Tag Archives: medical science

Shit in a box…

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I’m not going to lie, one of the things that has changed unexpectedly since I turned 45 has been how often I’m required to shit in a box… for science. Admittedly, the total number of times that’s happened in the last 15 months is twice, but that is exactly two times more often than it happened in the previous 45 years, so it feels like a significant deviation from the norm. 

The first of these experiences was to check for any underlying gastrointestinal issues causing my acid reflux. The second was as a screening tool for early detection of colon cancer. Both are worthy objectives and I support the goal entirely. That doesn’t make it any less weird when you have to spend some part of your morning packaging up your own shit and then driving it over to the nearest UPS store. There’s something intensely surreal about the whole process.

Despite the warnings that “things change after you hit 40,” I’ll admit I was entirely unprepared for some of what that was going to entail. In some ways, regularly shitting in a box and then posting it off for someone else to analyze is, perhaps, not even the strangest part of this brave new phase of life. I’m equal parts curious and terrified of whatever comes next.

It’s been a very strange year…

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It’s just a few days shy of the one-year anniversary of experiencing the still unexplained tachycardia that started me down what feels like a very long and often unfulfilling series of medical appointments and major life changes. As June 28th looms larger on the horizon, I’m still not sure what to make of the experience. Maybe it’s not surprising to anyone else but learning that I am not actually indestructible came as something of an unwelcome surprise. 

I won’t say that I ever considered myself particularly healthy, but I always felt robust and strong as a bull moose. I rarely gave much thought to my physical limits. This experience has forced me to confront both human fragility and the illusion of invincibility I once held. Every medical appointment since has been a reminder of my body’s unpredictability, and despite numerous tests and consultations, the cause of my tachycardia remains elusive. This uncertainty has become a constant background noise in my life.

Each day carries a mix of hope and frustration, as I swing between optimism that the next appointment might bring answers and the annoyance of another inconclusive result. It’s a challenge to remain patient and positive when the path to wellness feels never-ending. Often, the struggle between my own ears is as or more problematic than the physical one.

As June 28th approaches, marking a year since this parade of fuckery, I find myself reflecting on the life changes that have accompanied it. Adjusting my lifestyle to accommodate both the knowns and the unknows has meant altering routines that felt as natural as breathing. From dietary changes and new exercise regimes to prioritizing rest and stress management, the shifts have been both major and minor but always impactful. The experience has reshaped my understanding of health and well-being and the surprisingly delicate balance required to maintain it. 

A year later I wish I had better answers than, “well, as long as the incidents aren’t recurring, keep doing what you’re doing.” Patience in the face of uncertainty has never been one of my strengths. This experience hasn’t improved that at all. As I gain some distance from the events that launched this ridiculousness, pondering on what it all means and what’s going to happen has receded to manageable proportions rather than filling a dominate place in my daily thoughts. That has gone a long way to letting me make the mental leap to getting back to what now passes for normal.

Simple concept, challenging execution…

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On June 28th I had an epiphany. Maybe a lot of people do when they find themselves laying on a gurney in their local emergency department waiting for tests to reveal if they’ve had a heart attack. The tests, fortunately, didn’t reveal anything immediately catastrophic, but that didn’t do much to change the simple fact that I felt awful and it was categorically impossible to keep plodding along as usual with all the warning lights that were being flashed for me. 

So, I did what any reasonable person would do… I slashed salt, downloaded apps, poured over internet discussion boards, and scheduled appointments with any doctor I could think of that might help get to the root cause of why I was feeling so badly… and more importantly why my heart occasionally decided to make a big show of trying to thunder out of my chest. Months of tests, scans, consultations still haven’t definitively what was going on with me through the summer of 2023. They keep poking at it, though, so maybe we’ll find out at some point… though as my symptoms have diminished, I’m less optimistic that will happen unless they reemerge and can be captured on one of their fancy tests or scans. If I’m honest, the part of me that things better out of sight and out of mind is winning out over the part of me that wants conclusive answers.

