Vision for a better content on the Internet

https://pashanomics.substack.com/p/a-vision-for-better-content-on-the

Responsibility over parasociality

https://pashanomics.substack.com/p/responsibility-over-parasociality

Social media and mental health:

https://pashanomics.substack.com/p/social-media-and-mental-health

A Maxillary Skeletal Expander (also known as MSE), is a class of devices that use at least 4 screws also known as Temporary Anchorage Devices / TADs to attach to the upper palate. While it’s not considered a “surgery,” the screws generally need to be inserted by a surgeon under anesthesia. It works by separating the mid-facial bones that were previously two separate bones, but fused together at the mid-palatal suture. The MSE is a newer version of  Miniscrew-Assisted Rapid Palatal Expansion (MARPE), which is a type of Rapid Palatal Expansion (RPE).

Rapid palatal expansion historically used teeth-based forces and only worked in teens. Trying to do tooth-borne-only appliances in adults would likely only damage teeth. An MSE generally uses only bone-based forces and can work in adults. There are MSE variants such as MANE which uses both screws and teeth attachments to exert forces. The last one is what I had done and my experience has been fairly positive.

Generally, an MSE can have issues, such as insufficient grip of the bone with the screw and the suture being too strong to split. In this case it’s very possible to either get “screw drag” where the screws cut through the soft tissue with no expansion or a partial expansion either on only front or back or skewed to one side. Some undesirable teeth “tipping” can occur as well, where the angle of the teeth changes from being straight down due to pressure. In case one’s issue is only a partial expansion, a second MSE or one with more than 4 screws might finish the expansion.

However, if successful, and MSE and similar devices can improve the airway and create a great improvement in sleep apnea outcomes.

The very name Paleo is taken from “Paleolithic era”. We eat like cavemen because that’s what we are adapted to it evolutionarily. It’s simple. If a caveman lived till 5 years old and also managed to avoid getting killed in war, they could live a very long life.

Wikipedia has a horribly written article on Paleo Diet, which I will not link due to disrespect. There is an unfortunately common near non-sensical “claim” that humans could have evolved better digestion since 10000 years ago to match their diets, therefore they must have evolved better digestion.

It’s pretty sad sight to see stuff like this on wikipedia, not just because it’s a bad argument, but partly because it perpetuates misunderstandings of what “evolution” actually is.

Let’s talk evolution 101. Evolution is change of genes frequencies in a population over time. Evolution is *not* humans collectively deciding to learn some new skill, nor should it be modelled as a “progress” or “regress” towards a point. Evolution works by some people dying more or less than others and having kids more or less than others. Inequality in outcomes is what drives change. Change has a directionality of “being more adapted” to the environment, however it does not have to have other directionalities, such as more “moral” or “happy” people.

It could, but doesn’t have to. Evolution isn’t a nice process, nor is it a mean one, it merely is.

if we suppose that a particular genetic dietary ability is in the process of “evolving” in humans, that means this ability is going from “rare” to “less rare” through conferring some sort of advantage to people who have it. Or, by conferring some sort of disadvantage to people who don’t have it, such as being poisoned by the food in question. So, if an ability to digest a particular food is in “evolving” in humans, that means either

1. the food is so incredibly valuable and able to give nutrients you can’t get elsewhere to people who can digest it

2. The food is actually poison to people who can’t digest it, but they are eating it for some reason anyways.

Now, explanation 1: food good is plausible really only for a strange situation when the food that not everyone can digest is capable of providing something that humans simply can’t get through foods they *can* digest. This can happen during famines or serious changes in food availability.

"Explanation 2: food bad" is a plausible explanation in times of higher food availability, but stronger cultural pressures to eat things that are bad for you.

However, "Explanation 2: food bad" is just the argument FOR the paleo diet, not against IT. Since “we are evolving towards being able to digest some food” is actually *evidence* FOR this food being poison for a large portion of the population, not *against* it. However, it’s easy to get strangely caught up in the “positive” affect of the word “evolution” without realizing this “evolution” might mean you dying from eating shitty food.

