Medical Mysteries

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Everybody likes a mystery right? Especially a medical mystery – whether it’s a crime show based on forensics, like Bones or CSI, or a doctor show with an irascible but brilliant main character like House, medical mysteries are great fun for all involved.

Well, except the patient. Or corpse. And if you are the patient, it’s no fun at all.

Recently, I’ve been feeling tired. A lot. My doctor suggested I drank too much wine (and I have dutifully reduced my consumption by a quarter – though it is still a lot) but also ordered a lot of blood tests. There was a lot of good news – almost everything was normal, including, by the way, liver function. My glycerides were high but that’s fixable by cutting out some carbs. My bad cholesterol, to quote the doctor, “looks like it would if I were taking drugs to control it.” Which I am not – so go me.

My B12 is low – low enough that diet won’t fix it, so it’s a daily supplement from here on in and a re-test in a couple of months. Low B-12 can lead to fatigue and may also cause a certain amount of poor moods. And I thought that was being caused by work.

Usually, low B12 is also a sign of anemia. But, mysteriously, my iron levels are abnormally high; high enough that the doctor will consult with a blood specialist. Because, right now, there is no explanation for this result – and it’s not one prone to false positives. Nothing in my diet explains it, I don’t take iron supplements (I actually take almost nothing on a daily basis) and I haven’t recently been blood doping. Not since my days as an Olympic sprinter. So low B12 and high iron is a bit of a mystery.

Big deal, you might think, high iron can’t be a bad thing right. Iron helps oxygenate your body and high iron should give you a real energy boost. Actually, according to my other physician, Dr. Google, high iron is just as bad as low iron when it comes to energy – so it might be contributing to my fatigue. And, when really high (I’m not – I don’t think) it can cause liver damage (or cancer), heart disease and, not surprisingly, premature death. More horrifying, it can even cause impotence! Fortunately, I’m like Donald Trump that way – no problem in that department. No, seriously. I wouldn’t kid you about something like that.

Strangely, the cure for high iron is quite simple – though somewhat medieval. There are no drugs or dietary changes that will help. The solution is to give blood every six weeks or so and, if for some reason you can’t give blood, that’s okay they’ll just take it. It has a fancy name – phlebotomy – but really it’s bloodletting. Like in the Middle Ages. With leeches or vampires or something.

I’m sure all this will work out fine. In the meantime, I’ll keep analyzing the clues and stay away from large magnets.

And that’s ten minutes.

Tales of Elderly Spouses

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Spring might be just around the corner but winter is still lurking nearby waiting to pounce. Before you let your guard down, I thought I’d offer some advice to keep you safe and warm – advice gathered from the stories of elderly spouses.

Don’t go out in the cold without enough warm clothing; especially don’t go out with wet hair as you lose 25% of your body heat through the top of your head. And the cold can make you sick. True? Only a little bit. As it turns out, getting cold can lower your immune response (as well as help you lose weight) but, as long as you don’t come in contact with a virus, you can’t catch a cold from the cold. Hypothermia is another story. But that won’t come about from a bare head – there simply isn’t enough blood flow up there to make a difference (for some less than others, I might add). Besides the colder you get, the more your body concentrates your warmth in the torso. Still, you could freeze your ears off if you’re not careful.

If you do catch that cold, chicken soup is a sure fire cure. Oddly enough, there is some truth to that – though chicken soup probably helps the flu more than a regular cold. The flu leads to dehydration (sweating, vomiting, the runs) and depletes your electrolytes. Chicken soup is liquid filled with salt and easily digested fats. At the very least it will make you feel less sick. And since chicken soup is almost always served to you by someone who cares, the emotional support actually will boost your own immune system.

Which brings us to hugs. We’ve all known those people who want to hug you all the time. Some of them are a bit creepy but no more so than some other members of the medical profession. It turns out that hugs also boost your immune system and, as well, when given with affection rather than from sexual predation, boost serotonin levels and alleviate mild depression. Human contact is important – without it infants wither and die, even when provided with other physical necessities. But these have to be genuine hugs, not the A-frame arms and shoulder pats that pass for them among the English.

Of course, a lot of the other nostrums spouted by elderly spouses are simply nonsense. Ginseng – unless laced with Viagra as is often the case – will not improve sexual functioning. Nor will rhino horn or anything else from nature that happens to resemble a penis. Otherwise bananas would be sold on the black market.