One of the deals I made with myself laying in the ED back in June was that I would finally head the medical advice I’d been getting for as long as I could remember. I couldn’t control the test results or the lack of official diagnosis of what was happening, but I could, in theory, control my weight. It had to come off and it had to happen in a significant way. As someone who’s life is almost defined by being a dedicated creature of habit, it would be arguably one of the hardest goals I’ve ever set for myself… and one I was being drug too unwillingly by my own traitorous body. 

July 1st I weighed in at 330 pounds. Not knowing a damned thing about weigh loss, I set an arbitrary goal of making it down to 250 by the end of the year. Eighty pounds. Six months. I had no idea if it was doable, or even if my own brain would let me stick with something I hated with a passion for that long. 

I downloaded the LoseIt app, plugged in my vital statistics, and told it I wanted to lose 1.5 pounds a week. It spit out how many calories I should be eating each day… and that’s when I realized I had no idea how to effectively measure food. After that it’s been all weights and measures before anything gets on my plate. If you ever want to take the romance out of food, definitely weigh it all up first.

If June 28th was my epiphany, buying that damned kitchen scale was a light bulb moment. I’d been protesting for years that I wasn’t eating absurd amounts of food. That’s objectively true. What I was eating, however, was incredibly calorically dense. A proper 400 calorie “serving” of lasagna is preposterously small. Same with anything involving cheese, really. Once I accepted the scale, though, things started happening. Yes, I was ravenously hungry all day every day, but the weight came off at a rate closer to 2.5 pounds a week than my planned 1.5. Chalk that up to the limited additional exercise I was willing to program into the day’s limited hours. 

Two months along, I discovered I wasn’t ravenous anymore. I was hungry for sure, but felt decidedly less likely to chew my own hand off. That’s about the time the anxiety I mentioned in last week’s post started to make its presence known. After that it was pretty much a war between my own stubborn determination to lose weight and my brain screaming that something was wrong. We seem, for the moment at least, to have concluded that particular war. I’m particularly grateful to that particulate respite.

What have I learned? Well, for me, losing the first tranche of weight was simple – radically decrease the number of calories going in while moderately increasing the number of calories burned. Calories in, Calories out as the people in the forums are fond of saying. The catch is, although the theory is simple, not a single part of it is easy. Learning about calories, how to measure them, abandoning long cherished menu items, learning to cook new recipes in an entirely different style, and sometimes being hungry all day no matter how well planned your meals are is hard. It’s damned hard. Every step of it is a goddamned fist fight with yourself. 

This how I sum up my experience so far… it’s an incredibly simple concept, but wildly challenging in execution.

I don’t think this process have given me any special insight. I still don’t know dick about losing weight. I don’t know much about macros or the fancy concepts of nutrition. I’m just a guy over here using an app and a scale to try to keep everything the experts say you need in between the lower and upper limits. Some days that works better than others. 

Anyway, I hit my mark of losing 80 pounds two weeks early. I’m still losing – down to 248.6 as of this morning. All the charts say at my height, I should “ideally” weigh in at 185 pounds. Frankly that sounds unreasonable. The chance of me hitting a weight I haven’t seen since high school at the latest doesn’t feel like something that’s achievable. Now 220 or 225, something that puts me in the range of being merely overweight instead of obese, does seem that could be within reach.

I’m plugging in my next goal as hitting 225 before June.

We’ll see how it goes.

What Annoys Jeff this Week?

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1. Heartburn. You know what you should definitely throw at a guy who’s trying very hard to get his cardiac health improved? A sudden onset burst of god awful heartburn, that’s what. Because there’s no chance at all that would trigger 17 bloody flavors of panic and hundreds if not thousands of dollars in fun new medical tests and their corresponding bills. This week proudly continues 2023’s ongoing effort to be marked out as the worst of my 45 years… so far.

