risk of disability with each attack becomes a 40% chance after 5 relapses. Cutting just 5 percentage points off that risk doesn’t sound like a big deal when you only consider the initial attack in the cost-benefit analysis, but after a few years that’s half as many TTP survivors with a disability.

And more than the hard economics of the cost-benefit analysis: nobody out there knows if they might get TTP. It’s super-rare, you may not have heard about it before now. But once you’ve had your first attack, you live with that constant fear that you might be one of the unlucky ~50% who will have a relapse. You live with PTSD, the constant triggers that any little every day thing might be the first sign of a relapse. Knowing caplacizumab is there to improve your odds if you do relapse would be a huge mental benefit even if you never actually need the drug yourself.

The other side of the cost-benefit was also hard to understand: it’s a niche, antibody-based drug, so it’s somewhat expensive, yes. But it’s not like a take every day forever kind of drug, more like an epi-pen: an emergency rescue medication taken during an acute episode to help buy time for other treatments to work, saving lives and tissue in the process.

Political Action

Right now, the patient group Answering TTP is sending a letter to some of the provincial leaders. It’s still possible for these leaders to choose to make caplacizumab available in their province — CADTH’s report is a recommendation only, it is ultimately a province-by-province decision.

Rare disease day doesn’t just have to be about awareness, we can also help improve treatment with a small step of getting a Health Canada-approved drug for a rare disease into the hands of the Canadian patients who need it.

So please, fire off an email to your province’s health minister, and CC your MPP. Or tweet at them and tell them CADTH made a whoopsie, it happens, but maybe they can go ahead and add caplacizumab to their formulary this rare disease day.

Thanks in advance from me.

Nitpicking

Screw it, I’m clearly never getting a job at CADTH, let’s burn some bridges and nitpick that CADTH report to show you why I just don’t get why this wasn’t instantly approved and lauded as a modern medical marvel!

“During the overall study period, a statistically significantly (P = 0.0004) lower percentage of patients in the caplacizumab group (nine patients; 12.7%) compared to the placebo group (28 patients; 38.4%) experienced recurrence of aTTP…”

Holy fucking shit, how is this not approved on that alone?!?! Yes, above I focused so much on the part they missed, about reducing the risk associated with each relapse, but it also pretty convincingly reduced the risk of relapses themselves in a statistically significant way!

“The submitted price of caplacizumab is $6,200 per 11 mg dose. Assuming 37.2 days of therapy (i.e., the mean exposure to caplacizumab for patients in the active treatment group of the HERCULES trial; the reported maximum was 65 days), the cost of caplacizumab for an aTTP episode is $236,840 per patient…”

That’s the worst-case cost. And like in many clinical trials, they didn’t really know what dosing regimen to use. I would place a sizeable bet that caplacizumab would give almost all of the benefits in a 10-day course costing just $62,000. The mechanism of action strongly suggests to me that it works best early on, and the anecdotes from other patients we’ve heard of include many dramatic turn-arounds in the first week or so. But if you’re running a clinical trial you’re not going to take a chance on that, you’re going to flood the study participants with the medication and be sure it works, and do some real-world evidence gathering to fine-tune the dosage later. More to the point, if Wayfare had a recurrence, she would instantly pay $62,000 out of pocket to get a 10-day course of caplacizumab… if it were available to Canadian patients to purchase in the first place. But CADTH only considered the all-or-nothing case of using the same dosing regimen as the clinical trial.

Indeed, the real-world experience in the UK is that they are tapering down the dosing regimen, stopping when levels are normalized, rather than continuing all the way through plasma exchange. A few years ago their average days of use was already down to ~30, and is likely lower now (as a non-expert pointing to the outfield, I tell ya, 10 days).

There are still a few days of the summer left, and it hasn’t been all bad, but 2022 has been right up there with 2020 as a summer that was not good for me.

Head Injury

It was after getting a head injury that I coined the term “Summer of Suck” in my mind.

