The Food and Drug Administration issued a forceful warning Tuesday that transfusions of young donor plasma, which have been marketed to fight aging and a variety of diseases, are not only unproven ― they could be harmful.

You’ve probably seen the headlines about the alleged “young blood” miracle treatments where for-profit medical startups charge thousands of dollars to inject older patients with infusions of blood plasma from young donors. If the reported claims about those treatments sound too good to be true, that’s because they are, according to the FDA.

Injecting young donor plasma to treat or prevent aging, as well as conditions such as Alzheimer’s and Parkinson’s disease, has “no proven clinical benefits” like those advertised and is “potentially harmful,” FDA Commissioner Scott Gottlieb said in a statement. Peter Marks, director of the agency’s Center for Biologics Evaluation and Research, joined him in issuing the warning.  

“It’s just a matter of time before there are going to be people harmed by this — and harmed by it, with no opportunity for therapeutic benefit,” Gottlieb told HuffPost in a phone interview.

He and Marks lambasted for-profit young plasma companies peddling an unproven therapy for financial gain: “Simply put, we’re concerned that some patients are being preyed upon by unscrupulous actors touting treatments of plasma from young donors as cures and remedies.”

“The promotion of plasma for these unproven purposes could also discourage patients suffering from serious or intractable illnesses from receiving safe and effective treatments,” they added.

In late December, HuffPost published an investigation into Ambrosia, a startup that sells young plasma treatments that offer numerous alleged potential benefits. Ambrosia’s founder, 34-year-old Jesse Karmazin, earned extensive, unskeptical media coverage, despite never showing any proof his transfusions actually helped people in the ways he claimed.

Karmazin — who cannot legally practice medicine in any state, and is explicitly prohibited from practicing in Massachusetts by authorities — announced recently he was soliciting customers in multiple states, charging $12,000 for two liters of young plasma. Other medical establishments, such as the Maharaj Institute in Florida, have also announced plans to charge patients for young plasma transfusions, and various studies of the treatments are ongoing.

Plasma transfusions have long been recognized as a treatment for particular health issues, such as for trauma patients. But the FDA urges people to be cautious and consult with their doctors before considering such treatments to combat aging or other conditions.

The agency also strongly discourages people from pursuing young plasma therapy outside of clinical trials conducted under “appropriate institutional review board and regulatory oversight.”

Companies generally need to get approval from the FDA before they can claim that a drug or medical product treats, cures or prevents a disease. Young plasma treatments have not gone through the “rigorous testing” that the FDA normally requires in order to confirm a therapeutic benefit and to ensure safety, the agency said.

Karmazin, Ambrosia’s founder, saw no need to go through the FDA’s drug approval process for his study, in which participants paid to receive plasma from young donors. He also never released the study’s findings, though he touted impressive results in the media, claiming young plasma could help everything from Alzheimer’s to blood cholesterol levels.

“I’m not really in the camp of saying this will provide immortality,” he told one reporter, “but I think it comes pretty close.”

Such claims are not only premature, according to the FDA, but risks surround plasma transfusions. In rare cases, the complications can be fatal.

For patients receiving plasma for a recognized use, such as managing clotting abnormalities, the FDA has determined that the benefits outweigh the risks.

Gottlieb and Marks also raised concern about the dosing of young plasma transfusions. They noted that they had seen reports of large volumes of young plasma being administered to patients, which can create “significant risks,” such as respiratory and cardiovascular issues.

This backs up what medical professionals told HuffPost last year: “In general, somebody who does not need a blood transfusion would be at great risk for all sorts of things, short term and long term,” by undergoing such treatments, said Phuoc Le, a physician and global health specialist who teaches at the University of California, San Francisco. Le was alarmed that Ambrosia claimed to give patients about 2 liters of plasma over just one to two days.

In wake of the FDA statement, the Ambrosia story can be seen in some ways as a media failure: Reporters ran with vampire headlines without answering basic questions about the procedure, effectively serving as free advertising for an unproven treatment. (A report that Peter Thiel, the tech entrepreneur billionaire, was interested in young blood, and the “blood boy” parody in HBO’s “Silicon Valley,” contributed to the media frenzy.) Meanwhile, Karmazin wouldn’t even tell reporters where he got his plasma.

HuffPost found that at least some of it came from a nonprofit blood bank in South Texas that recruited teenage donors for “saving lives,” but noted on a consent form that blood components could be used for “any other medical purpose.” The bank decided to stop selling young plasma after HuffPost reached out.

Generally, the FDA will consider taking regulatory and enforcement actions against companies that “abuse the trust of patients and endanger their health … by promoting so-called ‘treatments’ that haven’t been proven safe or effective for any use,” the statement noted.

The FDA is going to look at what enforcement activities it can take given “the scope of our concern,” Gottlieb told HuffPost.

“The first step was to put out a public health advisory alerting consumers and providers,” he said. “We’ll take it from here.”

This story has been updated with additional comments from Gottlieb.

Tips? dana.liebelson@huffpost.com and jesselyn.cook@huffpost.com.

Mariah Carey has a lot to worry about these days (messy legal drama with a former assistant, cashing checks from “All I Want for Christmas” residuals, an upcoming Las Vegas residency, etc.), but she remains unbothered by a little thing called aging, dahling. 

The legendary diva tried her hand at the 10-year challenge dominating social media timelines that has users sharing a photo of themselves from 2009 next to one from 2019 to boast about glow-ups, regret bad fashion choices and praise the powers that be for Instagram filters. 

But Carey, who’s historically demanded that people refer to her birthday as an anniversary, rewrote the rules of the entire challenge with a post on Instagram Wednesday. 

Instead of sharing a photo of herself from 2009 ― our choice would be a screen grab from her very-much-underrated performance in “Precious,” for the record ― the singer posted two identical photos taken recently. 

“I don’t get this 10 year challenge, time is not something I acknowledge,” she wrote. “*Picture taken at some point prior to today.” 

Fans of the singer, of course, had a field day with her peak Mariah response.

Other celebs, however, couldn’t resist the challenge. Famous types like Busy Philipps, Kevin Hart and Snooki participated, but no one came close to Carey’s levels of extra. 

The elusive chanteuse FTW.

Jesse Karmazin, the 34-year-old founder of the startup Ambrosia, had a pitch journalists couldn’t resist: For a fee, he could help his clients combat aging and its related ills with infusions of blood plasma from the young. Teen donors, vampiric undertones, a serious-sounding study, an $8,000-per-person price tag and rumors that venture capitalist Peter Thiel might be interested earned Ambrosia more than 100 press mentions in just two years.

The effects of young plasma, Karmazin told reporters, were astounding. Just one infusion “dramatically improves people’s appearance, their memory and their strength,” he told one reporter. “I want to be clear, at this point, it works. It reverses aging,” he told another. “I’m not really in the camp of saying this will provide immortality but I think it comes pretty close,” he told a third, adding, “It’s like plastic surgery from the inside out.”

The free publicity helped Ambrosia attract clients: One hundred and four people paid to receive plasma from 16- to 25-year-old donors as part of Ambrosia’s participant-funded study, Karmazin told HuffPost. 

But despite declaring the study a success and announcing plans this week to accept new clients, Karmazin never showed any proof that the transfusions actually helped people. In the media, he touted impressive results, but almost a year after his study officially concluded in January 2018, he hasn’t released them. Scientists have criticized the study as flawed and the procedure as medically unnecessary and not without risk; in rare cases, transfusion complications can be fatal. One of the doctors Karmazin hired had previously been disciplined by a state medical board for unprofessional conduct. Karmazin himself cannot legally practice medicine in any state; he is explicitly prohibited from practicing in Massachusetts by authorities. Ambrosia’s president and chief operating officer quietly left the company in late December, leaving Karmazin as the sole employee. And the only patient who spoke publicly about Ambrosia’s transfusions — treatments he hoped would help him live healthier into old age — died at 65 after going into cardiac arrest.