2. Samples. Well, the do it yourself stool sample package they sent me home with in hopes of ruling out a stomach ulcer and more or less confirming acid reflux has definitely unlocked a new level of disgust. It also reminded me that modern medical science is apparently not nearly as far away from reading entrails, casting bones, and balancing the humors as they like to think they are.

3. Fall yard work. It’s not so much that it’s a lot to do as it is that fall yard work is just bloody continuous. In the summer, I cut the grass once a week and trim every second week unless it’s growing unusually fast. In the fall, however, the minute I’ve finished mulching up leaves and blowing what can’t be mulched, the yard is every bit as covered as it was before I started. Yes, I know this was a self inflicted wound when I decided to live in the woods, but still it’s just a little bit maddening.

Non-painless gains…

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I’ve been doing the exercises assigned by my physical therapist for a week now. So far, the net result has been to see the pain near my lower back and raise it occasional mid-back spasms and, rather inexplicably, a sore left shoulder. I’m not entirely sure this is going according to plan. I’m sure all will be revealed to me tomorrow at my next appointment. Or not. If my track record of these things proves consistent, what we’ll really do is add new and different exercises so I can get sore and achy in even more places that were previously pain free.

I’m sure there is plenty of evidentiary proof behind why physical therapy is a good thing, but honestly, I’m always going to be more appreciative of the medical sciences that involve a pill or a jab and send me on my way. Yes, I want the easy way out. Sue me.

Oh, don’t worry. I’ll keep up with this new assigned routine through the four or five weeks it’s set to run. I’ll bitch and complain about it the whole way, of course, because that’s just what I do when something comes along to interject itself into my well-honed routine… especially when it also brings me new aches and pains for my trouble. So far, I’m willing to withhold judgment on this process, but if we get into week three and four with even more new stuff hurting, we’re going to need to have a long think about where we are and where it’s headed.

In conclusion, whoever coined the phrase “no pain, no gain,” was a putz. I’ve achieved many painless gains and I rather wish this could be counted among them.

I want my money back…

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I’m going to a few weeks of physical therapy in an effort to resolve some lower back issues. I don’t love it. Being laid out flat on my back (or front) in an open bay storefront getting worked over by a perfect stranger just isn’t my idea of high jinks. That’s not the worst part, though.

The worst part is the five pages of “homework” that I’m supposed to lay down on the floor and do three times a day. Firstly, have you ever tried laying down on the floor in a home occupied by a young dog who lives for attention? Yeah. Then thrown in a cat who thinks he’s a dog and insists he should also be part of the program. Something that’s supposed to be 30 seconds and three repetitions takes approximately nine minutes to get through. Then there’s four more pages of things to do, each more ingeniously designed to provoke more attention from the resident canine who’s determined it all means uninterrupted playtime.

I’m pretty sure I dislocated my shoulder trying to keep the dog from licking my eyeball this afternoon. I guess that’s something I can bring up with my new PT guru next week. Maybe there’s some other kind of supine bend-twist-arch-single-elbow-tuck I can try out to get after that one. 

I can’t believe we’re living here in the 21st century and this can’t all be solved with a pill or a shot. This isn’t the future we were promised and I want my damned money back.

Specialists…

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I’m old enough to remember taking the family dog to a vet who ran his practice out of a converted shed in his back yard. Treatment for most any ailment was a shot of antibiotics and a bland diet – his weapon of choice was boiled hamburger and rice. It was the middle 1980s and the very notion, at least in the mountains of western Maryland, that there should be anything remotely like a “specialty” vet didn’t cross any of our minds. Dogs got their rabies shot every 3rd year, ate table scraps mixed with their dry food, and all lasted for somewhere between 8 and 10 years.

Flash forward 30 years…

My bulldog, being typical of his breed, assembled an impressive roster of medical professionals on his “healthcare team.” Cardiologists, allergists, orthopedic surgeons, and anesthesiologists over the course of treating his many various conditions. My labrador, now into old age herself, has already acquired a opthmologist. In the coming weeks it’s likely we’ll add a radiologist, an oncologist, and a general surgeon to her list.