There is actually an interesting example of a food that is in the Explanation-1. It’s milk. Ability to digest milk has actually become far more common in Europeans in the last 10000 years. It’s not as common in other peoples. This actually presents a little bit of an evolutionary puzzle as to why milk is so valuable, especially since cheese and other milk by-products have less lactose and are thus easier to digest even without this ability. Also, if it is so valuable, why is it more valuable for Europeans? One guess is that likely Vitamin D is harder to acquire in Europe than other parts of the world. Another guess is that milk was cleaner from bacteria compared to water.

Still the ability to consume milk, or lactose tolerance is still not genetically 100% despite the surprisingly massive, but not yet understood advantage. Lactose intolerance still exists and likely is less hurtful if one can get both clean water and vitamin D from sunlight or supplements.

The important thing to understand here is that milk is an exception not the rule. There are well understood genes affecting it. The protein for digesting milk has always been present in people, it’s just that its production has been turned *off* in adulthood. One can imagine that evolutionary changes that merely turn a feature *back on* are simpler to acquire than ones responsible for a brand new protein. Lactose tolerance conferred a significant advantage in one part of the world, but not others and it still remains a mystery of why it evolved so quickly.

Other non-paleo foods do not share the same path. If we take celiac disease, for example, which might seem like clear potential negative, we find a hugely surprising “The genetic variants behind celiac disease seem to be just as common now as they've been since humans began eating wheat.”

This may be surprising to you because effectively a large portion of the population is *not* adapting to eating wheat and doing perfectly ok despite it. In reality, “Celiac disease” is likely called a disease by mistake. A more precise name is an auto-immune disorder, but I suspect it’s merely an immune system with a more aggressive Self-Other distinction. This likely confers massive advantages when not eating wheat to compensate for the dis-advantages. Ability to digest foods doesn’t come for free, it may require down-tuning one’s immune system to not recognize certain things as enemies. I wouldn’t actually be surprised if the genes coding for this actually became more prevalent in today’s world which has a large variety of both foods and hostile parasites.

If we take a lot of other foods that Paleo prohibits, we find that they are actually quite recent and certainly did not have the 10000 years that milk had. Not that there is a guarantee they would become more digestible if they did.

Sugar Cane arrived in Europe in the 13th century. Potatoes and sunflower didn’t arrive in Europe until 16th century. Soy in Europe was even later, however it has been cultivated in China for thousands of years. Gluten content of wheat has also risen in the last century, making it quite different from what it used to be.

It worth noting that different groups of people have had different foods for the last 10 000 years and likely in the years prior as well. You might be more adapted to eating the foods your particular ancestors ate, but this isn’t a guarantee.

The big picture here is that we didn’t adapt to eat many of the foods outside of the Paleo List. Milk is the exception, which some Paleo people approve and others don’t. Some foods are too new and some, like wheat contain gluten which is too similar to in profile to hostile chemicals.

However, this version of justification for the Paleo diet is too strict for some people. Europeans are more adapted to eat tomatoes than potatoes even though they were introduced to Europe at the same time. Some foods are natural and are able to be digested due to being similar enough to other foods, despite being new to a particular group.

Jaw Surgeries and orthodontic expanders for sleep apnea purposes are very complex topics with many approaches and branches with slight variations. A lot of procedures are relatively new, used by only a few doctors. Procedures frequently go through refinement over time, sometimes getting new names. There does not seem to be a good central repository of all the possible surgeries and variations, which makes communication somewhat difficult. I am mainly considering the purpose of surgery being improvement in sleep apnea, sleep breathing as well as some potential postural and symmetry benefits. There are frequently aesthetic benefits (or looksmaxxing) to jaw surgeries or post / pre surgery teeth alignment work, however I don’t focus on those.

Of the good type of surgery and devices that are worth considering there are several commonalities. Generally, they target either low or upper jaw being either too narrow or too far back. It is common for the width of one’s jaws to match and therefore both be too narrow, necessitating a plan for both jaws to maintain long-term teeth alignment.

Tongue tie release

Tongue ties can prevent the tongue from properly reaching the upper palate. An adult tongue tie release surgery may or may not help with this problem.