Karmazin couldn’t comment on individual patients but said there were no deaths during or after the trial related to the treatment. 

HuffPost found that at least some of Karmazin’s young plasma came from a nonprofit blood bank in Texas that recruited teenage donors for “saving lives,” but noted on a consent form that their blood components could also be used for “any other medical purpose.”

The bank abruptly decided to stop selling young plasma after HuffPost reached out, according to an employee email.

Ambrosia, which declined to comment on whether the company has any investors, is only one of many firms investigating how to help people feel younger for longer. But Ambrosia’s ability to attract paying clients and years of positive press coverage — without providing scientific data to back up its claims — shows just how easy it can be for promises to outpace the research when Silicon Valley gold-chasing mixes with Americans’ fear of death.

“You can easily imagine a situation where somebody who’s vulnerable, and not wealthy, and not healthy, and may be desperate … would potentially feel like they have no option but to spend this money,” said Phuoc Le, a physician and global health specialist who teaches at the University of California, San Francisco.

“They could literally spend their life savings on an unproven treatment,” he said. 

Karmazin was born in Palm Beach Gardens, Florida, and attended Princeton University, where he became a highly accomplished rower, going on to win a silver medal in the Paralympic Games in Beijing in 2008. He attended Stanford Medical School and participated in labs that focused on longevity and stem cell biology. His experience as an athlete — and feeling slower athletically after turning 30 — influenced his desire to work on aging as a treatable condition. After graduating in 2014, Karmazin started a residency at Brigham and Women’s Hospital in Boston with a plan to eventually specialize in psychiatry. But as Karmazin tells it, he didn’t like working the long hours and felt he didn’t have time to pursue his other interests, transfusions and aging, in addition to general practice, so he left his residency in 2016 to start Ambrosia.

There is an asterisk to that story: On Feb. 29, 2016, Karmazin and his attorney signed a voluntary agreement with Massachusetts officials in which he promised to immediately stop practicing medicine in the state. Karmazin told HuffPost he signed the paperwork because he left his residency early, that doing so was “pretty routine,” there were no additional circumstances that he was aware of and that’s all he knew. That account seems unlikely. Karmazin was practicing under a limited license; such a license terminates automatically if a physician leaves a residency program early for any reason, according to George Zachos, the executive director of the Massachusetts Board of Registration in Medicine. The board wouldn’t typically pursue such an agreement with a limited licensee for leaving a residency early, Zachos said. Such a public agreement is used to protect patient safety. Last year, only 12 physicians in Massachusetts reached similar deals.

The board’s review is confidential, but a representative noted the circumstances that led to the agreement were unrelated to Karmazin’s work with Ambrosia or xVitality Sciences, a separate “rejuvenation” project he also worked on.

Karmazin, who introduces himself as “Dr. Karmazin,” moved forward with Ambrosia after signing that agreement. He said he got the idea for young plasma transfusions from several studies in which young and old mice were surgically conjoined in order to examine the effects of mixing their blood. In some cases, the older mice became temporarily stronger and showed slight improvements to their health. Karmazin believed those results could be replicated in humans.

Scientists have questioned Karmazin’s interpretation of the data. Researchers at the University of California, Berkeley, who led conjoined-mice tests noticed small positive changes in older animals’ muscles, livers and brains. But the more important finding was the significant decline in the health of the younger animals. For the older animals, the young blood was largely diluted by the old blood.

“There was much more negative effect from the stuff in the old blood than there was positive effect from the stuff in the young blood,” said Irina Conboy, an aging and rejuvenation researcher at Berkeley, who compared young blood transfusions to taking “a pile of rotten bananas” and throwing “one good one” on top. “Maybe there are secret sources [for human rejuvenation] in young blood,” she said. “But there is no scientific evidence for that.”

Karmazin went ahead anyway: In the summer of 2016, he announced that he would charge people ages 35 and older $8,000 each for about 2 liters of young plasma as part of what he called a “clinical trial.” Karmazin didn’t feel the need to go through the Food and Drug Administration’s drug approval process, as plasma transfusions are already a well-established procedure. Most of the time, however, they are used to treat patients who have specific health issues, not carried out to potentially make people feel younger.

Ambrosia’s trial whipped up the flurry of press coverage that doubled as free advertising, and in some cases, suggested inaccurately that people were drinking young blood. But what really got people talking about Ambrosia was a report that Peter Thiel, the tech entrepreneur billionaire, was interested in young blood. Karmazin himself appears to have made the explicit connection to Ambrosia. In 2016, he told an Inc. magazine reporter that Jason Camm, chief medical officer at Thiel Capital, had contacted him to express interest in Ambrosia. It’s not clear whether Camm was reaching out on Thiel’s behalf, or how extensive the alleged contact was. But the story prompted a wave of Thiel-vampire insinuations in the media. Later, in an interview with TechCrunch, Karmazin completely denied having contact with anyone from Thiel Capital, raising questions about who wanted to quash the story.

Camm and Thiel Capital did not respond to requests for comment. In November, Thiel said at the New York Times DealBook conference: “On the record. I’m not a vampire.” He also said he’s never injected himself with young blood. Karmazin reiterated to HuffPost that he’s not in any contact with Thiel. When asked why his story appears to have changed, Karmazin repeatedly declined to comment.

To launch his study, Karmazin needed plasma, the liquid part of blood, from young people. He needed a lot of it — Ambrosia performed more than 150 roughly 2-liter transfusions (some clients reportedly returned for multiple treatments), according to Karmazin, which would have required at least 80 gallons of young plasma, hundreds of donations’ worth. But he faced a hitch: Blood banks don’t typically separate out blood plasma by age and sell it for rejuvenation purposes; their primary mission is to provide donated blood for hospital patients and save lives.

When blood centers have unused plasma, they commonly provide it to different companies in order to make products to treat serious medical conditions such as hemophilia, according to a spokesperson for AABB, a nonprofit that accredits blood centers.

But it wasn’t easy to find a blood bank willing to supply a startup for Karmazin’s purposes. In the beginning, Karmazin called some 20 blood banks, he said. It “took a while to find the right partner,” he added. There was interest, he claimed, but banks didn’t have a process in place to get him the plasma he needed. HuffPost contacted more than a dozen U.S. blood banks, many of which cited ethical concerns and raised questions about Ambrosia’s study. The chief medical and scientific officer of Vitalant, a nonprofit that distributes blood to more than 1,000 U.S. hospitals, told HuffPost that Vitalant leadership contacted all its donation centers after hearing about Ambrosia to confirm none worked with the company. Ambrosia’s study didn’t seem to be a legitimate clinical trial, Dr. Ralph Vassallo said, so Vitalant shouldn’t be selling to the startup.

Eventually, Karmazin said, he found two blood banks to provide the company with “excess” young plasma that he could use for his study. Karmazin refused to say which ones they were.

One of his partners for Ambrosia’s trial was the South Texas Blood & Tissue Center, a subsidiary of BioBridge Global, a nonprofit headquartered in San Antonio.

STBTC has lamented “critical” blood supply shortages and called on millennials to “step up and donate.” It has sent blood collection buses to schools and asks students on its website: “Are you up for saving lives?” It holds a donation competition for local high schools called “Generation Give” with $750 top prizes, and has offered incentives to donors such as free movie tickets and amusement park passes. Students who have donated six blood products or more “have made the difference in the lives of over 18 hospital patients,” STBTC states on its website. Honored students receive a special red cord to wear at their high school graduation ceremony.