You can’t tell the sex of a baby from whether it is carried high or low – unless you have a portable ultrasound in your pocket. Nor can the weather be predicted by the behavior of squirrels (they long ago stopped being sensitive to nature as they adapted to an urban human environment). While red sky at night might be a decent suggestion of a fair day on the morning – even that is not a hundred percent in the face of an eastern wind.

My real point is that there is wisdom in folklore but a lot of it is trapped within nonsense and superstition. All the effective measures listed above – they were proven by science. Better to listen to a young white coat than a white haired spouse.

And that’s ten minutes.

The Water Con

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There is nothing like walking on a beach to reconnect you to the world. On one side is the ocean, filled with life both large and small, the steady pounding of the waves on the shore much like a heartbeat. On the other side is the land – in this case, jungle – filled with dense vegetation, the stirring of animals and the twitter of birds. Beneath your feet, rocks and sand – itself the product of thousands of years of steady grinding to turn coral and stones into fine soft grains. Where the land and sea meet, endless interactions between the two worlds – most visible in the pretty hunting birds darting into the surf.

And after a storm you see the other world – the human world – in the detritus of civilization washed up on the shores. Some things are almost natural – bits of wood or concrete washed away from human buildings. Even lost shoes don’t seem so bad, sandals and beach shoes torn loose by the waves.

But the rest? Endless water bottles, plastic rings from six packs and bottle caps, scraps of plastic of all kinds, even toothbrushes and hair combs – all the disposable junk we throw away and forget. So much of it winds up in the ocean, clogging the waves and killing millions of seabirds and mammals.

And for what? For convenience – nothing more than that.

There is seldom any need for anyone to buy water in a plastic bottle. There are exceptions, of course. Many First Nations have been on boil water advisories for decades. Places like Flint, Michigan, have had their water systems ruined by clumsy or venal politicians (who really need to go to jail). But for most of us in North America – where the bulk of water bottles are produced and discarded – the water in those bottles is no better, no cleaner, no healthier than the water that comes out of our taps.

This disservice we do to the environment, we do because we are too lazy to fill a renewable container with water from a tap. Even in Mexico, where municipal water systems don’t always supply potable water, you can get clean water at your hotel. There is no need to spend a lot of money for a product you have, in fact, already paid for.

It is a vicious cycle. As tax payers we have already spent money to produce reliable water systems – which when we obsessively use bottled water — It’s more healthy!!!! – become underutilized and so underfunded. And, of course, as water systems fall into disrepair we actually begin to need bottled water. Which is exactly what the corporations who sell the stuff want.

Which is funny. Because a lot of that bottled water comes from the same source: a municipal water system. This has been proven over and over again. A number of companies have been sued and forced to pay settlements because of falsely claiming to have drawn their water from mountain springs when it was really the town down the road that did the purification. By the way, most mountain springs are filled with parasites and other contaminants. Beaver Fever is not nearly as much fun as it sounds.

So when you buy that bottled water in the store, you are not only committing a crime against nature, you are being conned out of your hard earned money. And the corporations – who used to rely on cola and sugar to make their money – go laughing all the way to the bank. And I don’t mean the river bank.

But that’s ten minutes.

Insomnia

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Of all the things I’ve lost over the years, the one I miss most is the ability to sleep through the night. For most of my life, I fell asleep within seconds or at most minutes of my head hitting the pillow and remained asleep for eight solid hours or more, unless I was yanked untimely from my dreams by the bleating of an alarm clock. Blessed with a huge bladder (TMI, I know), I seldom even had to get up in the night to pee.

Oh, to return to those days. While my bladder remains huge, I seldom sleep solidly through the night. I wake up because I’ve gotten sore from lying in one position, because I need a drink of water, because my snoring wakes me or my wife up, because of no reason at all. On a very good night, I’ll awake once or twice. On a bad one, my eyes flop open every 45 minutes. Sometimes I can go back to sleep fairly quickly; others I lie awake for an hour or more, thinking circular thoughts about something that is troubling me.

On occasion, I’ve composed one of these little essays at 4 in the morning and then repeated it over and over in my head so that when I finally stagger up it is no effort at all to transcribe it. Then there are the times when I’ve thought of something brilliant to say only to have it slip away in the time between 4 and the dawn.