It’s not even a very good story to tell: my indoor cat ran outside when my neighbour came to the door. So I tore out after the cat, with my hands making contact, just about to snatch him back up… when I ran head-first at full speed into the overhanging bay window. What they say about scalp wounds is true: they bleed a lot. Within a breath or two I had a big puddle of blood at my feet. My neighbour grabbed some paper towels for me, collected the cat from under the bush, took her dog back home, and kindly drove me to the hospital for some stitches and glue. No cracking under pressure with that one!

I had a ~3″ long slice across the top of my head, deep enough to bleed ridiculously but not showing bone. Thankfully I was seen fairly quickly, and was in and out of emerg in just over 2 hours.

In a bit of comedy, my mask’s straps ended up inside the bandages the doctor put on, so I had to wear it the whole way home until I could cut it off.

The wound healed up fairly well — I’ve got a small pink scar (with a palpable dent) where the stitches were, and the other ~1.5″ of the cut that was glued together seems to have healed without a trace.

Amazingly, I didn’t seem to get a concussion, even though it seems like I exploded my head from the force of the impact — I was wearing a hat which didn’t get cut, which casts doubt on my theory that I got sliced open by a sharp part on the siding.

Grant Conjunction

It was also an insanely busy period at work, another one of those projects where you’re thankful for work-from-home because there simply weren’t enough hours in the week to fit in commuting too (assuming, as we do, that running on 3-4 hours of sleep/night was already on the wrong side of the insane line and that there was nothing left to cut for train time).

It is not done to bite the hand that feeds you and criticize the agencies that provide research funding. But I have to note how crazy this summer was, and it was not because of so many researchers demanding my services. This year an agency launched a call on top of another agency’s major call (they often attempt to coordinate their deadlines better than that), and even just the one competition was so over the top on the work required and the lack of time provided that it was essentially a denial of service attack on the administrative hearts of the research institutions involved.

But the response was their hands were tied because their funding agreement with the federal government required such insane timelines on our end to make it work. And perhaps they have the same don’t-bite-the-hand-just-suck-it-up attitude we have (esp. as we’re the ones dealing with the fallout), but, like, funding agreements can be amended if you realize there isn’t enough time to complete the project on time. Just sayin’.

And that’s all I’ll say about that SNAFU for now.

Site Attack

Oh and speaking of attacks, I also had someone decide to attack the Value of Simple shop with hundreds of fraudulent orders, which soaked up what little blog/writing/side business time I set aside this summer.

Thankfully, Stripe, my main credit card processor, flagged the fraudulent transactions and stopped them after a handful had gone through.

You may not know this about running a small business, but when you issue refunds, you’re still on the hook for the credit card processing fees for that transaction. So if you buy my $7 e-book and then demand a refund (say for the very legitimate reason that someone stole your credit card), and I refund your $7, I still have to pay the credit card processor roughly $0.50 for handling that non-transaction. So I was out about four bucks, which is not a big deal in the grand scheme of things.

But here is where things get ironic: you cannot pay your bill to the credit card processor with a credit card. They want a wire transfer. I haven’t actually ever done a wire transfer, so I went to Tangerine to see what I should do (and how much they’d charge me to do one). While I was afraid it was going to be like a $20 bank service charge to pay my $4 debt, it turned out to be even more of a Catch-22: they don’t offer wire transfers, period.

Eventually my (concussed?) brain caught up with the obvious work-around: I bought a copy of my own book to get money into my Stripe account to cover the deficit.

At the moment, direct sales are suspended until I can figure out a way to help prevent a future attack — Stripe suggests adding a captcha, and I honestly can’t believe that’s not included as an out-of-the-box option in WooCommerce. There’s a third-party plug-in that will do it for $38/yr, which is right in that valley of being much more than the economic loss I’ve suffered while also being less than the brain damage and time I’d have to commit to re-learn a minimal amount of PHP to functionally drop in the code snippet myself.

The book is still available from Kobo, Amazon, Indigo, Google Play, etc., so I’m not in a hurry to make my direct-from-the-author webstore work again, so that may be a while.