The South Texas blood bank’s main mission is to provide blood to approximately 100 hospitals and clinics, Elizabeth Waltman, STBTC’s chief operating officer, said in a statement. But “after community needs are met, and to ensure no donated blood is wasted, we provide blood where it is needed, including to support research that will advance medical care,” she added. Ambrosia’s study met STBTC’s requirements for research-related use of their blood components, she said.

STBTC did not comment on whether it sold donations that came through Generation Give as young plasma. But its consent forms for blood donors “clearly state” that donations will be used to serve “both clinical and research purposes,” Waltman said. HuffPost reviewed a copy of STBTC’s 1,200-word student consent form, which requires kids and parents to acknowledge that donated blood may be used to help patients “or for any other medical purpose.” The form praises students for “giving the gift of life.”

By the fall of 2016, Karmazin was ready to launch his study.

Ambrosia told trial participants that “abundant data” from mice studies suggested young plasma infusions could help with “rejuvenation,” but the company said it couldn’t guarantee participants any specific results, such as the treatment of a disease. Rather, it noted in its informed consent form that there are “no known improvements” directly related to young plasma infusions. In fact, the form contained “an appalling lack of detailed explanation of what the actual effects of this intervention are supposed to be,” said Alta Charo, a professor of law and bioethics at the University of Wisconsin-Madison who reviewed Ambrosia’s form at HuffPost’s request.

Karmazin contracted physicians to carry out the young plasma transfusions at clinics in San Francisco; Monterey, California; and Tampa, Florida. The Monterey-based doctor, David Wright, had been publicly reprimanded by the Medical Board of California in 2015 for charges that included gross negligence related to diagnosing a patient with a chronic tick-borne infection without an adequate basis, and then using a medically unsupported treatment ― daily antibiotic infusion therapy ― that led to significant side effects. Wright did not admit to wrongdoing in the agreement; the reprimand did not preclude him from practicing medicine.

Plasma transfusions are regularly administered to people with certain health issues, such as patients with liver disease and trauma patients requiring massive transfusion. But there is still a risk of complications, some very serious: Transfusion-associated circulatory overload ― which can occur after transfusing too quickly or at excessive volume ― can lead to death, for example.

Then-New Scientist writer Sally Adee traveled to Monterey to cover Ambrosia’s trial in 2017 and reported that a patient who came from Russia had an anaphylactic reaction after a transfusion. Wright was “visibly shaken” after the incident, Adee wrote.

Ambrosia ultimately reported four adverse incidents during the trial, according to Barbara Krutchkoff, the executive director of the Institute of Regenerative and Cellular Medicine, a small nonprofit that houses an institutional review board that oversaw the study. They included a rash in March 2017, a runny nose and cold symptoms in April, hives and edema in June, and itchiness in December. All were considered mild allergic reactions and resolved, she said.

Ambrosia was fortunate there weren’t more adverse reactions, said Le, the physician and global health specialist.

“In general, somebody who does not need a blood transfusion would be at great risk for all sorts of things, short term and long term,” said Le, who was alarmed that Ambrosia claimed to give patients about 2 liters of plasma over just one to two days.

“For patients with true indications, plasma transfusion can be lifesaving,” said Robertson Davenport, director of transfusion medicine at the University of Michigan. But doing this procedure for anti-aging purposes is “not scientifically or medically justified and exposes patients to risk of harm,” he added.

During the study, Karmazin and Wright had a falling-out. They disagreed over Karmazin’s plans to transfuse smaller amounts of young plasma over a shorter period of time — a change Wright deemed risky, according to the New Scientist article. “We just had different ideas for what this treatment could become,” Karmazin told HuffPost. Wright stopped working for Ambrosia before the study was complete.

Wright did not respond to several calls and emailed requests for comment. When HuffPost sent a reporter to his new office in Pacific Grove, his receptionist threatened to call the police.

Ambrosia’s trial formally ended in January 2018. It was a great success, according to Karmazin, with about one-third of the participants returning to purchase additional treatments and around 150 treatments delivered in all. Some people continued to receive transfusions as late as this past summer, he said.

By the end of the trial, Ambrosia had been touting findings for months. Karmazin claimed to Canada’s National Post, for example, that an early-onset Alzheimer’s patient showed improvements with one treatment and a person in their 60s saw their graying hair turn darker. He told New Scientist that he saw a 10 percent decrease in patients’ blood cholesterol levels, and told Boss Magazine there were “really dramatic improvements” to biomarkers for inflammation.

The company said it tested patients’ blood for more than 100 biomarkers before and after the transfusions, looking for improvements in markers for aging and disease. Ambrosia’s study did not have a control group that received a placebo. And a change in a biomarker isn’t necessarily proof of a change in actual health status, noted Charo, the University of Wisconsin-Madison professor. Such changes must be matched to “real health outcomes,” which requires long-term follow-up. Karmazin said patients wrote diaries, and that some later volunteered additional health data.

“I’m not sure how Ambrosia’s was set up as a clinical trial,” said Michael Conboy, husband and research partner of Irina Conboy, the aging and rejuvenation researcher at Berkeley. “It seemed to me that it was set up as more of a ‘fee for service’ type thing and the ‘trial’ part was slapped on to legitimize it. It seemed to be starting off as someone capitalizing on the hype and trying to make some money.”

And there’s still no public data. Karmazin shared some “preliminary results that he was excited about” with his hired institutional review board, Krutchkoff said, but she hadn’t seen the final results. Speaking to HuffPost with Karmazin’s permission, Krutchkoff praised Karmazin’s professionalism and brushed off criticisms of the study. “As controversial as this study was, there’s a lot worse being done,” she said.

Howard Chipman, the doctor Ambrosia hired in Tampa, also said he hadn’t seen the results. HuffPost could not find a participant who had.

Tom Casey, the CEO of NuPlasma, a company that sells young plasma to physicians in Texas ― and is supplying another young plasma study in Houston — urged Karmazin to release the data. “The people who are criticizing you are criticizing you because you called this a trial and said you were collecting data,” he said. “But there’s still no data.”

Karmazin and David Cavalier, Ambrosia’s then-president and chief operating officer, said earlier this past fall that they had to be careful not to make any guarantees about the effects of Ambrosia’s treatment. Companies generally need to get approval from the FDA before they can claim that a drug or medical product treats, cures or prevents a disease. Cavalier noted that Ambrosia transfused a Parkinson’s patient who reported an improvement in a tremor, a patient with depleted testosterone levels who was soon “enjoying morning erections again,” and people who reported improvements with arthritis symptoms, sleep, memory and energy levels.

Some of Ambrosia’s claims to the media have been “maybe a little bit exuberant” but still “100 percent accurate,” Karmazin said.

Karmazin told HuffPost in the fall he temporarily paused transfusions to focus on opening a clinic in New York City by early 2019. Ambrosia is required to obtain a permit to transfuse a blood component in New York, but as of mid-December, the company had not applied for one, according to a New York State Department of Health spokesperson.

He initially claimed he planned to publish the findings of Ambrosia’s study in a peer-reviewed journal after its clinic was open. He announced this week on his website that Ambrosia is scheduling clients again in San Francisco and Tampa. He brought back two doctors he worked with during the study, he told HuffPost. He said this week that he still hadn’t submitted any data for peer review — a process that can take months. He was “eager to do so,” but didn’t know precisely when he would. 

Cavalier quietly left the company this week, right before Ambrosia announced it was offering treatments again. He would not comment on the circumstances of his exit, but noted in an email that he was only with the company for “a very brief period.” Karmazin declined to comment further on Cavalier’s departure.  

And at least one of Ambrosia’s blood bank partners no longer sells young plasma. Shortly after HuffPost reached out to the South Texas blood bank in October, it abruptly halted all sales of young plasma products, according to an employee email chain HuffPost obtained.

