Prosthetic Physiology

Prosthetic Physiology is a podcast about what happens when the body's automatic systems stop working and you have to build replacements for them. David Bainbridge is an ultra-endurance adaptive cyclist living with Classical Ehlers-Danlos Syndrome, structural baroreflex failure, complete GI dysmotility, dysautonomia, Complex Regional Pain Syndrome, coronary heart disease, and narcolepsy. He takes no oral medications. His gut cannot absorb them. In December 2022 he was ending his 19th year as a full-time wheelchair user. He has since ridden over 6,000 miles, including 148 miles solo and unsupported at the Dunwich Dynamo Plus, and a 450-mile Yorkshire Divide with 30,000 feet of climbing. None of that is the subject of this podcast. The subject is the framework that makes it possible. Six components built to replace autonomic functions the body no longer performs: cognitive anticipation in place of absent reflexes; continuous motion as a circulatory pump; precision timing governing effort, nutrition, and recovery; controlled micro-feeding across narrow windows; environmental management through heat, cold, compression, and posture; and data, specifically HRV, heart rate, and trend patterns, standing in for somatic signals that either never arrive or arrive too late. This is not a motivational podcast. It is a technical one. The episodes deal in mechanisms, numbers, failure modes, and the architecture of a system built under conditions where error was not an option. VO₂ max from 30 to 55 in under two years. HRV range of 6 to 142 milliseconds. Blood pressure swings from 198/141 to 108/61, managed without pharmacological intervention. These are not achievements. They are data points. The framework is how they were produced. If you are managing a broken body, coaching adaptive athletes, working in performance physiology, or simply want to understand what human physiological adaptation looks like at its outer boundary, this podcast is built for you.