I Was Once an Adventurer Like You

I picked up another fun injury this summer: apparently from sitting too long at my desk in suboptimal positions (hundred-hour workweeks will do that), I have blown out my ankle. It certainly wasn’t from physical activity or sports! Too busy to see anyone about it, of course, it seems to be healing slowly (very slowly). Nice big lump in my Achilles’ tendon, and it kind of gives out and won’t hold my weight if I lean to the right. I just hope it’s fully healed by curling season!

Road Trip

Once the grants were in, I was off to PEI on a road trip with Blueberry! This was actually a really nice part of the summer, I’m sure she’ll remember her daddy-daughter road trip for a long time. I was really nervous about it — I used to drive 2 hours at a time every week before she was born, and did the trip out East almost yearly. But in the last 10 years the longest road trip I’ve taken has been 3 hours, and I felt worn out after that. So on the way out I decided to space the ~19 hours of actual driving (plus meal breaks and pit stops makes it even more in the car) over three days, which also gave us a bit of time to hit some tourist attractions.

The driving itself was fine, and she was a great little passenger. So on the way home I decided to do the drive in two days.

And we’ve been home for 8 days as I write this and I still have motion sickness — like when you’re on a boat all day then feel as if you’re swaying when you get back on land, I feel as if I’m rumbling along the highway and get dizzy if I look anywhere but straight ahead. I keep hoping one good night of sleep will fix that… and am just waiting for that one good night of sleep to happen!

The Cat

Not too long after our return, the cat got sick. He threw up in every room of the house (more than once in a few), and stopped eating. I took him to the vet, and he had all the signs of a blockage in his digestive tract. A quick surgery found a section of diseased intestine, like bowel ischemia… but no foreign object causing it! Quite the medical mystery.

He’s forbidden from any climbing or jumping activity, not even going up or down stairs for 14 days while he recovers. Yeah, try telling a cat that. The first few days he was so sick and tired and low energy after not eating for a day and then surgery that it was easy to comply, but we still have the better part of a week to go and he is done with recovery.

More Injuries

And then I fell down the stairs randomly. I’ve tried to replay what happened but while I remember the landing, I don’t recall exactly what caused me to fall in the first place. I don’t think I was dizzy from my weird road trip motion sickness, but it could have played a part. I don’t think my weirdly injured ankle gave out, but it was the one that I fell on.

I managed to land pretty much on my kidney, catching a riser across that lower back area. On the plus side, I didn’t hit my hip or a rib so no broken bones. On the down side, everything hurts. And honestly, who lands on their kidney?

The Next Quadrennial

The past few years I’ve gotten more serious about curling (by which I mean, I play more often. I’m still plenty silly on the ice). I even have a team in the team-entry league! We have matching jackets!

Or, had. After the Olympics, many of the pro teams broke up and re-formed for new configurations to try to win their medals in the next 4-year cycle. And I guess that happened to us, too? So now I’m sad because I have to find a new curling team.

My Mom

And of course the worst for last: in case you weren’t aware, my mom has MS, and has been living through the gradual loss of function for years, but up until recently was still walking with assistance (i.e. a walker), could stand up, etc. Early in the summer she very suddenly and unexpectedly lost a lot of lower-body function and requires significantly more help in the daily activities of life. She apparently didn’t want to tell any of her relatives out on the east coast, and had just mysteriously cancelled her planned trip out there on them. So I got to be the herald of bad news while I was out there.

I had originally written that we were waiting on PSW support from the Province, but before hitting publish (and after two months) we finally got coverage for two visits, five days a week, which should help with some of the burden (which is falling mostly on my sister).

The Summer of Suck Comes to a Close

So, as August comes to a close, hopefully that is it for injuries and stress and bad news and health problems.

I haven’t had a chance to work on any of the site/side business goals I had for this year yet. No fun blog posts. And the health goals are way out the window, there’s no getting those back.