“We have had a few developments internally due to some negative press,” an employee wrote on Oct. 22. Waltman, the STBTC executive, told HuffPost the bank would not supply Ambrosia with plasma for a clinic rollout because doing so would interfere with their ability to fulfill local needs. The HuffPost inquiry had no bearing on that issue, she added.

For all its press coverage, Ambrosia did not have any investors as of April 2017, Karmazin said; in September 2018, Karmazin told HuffPost that Ambrosia hadn’t yet raised any money. That same month, he advertised on his LinkedIn page that the company was looking for $3 million to open its first clinic. By November, Karmazin said the LinkedIn posts had been removed because the company had garnered a “large amount of interest,” but Ambrosia would not comment on whether it had any investors.  

Despite Karmazin’s insistence that many people are excited about the treatment, over the course of reporting this story, Ambrosia declined to put HuffPost in touch with a single patient. Initially, Karmazin said the patients are protective of their privacy and “after the hundredth reporter asked to talk, people were just getting a little tired of answering the same questions.” After HuffPost noted that it could find only one trial participant who had spoken to the press, Karmazin said that in the beginning, he had asked about 10 to 15 patients if they wanted to speak to reporters, but they all declined.

It appears the only participant in Ambrosia’s trial who spoke to the press was a man from Georgia. He told a German newspaper that he was one of Ambrosia’s first patients and had perhaps received “more blood plasma than anyone else in the world.”

The Georgia man was “the most excited person about this treatment,” Karmazin told HuffPost. He died after going into cardiac arrest in February 2018 at the age of 65.

Young plasma “isn’t a silver bullet,” the man told New Scientist last year. But he had hoped he could “just get 10 more healthy years of living.”

The man’s family did not respond to multiple requests for comment about the circumstances of his death, and a doctor familiar with his case declined to comment without a family member’s permission. Karmazin said there were no deaths during or after the trial related to the treatment. It is unclear when the man received his final treatment with Ambrosia.

These days, Karmazin won’t even publicly admit whether he has tried the treatment Ambrosia is hawking. He told one news outlet in June 2017 he hadn’t, claiming he was waiting until he’d be “old enough” at 35. In a separate interview in December 2017, when he was still not yet 35, he said he’d tried it “a few times” and it felt “pretty phenomenal.” Speaking to HuffPost, he refused to comment, citing privacy concerns.

“I wouldn’t want to confirm that I’ve done it for the purposes of this interview,” he said.

Regardless, spending $8,000 on a young plasma transfusion is a “really good use of people’s health care dollars,” Karmazin said. Those with certain diseases “should be getting treatment right away,” he added. “We want to be treating as many people as possible.”

This week, Karmazin announced Ambrosia has lowered its age limit and raised its prices. People as young as 30 are now eligible for treatment. And two liters of young plasma costs $12,000.

Got tips? Contact us at dana.liebelson@huffpost.com and jesselyn.cook@huffpost.com.

Gabrielle Canon contributed reporting.

Emma Stone had a difficult time coming to terms with turning 30 this past November, the actress revealed in British Vogue’s February issue. 

“I got gloomy for about a week,” said Stone, who graced the magazine’s cover. “But [I] realized the most interesting part about becoming an adult is most things become bittersweet. I’m still finding my voice.”

She shared a few lessons she has learned in her three decades of life so far. 

“It’s OK if not everybody likes you,” Stone said. “So that was a major lesson, not falling over myself to win over the unwinnable.”

The “Favourite” actress also observed, “Nobody knows what they’re doing! We’re all just a bunch of people trying to figure out how to get through the day.” 

Stone told Vogue she has been taking a long break ― it will be 14 months off when she gets back to work in 2019 ― although she couldn’t quite figure out what she’d done with all her free time. 

“I didn’t learn a language, I didn’t learn to cook, I’ve been a little … drifty,” she admitted. 

The actress only recently returned to the press circuit to promote “The Favourite,” her new costume drama, which has received critical acclaim. 

The film marked a major first for Stone, as she insisted on doing her first nude scene. The star opened up about that experience during a roundtable interview with The Hollywood Reporter in November. 

“I had the sheet up around me, and as we were shooting it and we did a few takes, I said, ‘Can I please just be [naked]?’ I think it’s going to give Sarah [played by Rachel Weisz] something to look at when she sees that I’m not just under the sheet covered up,” Stone said.

She added, “Olivia [Colman, who played Queen Anne] was like, ‘No, don’t do it!’ [and director] Yorgos [Lanthimos] was like, ‘Are you sure that’s what you want to do?’ And I was like, ‘Absolutely.’”

Stone told HuffPost in a recent interview that one of the hardest parts of doing the movie’s steamy scenes involved a sponge and trying not to break on camera. 

 “Ska sucks / The ska revival isn’t cool, you stupid f**k / The bands are only in it for the bucks / And if you don’t believe me you’re a schmuck / But the trend will die out with any luck.” 
— Propagandhi, 1993

The memories of my first kiss are splotchy but they go something like this: In the summer between sixth and seventh grade, I went to a friend’s birthday party on the section of coastline located at Magnolia Avenue and Pacific Coast Highway, in Huntington Beach, California, where I was born and raised. The party was a bust — hardly any of the invitees showed up, confirming what I sorta knew: My buddy wasn’t popular. His parents were divorced, and he lived with his mom in an apartment; he wore the same flannel every day, and his shoes were L.A. Gears. (Three years later he’d introduce me to pot smoking.)

The three of us friends who did attend found ourselves outnumbered by aunts and uncles, so we took the birthday boy on a walk down the beach, whereupon an elaborate sixth-grade flirtation ritual took shape: Two girls our age started following us, started closing in, started yelling things. In the pairing off that came next, the birthday boy, in a testament to the cruelty of childhood, found himself walking back despondently to the aunts and uncles as I sat nervously on the beach with a girl named Yvette from the Valley. It was dusk, so the sun was setting over the Pacific Ocean, and the oil rigs dotting the coastline were throwing long shadows.

Yvette was pretty, and we talked for what felt like a long time, but the only exchange I remember was her schooling me in the dynamics of French kissing, which she proceeded to demonstrate. Our kiss was squishy and warm and fired every neuron my little 12-year-old brain contained at that time.

I never saw Yvette again after that night, but I kept coming back to that same stretch of beach, not to remember the kiss, but because it was our beach — mine and my friends’, the spot closest to our high school and our houses, where we would ride our bikes to go boogie boarding. We spent whole summers at that spot. On warm weekend days it’d overflow with interlopers from Riverside and Fullerton, but during summer weekdays, especially around sunset, during surf sessions when the surface of the ocean would become flat and glassy, it felt as if we had the place all to ourselves.

Twenty-eight years later, I’m sitting at a picnic table in what’s technically the parking lot of our beach, next to a barrel full of ice and RockStar energy drinks, asking the members of seminal LA ska band Fishbone what it’s like to turn 40, an imminent event in my case, and one that I am dreading.

“You see this gray beard?” asks Philip Fisher, aka Fish, the band’s drummer. “Do I look like I give a fuck about getting older? No, I embrace it.”

If you want to feel better about getting older, or at least gain some perspective on it, talk to a handful of people who’ve been playing in ska bands for 20 years. This was the premise that landed me backstage at the Back to the Beach Festival, a two-day celebration of third-wave ska whose inaugural installment was going down in Huntington Beach. Over the course of two days, 30,000 fans would come to see a lineup of bands who had their heyday during the Clinton administration: Sublime, Goldfinger, 311, Save Ferris, The Mighty Mighty Bosstones, Fishbone, Less than Jake, The Aquabats.