Surgically Facilitated Orthodontic Therapy (SFOT)

Surgically Facilitated Orthodontic Therapy is generic name. However, in practice it usually refers to a procedure that “packs bone” onto the jaw, thus is capable of extending it a few millimeters as well as strengthening the bone. The teeth then can be safely moved in the desired position and tooth movement can also occur faster. Teeth can be moved using a fast Invisalign or an SFOT-specific device. Generally, the benefits of SFOT are said to be faster orthodontic outcomes, however in my view avoiding tooth extractions is likely the main benefit, as well as potential for safe movement of the teeth forward a few millimeters.

Lower Jaw Sideways Expansion Osteotomies (MSDO / DAME)

Mandibular Symphyseal Distraction Osteogenesis (MSDO) and Distraction Assisted Mandibular Expansion (DAME) are a single cut to the middle or close to the middle of your jaw.

After MSDO / DAME cut to the lower jaw, it’s followed up by an expansion using a device. I expanded the device around 8 mil, which made my lower jaw actually wider than the upper jaw (until I got the MSE). Preparing for surgery may need to do some orthodontic work. For example, I had to do Invisalign for 10 months in order to separate the two front teeth’s roots and simplify the surgical procedure. This is one of the least invasive ostetomies. 

Upper Jaw Sideways Expansions ( SARPE/ DOME / DONE / EASE)

This is a class of procedures used to help expand the upper jaw sideways. Ideally used with an MSE-style mini-screw appliance.

Surgically Assisted Rapid Palatal Expansion (SARPE) is the oldest and most invasive version and is likely not needed anymore. While it’s possible to use it with a tooth-borne appliance, the overall invasiveness is much higher and results are likely similar

Distraction Osteogenesis Maxillary Expansion (DOME) is the newer version of SARPE which makes fewer cuts. See also 

DONE is the version of DOME, which aims for nasal expansion as well. Many of the procedures mentioned aim for nasal expansion, so the differences are likely minor.

Endoscopically-Assisted Surgical Expansion (EASE)
Endoscopically-Assisted Surgical Expansion (EASE) by Dr Li is another procedure claiming to make fewer cuts than other surgeries, which uses a custom expansion device rather than a standard MSE. It claims to have better recovery time than other techniques and smaller eventual gab between the front teeth and therefore a smaller tooth movement required to close it.


Double jaw surgery / Maxillomandibular advancement (MMA)

Maxillomandibular advancement (MMA)  is a combination of Lefort 1 Osteotomy for the upper jaw and Bilateral Sagittal Split Osteotomy (BSSO). The upper jaw is cut from the rest of the skull and then held in place using either plates or wires. The lower jaw is cut on both sides and moved forward after which it’s help together by screws and/or plates. See image Both components of MMA are quite invasive. As a whole MMA is one of the most invasive jaw surgeries with a very long recovery time. It is highly worth exhausting all available alternatives, both less invasive surgeries mentioned here, various devices, night-time devices, Neuro-Cranial Restructuring and postural correction, before coming to this path.

Paleo avoids a number of micro-toxins and allergens.

Another reason for certain specific Paleo guidelines is summarized in a simple fact: seeds are bad. The guideline also follows an evolutionary argument, though not for people, but for plants. Plants don’t want to have their seeds be digested. Plants create fruit with a number of nutritional qualities that are appetizing to eat. However, inside the fruit they hide the seeds. The plantd doesn’t want the seeds to be fully digested, but rather discarded in some way. The plants can accomplish this by adding anti-nutrients to hurt digestion.

Apple seeds have cyanide, wheat has gluten, peanuts, beans and other legumes have a few toxins. Soy is, of course, horrifically disruptive to hormones especially male ones. Much noise has been made about the toxicity of seed oils and I agree. However, it’s worth noting that the seeds *are bad to start with* in addition to the processing making the situation worse. This perspective is important for people who might think oh, well, beans existed for a while, how bad can they be? The answer is that beans are probably slightly toxic and are not approved on paleo.

nother important and somewhat contentious point is that roots are also bad. Unlike fruits, where the plant stores nutrients for the animal, roots store nutrients for the plant. Potatoes are somewhat contentious, but I agree with thepaloediet.com on this.

Personally, I actually take an even more hardline stance on this and I avoid potatoes, onions, garlic. I am not against carrots, but I don’t eat them often either. Onions and garlic are strictly forbidden under Buddhism anyways.