It’s been a hard slog for mental health this last year. Tough on physical health, too.

Err… year and a half. Damn.

Anyway, it just never seems to end.

There are some things we can do to help cope better, of course. They’re not panaceas, but they can help at least a little. The thing is, I have never managed to internalize those lessons.

Some pretty basic things can help with mood and energy levels: if I do some exercise, if I eat some fresh fruit, and I do it consistently, I’ll start to feel a little better in about 2 weeks. I’ve done enough tests with getting into a depressive funk where I don’t do those things and then forcing myself to do them again and it helps (not a full cure, but helpful).

So I try, every day, to at least go for a walk and it’s such an easy sounding thing to do and yet so hard. The eating is even harder — pandemic baking and potato chips have done a real number on my diet, but I consciously work in at least one piece of fresh fruit.

Then someone posted this meme of a determined/upset-looking bald eagle and that has become my new slogan. “I’m going on a stupid walk for my stupid mental and physical health. See you in an hour.” and I repeat it each night.

It’s still not a habit, and it’s still not an internalized lesson — I very much consciously get up and go for that walk (and repeat my refrain about my stupid mental and physical health). Maybe one day I’ll be one of those people who jumps out of bed and then exercises before staring the day, though that has always sounded just terrible to me. I also have to try to remember the gremlin rule: no snacking after midnight (I mean, no snacking ever would be even more effective but it’s not as cute and super-hard).

Am I feeling better now that it’s been a few months of semi-consistent bare minimum self-care? I don’t know, I guess, a little.

I think there was also something about sleep? Crap, forgot about that one.

Anyway, I think because the effects are so delayed I never learn that lesson. I don’t often feel energized after exercising, I feel tired and sweaty — but after a few weeks of doing it every day, I do feel more energized. But such a long stimulus-response delay keeps me from internalizing that message, and without that constant conscious effort, I quickly slip back into slothful inaction.

I can of course relate that back to investing: there are lots of lessons that aren’t easily internalized and we have to keep reminding ourselves of. Market timing and adding complexity are two that immediately spring to mind, especially in the current age of meme stonks and bubble warnings.

Ontario provided its updated figures and modelling for covid today. The slides are available here if you want to look at the data without squinting at the video.

It’s not all that unexpected — I was sketching vaguely similar curves and worried about what an even more contagious version might do. But hearing it made real was just crushing. Covid’s on track to challenge heart disease and cancer for the top cause of death in Ontario this year (and will make the top 10 easy). And the strain on the hospital system is delaying treatments (esp. surgeries) which will make those other conditions worse.

But the big, not entirely surprising bad news is the hospital system and ICU beds: we’re just about out of empty ones, and the curve is still rapidly going up and to the right. Surgeries are being cancelled (again), and we’re not far off from very painful decisions about what happens if there’s a car accident.

One thing that’s crushing is that we were so close to getting to zero in the summer, and just opened back up a few weeks too early, without the testing and tracing capabilities ready. Still, the cases were low, everyone had stocked up on masks, and I genuinely thought we could get back to normal-ish with masks, handwashing, and social distancing*. I signed up for curling, expecting we would get a season, esp. with the modified rules of play (everyone wears masks, and things like using one sweeper to maintain 2 m between players at all times) — I had my mask rotation all planned out, and even got contact lenses so my glasses wouldn’t fog up. Schools reopened, and we kind of talked about how important that was for parents to be able to go back to work.

Then the cases started rising in the fall, and we did nothing about it until we’re now finding the hospital capacity getting crushed again. More people are going to lose their dads and other loved ones to cancer because surgeries had to get postponed, again.

I’m depressed and angry and just crushed at the whole thing.

I’m also a touch confused. They showed some data about how many people were moving around — people going to work has stayed steady since the summer, even as Toronto, Peel, and York went into lockdown (code red or grey or whatever). How there was a big spike in people visiting other residences at Christmas (to the surprise of no one). But I haven’t heard much on contact tracing and explaining what’s behind all the transmission. Are masks and handwashing and social distancing working, but some people aren’t compliant, and it’s that movement that’s the problem? Is it schools or workplaces or superspreader weddings? A little bit of everything adding up?