For those who don’t remember or never learned, third-wave ska was one of the more ignominious blips on the ’90s pop-culture continuum. Centered in Southern California, with clusters of bands in Florida and New York, its most lasting cultural contributions include soundtracking a number of ’90s rom-coms, popularizing the then-novel semi-ironic cover (as in Reel Big Fish’s “Take On Me”) and gifting the world with No Doubt, the heavyweight champ of ska bands who took third-wave ska to the apex of mainstream popularity, despite almost totally jettisoning most of the genre’s signature qualities — horn sections, skanking, making an ass of oneself. These tweaks were not accidental.

Because yes, definitely, for sure: Ska sucks, specifically third-wave ska. Few musical movements can compete for the derision it routinely receives, if it receives any thought at all. In an era during which nostalgia acts are a key part of major festival bills, ska gets the cold shoulder. To be playing this music in 2018 requires a special kind of obliviousness to its wider perception, a near imperviousness to self-doubt and embarrassment. As someone riddled with such feelings as I approach my fourth decade, I figured it might be good to surround myself with such naive optimism. I mean, just look at Fish’s brother and Fishbone bassist Norwood here:

“I got a friend who told me he cried when he turned 40,” Norwood says (his full name is John Norwood Fisher, but everyone just calls him Norwood). “You know, because he thought he was getting old. And I was like, I’m celebrating it! Something got better. The older I get, the more I’m like: Oh wow, this is what it’s like if you live in the moment and you can appreciate it. I’ve refined my role in life as I got older, and it’s just better.”

As Norwood finishes this thought, a roadie swings by to remind the brothers of their next appointment, which is fortuitous, because I can tell by their body language that they’re not amused by the subtext of my questions. “Sad 40-Year-Old Man Attends Ska Show” was the working title for this article. In contrast to some of my professional peers backstage, I’m apparently wearing this headline across my face. Next to me near the picnic tables, a woman in her 20s is wearing six-inch spikes in her heels and 12-inch spikes in her hair, asking excited questions to all the bands for some kind of web series. For a certain type of person, Back to the Beach feels like a triumphant reunion, something to feel proud and excited about. It feels like something else to me.

“The ageless thing is inside,” Fish says. “I just try to keep the whole package oiled and moving. Speaking of which, we gotta go.”

Maybe one reason (among many reasons) that third-wave ska seems so stupid and embarrassing is that it seems to be gleefully squandering a rich musical inheritance. It can be traced all the way back to 1950s Jamaica, when American rhythm and blues songs like Fats Domino’s “Be My Guest” were popularized and then imitated by Jamaican soundsystem DJs like Prince Buster and Coxsone Dodd. In the hands of these Jamaicans, the shuffle became the skank — that emphasis on the upbeat that distinguishes ska and reggae, which arrived on ska’s heels (that’s right: ska came first). The first wave of ska included artists like the Skatalites, Derrick Morgan and Desmond Dekker. Many of these artists’ songs were informed by and sometimes directly celebrate Jamaica’s independence from England in 1962, which goes some way toward explaining why a fundamental quality of ska is its slack-jawed ebullience.

From Jamaica, the music jumped over to the U.K., where it was given a mod makeover and mixed with elements of pub rock, punk, then new wave. This was ska’s second wave, also known as 2-Tone, a term coined by the Specials’ Jerry Dammers. The term “2-Tone” was a explicit nod to ska’s miscegenation and a direct rebuke to phenomena like the U.K.’s fascist National Front. With their black and white duds, two-tone album covers and songs like “Do the Dog,” The Specials codified some of ska’s most important, longstanding themes — fighting racism, imploring unity and wearing funny hats. And they were soon joined by acts like Madness (named after a Prince Buster song that they then popularized), The English Beat, The Selecter and others in introducing ska to a much wider audience, which is of course what brings us to ska’s third wave.

Now, do I feel bad that a music so thick with history and purpose became, in its third wave, a vehicle for dispensing advice about how to scratch one’s nutz, celebrating the palliative effects of malted beverages and/or grousing about missing the bus? Should anyone feel bad about that? Does anyone? Allow me to invoke the persona of the Aquabats’ “Bat Commander” in saying, I dunno, kids — let’s find out!

Two days before the festival, I visit the Aquabats in the Fountain Valley rehearsal space where they’re practicing for their set. In their heyday, these guys were one of the most popular and successful third-wave ska bands extant. Known for their spandex costumes and kitschy stage shows — a mash-up of “Barbarella” and Captain Kangaroo — the band eventually landed a short-lived kids TV series, and its frontman, Christian Jacobs, was one of the creators of the popular Nickelodeon show “Yo Gabba Gabba!” which was itself largely informed by the Aquabats’ aesthetic.  

“Garrett!” Jacobs says when I poke my head in the rehearsal space. “I didn’t recognize you without the glasses.”

Oh, I probably should have mentioned this before: I was a devoted ska kid growing up. My first shows were ska shows, my best friends were ska friends. I played in a band called Tricky Dump Truck, an allusion to the scatting at the heart of ska (pick-it-up-pick-it-up). We booked exactly three shows. Back then I was beanpole skinny and wore the kind of thick Buddy Holly glasses you used to only be able to find at thrift stores. And I attended tons and tons of shows, including many of the Aquabats’ early shows, on bills they shared with all my favorite bands of that time: Reel Big Fish, Skankin’ Pickle, Dance Hall Crashers. If this lede feels buried, that’s on purpose.

“You guys,” Jacobs announces to the group, “Garrett’s here to write an article about people who waste their lives playing in a band.”

It’s worth noting here that I didn’t have to inform Jacobs of these intentions in advance for it to be obvious. For as long as I can remember, the current and former members of the Aquabats whom I’m personally acquainted with, including Jacobs, have never been anything less than exceedingly self-deprecating about the fact that their primary occupation as artists and musicians is to dress up in cheap costumes and perform songs like “Martian Girl” and “Super Rad.”

“What we were doing almost felt farcical in a way,” Jacobs will explain of the band’s early days, the two of us standing around in the parking lot after practice, bathed in the glow of suburban street lights. “What we felt about the ska scene was it was just fun, it was stupid, it was corny, and we were being stupid right along with it. We were the cherry on top of the stupid.”

And yet, somehow, they’ve been doing this for 20 years. Here in the rehearsal space, everyone looks a bit heavier than he did in the band’s heyday. And now that these guys are all suburban dads, their claim to superhero alter-egos like “Crash McLarson” is specious at best. (Crash himself, aka founding member Chad Larson, sits in a folding chair for the whole practice session.) Watching them rehearse songs like “Idiot Box” and “Pool Party” as various members’ preteen daughters sit quietly in a corner is particularly surreal, as is listening to Jacobs strategize with his bandmates in between songs about how he can score tickets to next week’s sold-out LCD Soundsystem show. It’s like poking your head in on Big Bird watching CNN; it’s just incongruous.

After practice, which ends around 9 p.m. in a state of total sobriety, the band members go home to their wives and kids. But at the show two days later, they will slay the crowd of 30,000. As the Bat Commander, Jacobs will lead his troupe through songs like “The Cat with 2 Heads” and in battle with the villainous Sand Fleas, one of the Aquabats’ signature mid-show melodramas. He will then invite onstage Back to the Beach co-producer Travis Barker — yes, that Travis Barker, of Blink-182 and reality TV fame, who got his first big break as “Baron Von Tito,” drummer for the Aquabats — to run through classics like “Powdered Milk Man.” For a certain type of ska fan, including your correspondent, this move will provoke pangs of heartwarming nostalgia and genuine glee.

“Some people play basketball at the park,” Jacobs tells me in the parking lot. “We put on rubber helmets and play shows.”