This perspective is harsher in some ways because it, for example, disallows a Chinese person to eat soy or New World native to eat potatoes. This also gives a good guideline for eating other vegetables. Peppers are great, but avoid the seeds.

This perspective is actually two separate reasons:

a) eating the part of the plant that doesn’t contain seeds or roots due to evolutionary reasons

b) not eating parts of plants known to have anti-nutrients.

Both are valid perspectives, just keep in mind that certain roots or seeds’s anti-nutrients are not actually well understood, so it’s safer to avoid them.

Best athlean x postural exercises:

AthleanX is popular youtube broscientist, who has a lot of exercises for postural correction. There a few themes that he has, such as thorastic rounding and pelvic tilts. He frequently recommends facepulls as well as various overhead raises and stretches.

Pelvic Tilts and Thorastic Spine

4 moves posture for thorastic spine and posterior tilt.

similar one for forward head posture:

Anterior pelvic tilt:

Shoulder focused ones:

Lat stretches

scapular winging

shoulder pain and popping

more about shoulder pain
 

Overall
Overall posture tests and targeted fixes
 

Full playlist

In regards to trying to fix sleep apnea and other jaw-related issues, there are some alternatives to jaw surgery or supplements to it. Very few of these except apnodent are true “replacements” in that their effects are likely smaller than a full jaw surgery or quasi surgical expanders.

1. Apnodent and it’s more sophisticated version ApnoTX are night-time devices to hold the lower jaw forward. For me apnodent provided strong night-time relief for managing sleep apnea in addition to acting as a night guard to prevent damage from teeth grinding. The device needs to be worn every night and periodically readjusted if you are doing any kind of orthodontics.

Generally, apnodent is more gentle than older versions of maxillary adjustment devices (MAD) and avoids bite re-alignments and other issues frequnetly associated with them. It can still exert pressure on the front teeth in some cases, which could be in an issue in rare situations of severely damaged front teeth or gumline.

Apnodent is one of the few “clean” ways to manage deficiency in the length of the jaw (especially lower jaw) without resorting to something as drastic as a jaw-lengthening surgery.

2. NCR
Neuro-cranial restructuring (NCR) acts on the spenoid bone and moves bones of the skull into a more symmetrical shape. While it does not directly act on the jaw, it can aid in widening the face and releasing tension that could be acting to make the jaw more narrow. In my case I tried to do a Maxillary Skeletal Expander without any associated surgery (DOME/SARPE/EASE), but with an NCR session before and after installing it. I had a split, which is rare for a man over 35. I suspect that this interaction can be fruitful, but only have myself as a data point.

3. Mewing
Proper tongue posture, putting the tongue on the roof the mouth is an important component of overall posture. Mewing is a popular exercise to do this. While it’s worth checking out, I generally don’t expect the exercise alone to significantly alter one’s facial structure past a certain age. And while it can potentially prevent further deterioration and that is important, I view it as more of a component, rather than a full solution.

4. Fixing forward head posture
Forward head posture can be both a cause and an effect of an under-developed lower jaw and associated TMJ issues. Being mindful of it and using various stretches whether from PRI or yoga is worthwhile. Some chiropractors can help as well. The impact to your health is likely very important, the impact on jaw issues specifically may vary.

5. Side sleeping (be careful with those shoulders).
“Sleeping position” is surprisingly contentious topic. Sleep apnea sufferers recommend sleeping not on the back to avoid one’s jaw dropping down and blocking the airway. Gym broscientists recommend sleeping on one’s back to aid proper shoulder rotation. Side sleeping seems to offer a compromise solution as long as you are careful about your shoulders. In either case, if you do choose to sleep on your back, it’s best to elevate your head as little as possible with potentially only a very thin pillow or only a neck pillow.

6. Chewing gum
 

Chewing mastic gum can strengthen jaw muscles and bones which can certainly improve aesthetics of your jaw.

7. Checking your dwelling for mold issues.

Mold allergies can be very disruptive to sleep and cause a number of other problems. It's worth having a plan for checking and destroying mold if it arises in one's house.

8. Whole Body Breathing:

Whole body breathing (also here) is a new technique that hopes to utilitize breathwork for improved skull growth.