For most of those questions there isn’t much I can do on a personal level. I’ve tried to cut out contact with the outside world as much as possible, stretching out the time between grocery trips to two weeks or so, and our social circle is a completely closed bubble of 5 people. Wayfare has been making homemade masks since the beginning, and she did a lot of research on the best patterns and designs. They’re 3 layers, with two layers of regular (cotton?) fabric sandwiched around a layer of non-woven interface material. They have metal strips to conform to the nose (important to minimize glasses fogging and get the air moving through the material for filtering and not around the material), and straps to tie tightly around the head, which keeps it pretty well sealed all the way around the face. Though she made a few models with noses or cone shapes or whatever, I wear the basic pleated rectangle ones, so there’s no tiny holes from stitching a seam right in front of your nose. I’m sure they’re a step up from disposable surgical masks, even after a few washes. And I’m very good about wearing it whenever I’m indoors (or with another person outside — though I don’t wear one on solo walks).

However, are cloth masks enough, especially with the new B117 variant? Should we all (but especially should I) be wearing a N95-equivalent to go grocery shopping?

* – Circling back around to add: I thought the masks, distancing, etc. precautions would be good enough to get r < 1 so life could return to more-or-less normal. It doesn’t look like those were sufficient in practice (whether it’s non-compliance or whatever is a bit of a moot point as we will have non-compliance, esp. as covid fatigue sets in). We are a long, long way from Covid-zero (and we were really close in the summer!), but that may be the only strategy that lets us avoid the hammer and the dance through the fall based on the current vaccine roll-out projections.

Phew, 2020’s over (or almost over, as Scalzi makes a good point about the calendar not truly representing the essence of 2020).

What a dumpster fire of a year. I had huge plans going into the year: I was taking time off work to take care of my dad, which was going to leave me with so much free time to update the blog (not just post more, but re-brand or whatever), write a book or two or three… and just none of that happened. I didn’t even play any cool video games, as my brain seemed stuck in neutral and was just fine playing the classics again and again.

And speaking of the old brain working at half speed, I already whined about this. I said back in September that I thought I was doing a bit better. And I suppose that’s true, though I didn’t make much progress on the side quests. I started working the day job again in October, and that seems to be about my limit. I’m working from home (global pandemic and a non-essential worker whose usual desk is in a hospital hell yeah I’m working from home), which means I’m saving a good two, two-and-a-half hours every day on my horrific commute, so a small part of myself keeps saying I should have time to edit that podcast episode and actually release it, or write a book chapter, or get something done… but that’s not the proper baseline. I suppose my brain is doing a bit better than the middle part of 2020 if I can manage to not get fired, but that’s about all I’ve got right now.

Anyway, it’s over. I missed all the goals for 2020, time to feel sorry for myself. And most of what I wanted to accomplish was not physically impeded by the pandemic (or dad’s death), so the only excuse that provides is that I was sad and mopey.

But that’s hyperbole. (Fitting as the expression originated with Hyperbole and a Half) I mean, I fell way, way short of what I wanted for 2020: gaining back weight, making no progress on the books, etc., etc. But way short is not nothing.

After procrastinating for an embarrassingly long time (esp. as a personal finance guy), I finally wrote an updated will to include instructions for what should happen with my kid (and she’s only 8 so I procrastinated for less than a decade — victory!). Part of the issue was getting both parents to a lawyer in meatspace — a surely insurmountable problem that neither of us had the motivation or time to deal with at the same time. For 8 years running. Finally I decided to use an online service (I used legalwills.ca but I’m sure Willful works too if you have also been procrastinating). So hey, that’s done.

I updated the CPP calculator for 2021’s numbers (which I didn’t manage to do for 2020’s YMPE).