After the set, Barker will go back to skulking around the backstage area with his extensive entourage and various members of the Aquabats will go back to their day-jobs as cabinet makers and electricians. For a few moments, we’ll all be basking in the glow of childhood wonder, but it won’t take long for us to return to reality, the reality where ska sucks.

On Saturday afternoon I sit down with Monique Powell, the singer and sole remaining original member of Save Ferris, which is most famous for its ska cover of the Dexy’s Midnight Runners song “Come On Eileen,” as well as the single “The World Is New,” which, like so many third-wave ska songs, made a number of appearances in cheesy mid-’90s rom-coms (Save Ferris had a cameo in the Heath Ledger-Julia Stiles flick “10 Things I Hate About You”).

A reconstituted Save Ferris is playing tomorrow, which means the band doesn’t have its own trailer backstage today, so Powell and her team have set up a makeshift tent in a special VIP section, complete with a cooler full of cold drinks and a couple of beach chairs, all of it set up in order to receive inquiring minds like myself.

Powell is 42, and today her look — bleach-blond hair, big glasses, white jumpsuit — is that of someone who will eventually retire near slot machines. I didn’t know her very well back in the day, but we attended some of the same shows and backyard parties, or at least that’s what we conclude after comparing notes — Reel Big Fish at Al Cappuccino, No Doubt at Viva Las Vegas. Today, in her own personal makeshift press tent, Powell is solicitous and endearing — she asks me as many questions as I ask her, especially once she discovers that we both survived life-threatening illnesses in the not-too-distant past.

“I’ll tell you mine if you tell me yours,” she says excitedly.

I tell her about having testicular cancer, which is a true story I’ve never quite figured out how to tell. Certainly it happened — I was diagnosed, had surgery to remove my right testicle two days later, spent anxious weeks waiting to see if tests would reveal whether we’d got it all or if it had spread to my lymph nodes, was eventually declared cancer-free (we caught it early, etc.) without ever having to do chemo — but in my case it happened so quickly and relatively easily that I feel weird calling myself a cancer survivor, even though that’s technically what I am. The reason I bring this up is because when I was first diagnosed and during those first few weeks after, when the test results were still outstanding and the worst-case scenario was very much a possibility, I never made any kind of bucket list. I didn’t promise myself I’d finish my novel or pledge to visit a holy site or anything like that. For whatever reason, this brush with … whatever it was, was for me one of the least regretful times of my life, which I’ve always found odd.

This was not the case for Powell. As it turns out, at around the same time I was dealing with my cancer, Powell was diagnosed with spinal stenosis, a condition that required risky surgery she was told she might not even survive.

“I made a deal with my dad,” she explains. “Right before I went into surgery, I promised him that if I woke up and if I could still sing and still walk then I was gonna bring the band back.”

This she did, recording and releasing a new EP that her father sang on. Then, sadly, he passed away. But Powell pressed on. She took Save Ferris back out on the Warped Tour in 2017, and is currently working on new material, coincidentally with one of the members of LCD Soundsystem (“Tell Christian I can get him tickets.”). Powell’s brush with death imbued her with renewed purpose, a determination to literally get the band back together. Here she sits, triumphant, ready to once again share the joys of ska.

This is a heartwarming story, but it has a flip side: It’s Powell’s readymade press hook, the one she’s been offering to anyone who will listen. I was disappointed to discover that she’d shared it (and was quoted) nearly verbatim with a reporter from OC Weekly last year. Undoubtedly, it’s part of her strategy for rehabilitating Save Ferris’ image following a very tumultuous decade or so during which Powell and her former band members sued one another for control of the band’s name, with the “winner” securing the right to play county fairs and nostalgia festivals like Back to the Beach. The whole affair was sufficiently heated as to create factions among the scene, and Powell’s become a kind of persona non grata to the extent that pitching her media tent a hundred feet from the backstage area may be more than just a symbolic gesture.

Like the Aquabats, Save Ferris kills it during their appointed set the next day; if there are detractors in the crowd upset about the brouhaha, none of them reveals himself or herself that I can see. Sporting her signature cherry-red bouffant wig, Powell performs three costume changes, peeling off layers to reveal skimpier and skimpier outfits beneath. At one point she invites Angelo Moore from Fishbone up on stage with her, which is the third-wave ska equivalent of Harry Connick Jr. singing a duet with Sinatra.

I can’t tell you what happens immediately after Save Ferris’ set, but I do know that in the weeks and months after Back to the Beach, the band will continue to tour. They’ll play a string of dates in Vegas, as well as festivals in England. They’ll release a live album and continue working on new material. I say “they” but it’s really just Powell at this point, going it alone with a crew of mercenary giggers. Having cheated death, she’s back in the only place that makes sense, on stage performing a rippin’ version of a Dexy’s Midnight Runners song. During our interview I ask her if playing ska at 42 still feels like living the dream: “For me, absolutely.”

I talk to a bunch of other aging ska musicians. I talk to Joe Gittleman, the avuncular founding bass player for the Mighty Mighty Bosstones, who’s a college professor most months of the year and a member of the one of the world’s most influential third-wave ska bands on his days off. Gittleman went on sabbatical recently to help write and record the Bosstones’ first new record in seven years. We talk about how when it comes to nostalgia acts, ska bands seem to get overlooked by mainstream festival bookers, that the music has never been re-evaluated or at the very least embraced lovingly if ironically a la yacht rock or synth pop.

“I think there’s a lot of value in ska music,” says Gittleman. He points to the tradition of advocating unity in the face of racial divisions, first as embodied by the 2-Tone scene, then as symbolized by the plaid worn by the third-wave bands. This is worthy message, even if it’s somewhat undermined by the preponderance of caucasian faces at the festival.

Whether you buy into the diversity angle or not, Gittleman thinks, and I agree, that ska is just plain fun. “What the fuck’s wrong with having fun?” he asks. “Just for the sake of argument, let’s assume that’s all it is. What the fuck’s wrong with that?”

I interview Chuck Robertson, the singer from the Mad Caddies, who looks every bit like the single dad he now is: handsome if a little dinged up, nursing a longneck and a smoke. The Caddies are a ska band from Central California that never had a big break but still draw well enough to tour and play the occasional nostalgia-act cruise ship (specifically, ahem, “Flogging Molly’s Salty Dog Cruise”). Seated next to a mason jar full of sticky green nugs in the band’s trailer, Robertson tells me about the beach party he had for his own recent 40th birthday, which arrived shortly after a painful divorce. He credits the songwriting sessions behind the band’s new record, “Punk Rocksteady,” with helping him through the dissolution of his marriage. “With the pain of my divorce,” he says, “that lit me up like I’ve never been lit up.”

He adds: “When you’re young, you really take everything for granted. Now I have this newfound appreciation of how lucky we are to be able to do this, to just keep going.”  

I talk to the guys in Hepcat, who are one of my favorite groups at this festival and probably the least successful in terms of metrics: their releases are few and far between; they rarely tour; they have no outsize shtick. Hepcat play a brand of laid-back soulful ska that’s as close to the Jamaican original as any of the bands from ska’s third wave. The most noteworthy thing about the band, aside from the fact that they really do make great music, is that their singer, Alex Désert, is the guy in “Swingers” who says about all LA parties, “This place is dead anyway.” His advice to me about turning 40 is this: “Just remember when you get your prostate examined that he or she is a trained professional.”