Veterinary medicine as it exists today – with the ability to diagnose and treat the family dog in a remarkably similar way to how how I’d be treated if I walked through the doors at Hopkins with the same symptoms – is a marvel. It’s also a money making juggernaught, but that’s a separate discussion. The practice I’m taking Maggie to this week in hopes of working up a final diagnosis and beginning outline of a treatment plan includes easily a thousand or more years of combined experience in emergency medicine, cardiology, dentistry, dermatology, radiology, neurology, oncology, and ophthalmology, in addition to maintaining six surgeons on staff. Their posted resumes are suitably impressive (yes, I’ve read them all). I’m cautiously optimistic that all this will translate into identifying what the best options look like for the road ahead.

I’m walking into this week with just enough knowledge based on internet deep diving and journal article reading to hopefully ask reasonably informed questions. I’ll be counting on this bunch to know the line between what science can do and what science should do. Don’t get me wrong here, I’m thankful that the state of the art has grown beyond crate rest along with boiled hamburger and rice, but there’s more than a little bit of me that misses simple, country diagnostics and treatment – and its inherent acceptance that the power of medical science to extend life has, and should have, logical limitations.


The sadists among us…

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I don’t like going to the dentist. You’d never know it from the amount of money that I’ve dumped into my teeth over the last 20 years, but I don’t. That’s probably why I generally put it off as long as possible between visits. I’ve convinced myself that the most logical approach is not to worry about it until something hurts and then I can have the issue addressed. Yes, I know that idea probably compounds the issues and means more time in the chair… but at least those times are less frequent.

I don’t mean to imply I have a random phobia of the dentist. It’s not like being afraid of spiders or thing that lurk in the dark. I avoid the dentist for good reason, the best reason – childhood trauma. My reluctance to fully commit to a modern dentistry stems all the way back to the early mid-1990s. That’s when the old dentist I saw as a kid decided that since it was a small cavity, he could go after it without Novocain and be finished in a jiffy.

As it turns out, having someone drill on a molar without numbing it up first hurts like a mother. I don’t recommend it. You might say that I’m pain intolerant. Being the rational creature that I am, I seek to minimize painful experiences. Which leads me back to the original statement: I don’t like going to the dentist.

I’m sure they’re perfectly good people and that they have the science to back themselves up… but you’re never going entirely convince me that dentistry isn’t just a vast conspiracy of the most sadistic among us to inflict pain on the masses under their diabolical cover as medical professionals.

Quack…

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Medical science isn’t likely to find a bigger cheerleader than me… most of the time. When the chips are down, I can almost always count on them to come up with some chemical concoction the in some way improves my quality of life. Except this week, of course. I’m not in any way disputing the official medical diagnosis of “it looks like you have some fluid behind your eardrum,” but I am, however, disputing the “keep doing what you’re doing and give it another week” advice. It’s not like I’m in there asking for uppers, downers, or even leeches. All I’m asking for is something better than the standard little red pill that I’ve been taking every time I get sick since I was a kid. After two weeks, I don’t think asking for something with a little more horsepower is an unreasonable kind of thing.

Medical science? Meh. Quackery. You failed me. Next time, I’ll just got to Walgreens, buy them out of NyQuil, and sleep til I’m better.

Can’t stay away…

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After what seems like an excessive amount of scanning, poking, prodding, and stressing, my faith in the marvel that is modern medical science, is somewhat less than complete. The good news is that there are no obvious signs of things that could cause me to suddenly drop dead. The bad news is that whatever it is that’s causing my head to occasionally explode remains as a diagnosis of “uhhh… we’re not really sure, but here’s some heavy duty pain meds to take in case it comes back.” Now I’m as big a believer in better living through chemistry as anyone around, I think It’d still rather know what it is than what it isn’t. Since that outcome is apparently a bridge too far, I’ll follow my other tried and true solution and try ignoring the problem until it goes away on its own.

… And now back to your regularly scheduled blogging hiatus.