I think I have my dad’s estate mostly handled (there’s still the Smart car to sell, and one account left to close, plus all the tax filing — but mostly). [PS: anyone looking for a 2016 Smart Fortwo that’s been sitting in a garage for a year and a half?]

And I started learning to play the ukulele. That’s a big step because I’m not the least bit musical. I couldn’t carry a tune in a bucket, and often lose time clapping along to a song. Wayfare still stares in amazement when I practice: “It’s like watching a dog talk. It’s not something you ever expected to see.” So I guess that’s progress of some sort? I also put Duolingo on my phone and have been practicing my French (with a 253-day streak as of this posting!)

The big book idea was tentatively titled the Personal Finance Mission Binder and it was all about planning — especially around emergency funds and various disasters. It had a chapter on “Rules for Freaking Out” in the detailed outline (which was all pre-pandemic), which may have been handy to have finished earlier this spring (though who really knows, it may have been terrible). Even though I did absolutely nothing for it this year and missed out on the best possible timing for a book on that topic, I can cross it off my list now! Because after this nobody’s going to need a book on emergency funds or preparedness (and I’ll bet that 10 other authors are going to be inspired to write one).

And one thing I hadn’t actually had on my to-do list but wanted for a long time was to get another pet. My cat was a magical one, who didn’t set off Blueberry or Wayfare’s allergies, and we weren’t sure we’d ever find another like that. They seem to be less allergic to dogs, but dogs are work (one benefit of the pandemic is that all the good boys have found homes, but makes it hard for us to find a pet). Then Wayfare managed to find a cat who was looking for a new home. She was looking hard in the background and keeping it a total secret from me, and got ghosted a few times along the way. So just two days before Potatomas, this little big guy moved in, which is a pretty good way to end the year and start the new one:

I could start listing all the things I wanted to do and didn’t, all the terrible disasters of the year, the mismanagement of the pandemic, the things still on my whiteboard and getting a real good depressive funk going. Instead, I’ll just say that this was a real dumpster fire of a year, and I’ll console myself with knowing that I got just a little bit more than nothing done.

It was also a very weird year for the passage of time. At times it’s felt like March 233rd, with a kind of sameiness to the days that comes from making no progress on any projects and staying inside all the time. But time also seemed to fly by — I’d blink and it would be a week later (usually when thinking I might get X done by Y, only to find Y came and went without any noticeable progress on X). I can’t believe it’s already 2021.

I haven’t set any specific goals or resolutions for 2021 — starting from where we are, I just want to survive the damned year.

Though I suppose I can copy-paste a part of my 2020 list as a start:

• Write a book: Personal Finance Mission Binder Oh right, off the list because who needs that book now?
• Write a book: untitled kid’s book based on the bedtime story I told Blueberry that one time in the car
• Update a book: do a 3rd edition of the Value of Simple now that all-in-one funds are in the market and Tangerine has finally released their new lower-cost funds
• Create a new stand-alone site for the directory of fee-only planners.
• Get the band back together (which starts with me actually editing the episodes that are in the can, the can being my harddrive)
• Try to take over the world
• Get back in shape

That last one has proven hard. The “quarantine 15” snuck up on me gradually, then suddenly it was the “quarantine 19” which was fine because the rhyming structure was still there, but then it became the “quarantine I’m too afraid to step on the scale whoops now there’s something blocking the scale guess I won’t know until I move that thing in the spring” which doesn’t seem healthy. I know how I lost the weight the first time, but sticking to the plan has been a lot harder — partly because it’s harder to get the exercise in regularly, and partly because sticking to the diet has taken emotional energy I just don’t have most days. I’m still afraid to step on the scale, though I’m fairly certain I have managed to at least arrest the rise. I got Ring Fit Adventure for the Switch, which is providing a way to get some exercise in even if I don’t leave the house.

Anyway, farewell to a terrible year for nearly everyone. Be kind to yourselves looking back on what you may or may not have accomplished with your time — even if it felt like you should have had done more but did less. I know it’s hard for me to look back and not berate myself for wasting so much time, but that was 2020 for you.