But the guy who has what is in my opinion the most interesting and balanced perspective on all this — both the cultural phenomenon that is third-wave ska and the biological reality that is aging — also happens to be the guy who’s made the most money off it, Back to the Beach’s co-producer John Feldmann. With his short bleached hair, tasteful tan and lithe surfer’s body, Feldmann, or Feldy, as he’s known and consistently referred to, is an unsubtle ad for the age-defying effects of being rich and living in Southern California. Feldy is best known as the founding member of Goldfinger, whose song “Here in Your Bedroom” is nominally ska but definitely one of the more ubiquitous hits of the era, with an enormous earworm chorus that sounds like it was delivered by ocean liner. After launching several hits with Goldfinger, Feldmann became a successful writer/producer/Svengali in the alt-rock world, minting new bands and contributing to a slew of hit records. He’s like the Rick Rubin of mall punk.

“I wanna be a good dad, I wanna be a good performer,” he says in his trailer backstage. “But I wanna go to bed at night saying, ‘I fucking like who I am.’” Feldy meditates and reads books like Three Magic Words. The only thing he acknowledges slowing down as he’s aged is his libido — “My drive for humping isn’t quite what it used to be” — but other than that his ambition has remained steady and constant, even if happiness has become more elusive over time.

“I know now, being 50, that career success and money do not equal happiness on any level,” he says. “I know that there’s definitely more abundance of happiness when I was striving to get here. But you can’t go backwards. Once you fly business class and lay down on your way to England and sleep, how do you go back to coach?”

Feldy strives to live in the moment, and thinks this is generally a good idea. “If I’m hard on myself, I’m gonna be hard on others,” he says. “If I look back and say, ‘God, you could have done better, John, if only you did this different,’ then I’m gonna do that to my kids, I’m gonna do that to my wife, I’m gonna do it to the people I work with, and who wants to be around that guy?”

Feldy’s the one who had the idea to attempt Back to the Beach, as well as the connections to actually execute it. After Goldfinger played a similar nostalgia fest focused on ’90s punk, Punk in Drublic, Feldy decided it was time ska had its moment. So he called his buddies in Sublime, Fishbone, The Bosstones, Less than Jake. “I just said, Can we do a ska festival in Huntington Beach? Will you do it if I put it on? Instantly, everyone was like, ‘Fuck yeah.’”

There was only one band that couldn’t play the festival: Reel Big Fish. The act had already signed on to play the Warped Tour, so a gig in Huntington Beach would violate their radius clause. This was a glaring omission and huge disappointment, because Reel Big Fish are among Orange County’s most popular and successful third-wave ska bands. Feldy, however, had planned a surprise that would help ease the blow: “Aaron [Reel Big Fish’s singer] is going to play ‘Sell Out’ with Goldfinger tomorrow.”

Yes! “Sell Out.” If there was a single song I wanted to hear most this weekend to complete the nostalgia trip, it was “Sell Out.” “Sell Out” is many things — a technically excellent songwriter’s song, a rousing banger if third-wave ska ever had one — but it’s primarily the best illustration of how quixotic this barbarically stupid genre’s worldview was.

You see, for as patently ridiculous as third-wave ska is/was, the genre’s adherents inherited one of punk’s most strident values, one that in today’s world seems quaint: an aversion to becoming too successful. Imagine that! Seriously, imagine it: It’s 1995, you’re in a group where half the members are acne-strewn horn players from the high school marching band, you all wear bowling shirts onstage and sing about breakfast cereal and space aliens, and one of your primary concerns in life is that you might achieve a level of mainstream fame and acceptance that would compromise your carefully manicured value system. You play third-wave ska, and you’re worried you might just get too rich doing it.

What’s really amazing here is that there was a moment circa 1996, the year I graduated high school, where this seemed like a real possibility — that if you weren’t careful, you might actually get rich. No Doubt was just starting to blow up MTV, and major label A&R scouts were becoming as common at ska shows as plaid pants. All the bands I knew secretly or not-so-secretly had their hearts set on the label machine reaching out and taking their hands, leading them into a world of fame and fortune and hookers and god knows what else — for playing ska! I mean, shit, look at the Aquabats! They had not one, but two TV shows. Christian Jacobs has been telling people how to scratch their balls for more than two decades.

This all seems especially surreal against the backdrop of the music’s history. The anti-colonialism and anti-capitalism of first- and second-wave ska had given way to a third wave that dispensed with most of the politics but retained the anti-bourgeois gestures. Selling out was the key issue now; the deeper political question of who was doing the buying had been left in the past. This was music made for and by people who had the privilege of wondering if they really needed the money. It was stupid and embarrassing, and it was also aware that it was stupid and embarrassing, but it was not exactly sure why. And it was this dynamic that, coincidentally or not (let’s say not), attracted me to this music as a gawky, self-conscious teenager and that persists here, now, to this day, as a gawky, self-conscious adult. This inchoate regret is strong stuff, to tweak an old line of J.D. Salinger’s, and it’s the animating essence of both third-wave ska and “Sell Out,” a song that both prompted Reel Big Fish’s incredible, unpredictable success and served as a pre-emptive apologia for it.

Which brings us to Sunday evening, when Reel Big Fish’s Aaron Barrett comes trotting out during Goldfinger’s set like Bruce Springsteen sitting in with Billy Joel, that is, if Springsteen had been sporting the same mutton chop sideburns and Hawaiian shirt for 25 years. The first song he plays with the band is Goldfinger’s hit “Superman,” which sounds decidedly like a Reel Big Fish song, maybe not coincidentally (“This guy played my wedding,” Feldy informs the crowd when he introduces Barrett). Then they launch into “Sell Out.” The horns blare like the drunkest guy at a New Year’s party, the song explodes like Evil Knievel jumping the Grand Canyon. I stand there in awe, a boneheaded grin slathered across my face that I couldn’t wipe off if I tried. Barrett sings: “The record company’s gonna give me lots of money / And everything’s gonna be all right.” In the middle of the song, Feldy hurls himself into the crowd, surfing along outstretched arms until he’s out in the middle of the throng. They prop him him so he’s standing upright, his arms outstretched, chin thrust to the heavens, lording over that which he has wrought, these tens of thousands of knucklehead ska fans, including your correspondent, having a blast on our beach.

“Ska was a joke,” Feldy had told me back in his trailer. “Even back in the day, it was so difficult for anyone to pay attention to it. Pick-it-up, pick-it-up, pick-it-up — it was a joke. But I think that it permeated the culture. And obviously people want to have a good time. We’re living in this weird era with this fucking president that makes no logical sense, and we’re all trying to connect the pieces and go, ‘Are we really living right now? Are we alive?’”

I don’t know where regret comes from, or why some people experience it more deeply and frequently than others. I don’t know what worry is — what are the chemicals, what are the contents of the thoughts? It feels a certain way and I feel it constantly, but I can never seem to describe the feeling to my satisfaction. Some people turn 40 and it’s no big deal; some people face death and it’s no big deal. I am one and not the other. I am both at once.

I spent the night of my first kiss in a sleeping bag at the birthday boy’s house in a neighborhood we all referred to as “slums,” which is a cruel description looking back (I regret it). When I woke up the next morning, this first thing I did was call my mom. For some reason I’d felt guilty in the aftermath of my first kiss — not because my friend’s feelings were hurt, which they were, but because, well, I don’t know why. I’d experienced something thrilling, and one of my first reactions was to feel shame about it, to feel my first initial pangs of that inchoate regret, to apologize to … someone. There I was, at 12 years old, already a ska fan.

Navigating the world of medical tests can be confusing and lead to a lot of questions. What age do you need to start getting mammograms? When should you schedule your first colonoscopy? And do you really need a physical every single year?

Since your health depends on getting the proper checkups at the right times, HuffPost talked to some experts to get to the bottom of what health measures you need to take, as well as which tests you need to get and when to get them. Take a look at their answers below ― then call your doc ASAP.

Once you reach your 20s, it is important to find a primary care physician that you trust and start seeing them for an annual physical. At these annual appointments, your doctor will check to make sure you have healthy blood pressure, body mass index (BMI) and cholesterol levels.

“These are the appointments where you can ask questions about which screening tests are needed and how to prevent disease from occurring as you get older,” said Anjali Kohli, an internist at Houston Methodist Hospital in Texas.

Take the time in your 20s to talk to older members of your family about their own medical history and that of their parents and grandparents.

“This information helps provide a road map for you and your doctor of issues that you may need to prepare for ― or work to avoid ― now while you’re younger,” said Garth Graham, a cardiologist and internal medicine physician and president of the Aetna Foundation.

“[Age] 21 is the beginning of a whole new chapter for many women. It’s also at about this age that women ought to begin routine annual pelvic examinations and learning how to do self-breast exams,” said Sherry Ross, an OB-GYN and women’s health expert in Santa Monica, California.

She noted that the importance of birth control and safe sex is a major topic for most 20-somethings and both should be addressed with an OB-GYN. This is also the time to start talking with your doctor about preparations you will want to think about if you plan to start a family at some point in the future, added Nieca Goldberg, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Health.

Testicular cancer is most common in males ages 15 to 35, so the younger you begin self-screening, the better. Check out this guide from the Testicular Cancer Society on how to perform one properly.

One in two sexually active people will contract a sexually transmitted infection by age 25.

“If STDs go without treatment, they can greatly impact an individual’s reproductive organs and overall health,” said Marra Francis, a practicing OB-GYN and chief medical officer at home health test provider EverlyWell.

“Sexually active women should be screened yearly or between new partners for sexually transmitted infections, including chlamydia and gonorrhea,” Ross added.

The American Optometric Association recommends people ages 18 to 60 receive a comprehensive eye exam at least every two years. This can reveal more than just vision issues, said AOA President Samuel Pierce.

“By detecting eye and vision problems, or signs of other illnesses and conditions, optometrists can help put patients on the path to good health long before visible symptoms or irreparable damage occur,” he said.

One in five Americans will develop skin cancer by the age of 70, making it the most common form of cancer in the United States. Early detection is key to treating skin cancer. The younger you start screening, the better, so this is the age when you want to start monthly self-exams.

“If you have a family or personal history of skin cancer, have numerous moles or freckles, or have fair skin with light hair and light eyes and regular sun exposure, you should have an annual skin check with a dermatologist,” said Kristine Arthur, an internist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.

Biannual teeth cleanings may or may not have been part of your childhood plan. Regardless, it’s important to keep up with these as an adult. As part of good oral hygiene, the American Dental Association recommends regular teeth cleanings at intervals determined by a dentist.

If you have any unexplained symptoms such as changes in sleep habits, weight or mood, it may be a good idea to have your thyroid checked out.

“An underactive thyroid can lead to weight gain and an overactive thyroid can lead to autoimmune disease,” Graham said. He recommends having these tests done around age 35 and then repeated every five years as long as tests are normal.

“In addition to a pap smear every three years, women aged 30 to 65 should also get an HPV test every five years to help prevent cervical cancer,” Graham said. 

The American Cancer Society recommends that people with an average risk of colorectal cancer begin regular screenings at age 45. You are considered normal risk with an absence of the following factors: a personal or family history of colorectal cancer, a personal history of inflammatory bowel disease (like Crohn’s disease), a confirmed or suspected hereditary colorectal cancer syndrome (like familial adenomatous polyposis), a personal history of getting radiation to the abdomen or pelvic area to treat a prior cancer.

“People who have a family history of colon cancer may need to move up their testing sooner,” said Glenn H. Englander, a gastroenterologist with GastroGroup, a gastroenterological care center in West Palm Beach, Florida.

“This is the time when you may notice your blood pressure beginning to rise,” Graham said.

He added that it’s important to remain even more diligent about it in your 40s, as maintaining a healthy blood pressure is an important factor that impacts your life expectancy.

The U.S. Preventive Services Task Force recommends lipid screening to help assess for heart disease risk starting at age 40. It also recommends repeating the test every five years for people without increased heart disease risk.

“This allows your doctor to estimate your risk and start a prevention program if necessary, [like] lifestyle changes and medications like statins,” said Tzvi Doron, clinical director at the men’s health service Roman.

According to Brian J. Moran, medical director of the Chicago Prostate Cancer Center, men should have a prostate cancer screening starting at age 50. He noted it’s worth beginning at age 40 if you have a family history of the disease or are African-American, because your risk is higher.

“This consists of a blood test to check for elevated levels of Prostate Specific Antigen, as well as a rectal exam to detect any abnormal nodules on the prostate. Both are key, as it’s very possible to have a normal [blood test], but abnormal rectal exam and vice versa,” Moran said.

Adults in their 40s without high risk factors should begin screening for diabetes every three years.

Diabetes risk factors including being overweight or obese, having a family history of the disease, having a history of gestational diabetes or polycystic ovarian syndrome, or being a member of certain racial or ethnic groups,” Doron said.

Recent research suggests that women should begin getting an annual mammogram at age 50 and continue to get a test every two years after that. Graham noted that even with regular mammograms, women should continue to perform breast self-exams every month. 

This is the decade when most women will experience the symptoms of menopause.

“Myths about menopause are abundant, and routine testing is not needed. However, women should discuss their concerns with their doctor early to get accurate information and be prepared if symptoms such as hot flashes, night sweats and weight gain develop,” said Lisa Doggett, a family physician in Austin, Texas.

If those symptoms begin to interfere with your life or are bothersome, it is important to discuss medications or treatment, which could include hormone replacement therapy, with your doctor.

“The decision for hormone replacement is not universal and your doctor will review the risks and benefits of both hormonal and non-hormonal therapies before starting a treatment plan,” Kohli added.

“Low-dose helical CT scans are recommended for people ages 55 to 80 with a smoking history of at least 30 pack years [the equivalent of smoking one pack per day for 30 years] who are current smokers or who have quit smoking within the last 15 years,” said Karen Leiser, an internist at Scarsdale Medical Group in New York.

This includes seeing your primary care physician yearly and keeping up with tests like mammograms, annual teeth cleanings and seeing any other specialists that your primary care physician has recommended, e.g., if you are at risk for heart disease, keep up with your cardiologist appointments. It’s also important to continue to review any medications you are taking with your providers and to have them adjusted as needed.

According to James Gilbert, a sports medicine specialist with The Centers for Advanced Orthopaedics, women age 65 or older should schedule a bone density test “to determine baseline and risk factors and identify whether they have osteoporosis, a disease that weakens bones and is more likely to lead to fractures.” Consider repeating this test every few years.

Doctors recommend two pneumonia vaccines: the Pneumococcal Conjugate Vaccine (PCV 13) and the Pneumococcal Polysaccharide Vaccine (PPSV23).

“It is important to get both, and they are often given a year apart,” Kohli said.

Pneumonia can become more severe and can sometimes require hospitalization or be fatal as you age. “Early vaccination is key in protecting people from a potentially deadly illness,” Kohli added.

“Once a patient hits their 60s, exams should increase to annually,” Pierce said. An older demographic can become more susceptible to vision disorders such as age-related macular degeneration, cataracts and glaucoma.

Most importantly, no matter how old you are, you should at the very least be checking in with your regular doctor.

“Regardless of age, adults should see their primary care provider regularly (at least every year or two), to check in on any health concerns, review risk factors for cancer and certain chronic conditions, discuss lifestyle choices like diet and exercise, and identify and address any behavioral concerns like depression or substance abuse,” Doggett said.

This can help with early detection of a variety of ailments, which can be crucial to working through them. And finally, in addition to keeping up with the recommended testing by the decades, Doron suggested keeping up on regularly recommended vaccinations such as tetanus shots and considering optional ones to protect against things like the flu.