I’ve developed a few tricks to get me through. Breathing helps, especially if a press my face into the crook of my arm so the sound is loud in my ears. I’m sure the gradual buildup of carbon dioxide under the sheets helps bring a return of unconsciousness as well. My wife uses visualizations but these have never worked for me – they get more and more complex and pretty soon develop exciting plots which either promotes wakefulness or guarantees nightmares that, you guessed it, wake me up.

Whenever my mind is whirling with some task that needs doing, usually related to my day job or to the publishing work, I have developed a simple process. I ask myself if I’m going to get up and do what needs to be done. I stick my nose above the covers and notice how cold it is and I snuggle against my pillow and notice how cozy it is and decide that perhaps I don’t need to do that task right now after all. But about one time in ten, I actually get up, put on a warm robe and head for my computer to work for a few minutes or an hour or as long as it takes.

I then spend the rest of the day longing for bed while resisting the urge to nap – which would only guarantee another restless night.

Recently, I read a study that suggested that the idea of sleeping through the night is a relatively new one, brought on by the schedules of the industrial age and the demands of the ever ticking clock. Three hundred years ago, people went to bed when it got dark, but often got up in the night to do some early morning chore by the light of the moon or write letters or read by candle light. Sleep came when it was required. And maybe that’s something I can look forward to when I am freed of other people’s schedules and can finally just… zzzz.

And that’s ten minutes.

The War on Drugs

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The war on drugs has taken a new and somewhat bizarre turn with the interview of El Chapo – the notorious Mexican drug lord – conducted by actor, Sean Penn and published in The Rolling Stone. It created a bit of a stir among the chattering classes and a lot of embarrassment for Mexican and American drug enforcement agencies who have been trying to track him down ever since he escaped from a maximum security prison six months ago. Meanwhile satirists, critics of the drug laws and Mexicans in general have been having a good laugh. A lot of them admire the nerve of the fugitive, it seems.

Guzman – his real name – wound up being captured, in part because of the interview, and is expect to be extradited to the USA to face charges ranging from murder on down. He will undoubtedly be convicted and shoved in a prison somewhere – if his money doesn’t, once again, help him escape.

The most interesting thing El Chapo said in his interview was that nothing – his capture, his death, millions more for police or fences or prisons – will interfere with the operation of the illegal drug trade. In that he is probably right. If the war on drugs was an actual competition between nation states, the United States would have been on its knees a long time ago.

Prohibitions never stop the prohibited product being consumed. The prohibitions of alcohol did nothing for America but increase deaths from tainted bootleg alcohol and establish the Mafia as the major crime organization in a multitude of cities. It also founded the fortunes of a number of still prominent Canadian families but that’s another story.

It is unclear to me why America is so determined to prohibit – rather than control – the use of drugs. No doubt, drugs do harm but there is plenty of evidence that drug use can be mitigated if treated as a medical condition rather than a moral failing. Studies in cities in England where pilot projects temporarily turned heroin use into a medical issue rather than a legal one saw dramatic reductions in death rates, a virtual elimination of petty crime and even the return of some addicts to productive work and family life – even while their addition was maintained and managed. The experience in Portugal has been similar.

Movements to decriminalize or even legalize drug use in America have taken halting steps, focusing on marijuana which is not, apparently, physically addictive though it may be psychologically so. In the long term, government control of drug sales will reduce the negative impacts of the drug trade and make it less attractive to criminal elements. There will continue to be some violations of the law but it will be reduced to the level of the local bootlegger – a problem for society but seldom a threat.

I’ve long believed that all drugs should be decriminalized, medicalized, regulated and, in some case, legalized. The savings in terms of law enforcement, health care, and personal suffering would be considerable. And I’m not alone – the mayors of America’s largest cities have called for the same thing.

You have to wonder who exactly is profiting – aside from drug lords like Guzman – from the current system?

And that’s ten minutes.

 

The Dark

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The sun is shining this morning – though it won’t last, not with freezing rain forecast for later today. On the first day of December I am eagerly waiting for snow to come and cover the ground. Winter is coming but it hasn’t brought its mantle of white with it. Why would someone wish for snow? Because it provides some relief from the darkness of the next two months.

The dark of winter didn’t always bother me. I lived in the North for nine years and while I hated the cold, the darkness didn’t bring me down. In December, the sun would rise by 10 a.m. and set again by 3 in the afternoon. Farther north, it would go down at the end of the first week of December and not come back until January was well underway.

But I felt no different in December than I did much of the rest of the year. It is true I had more energy in June and July when it essentially never got really dark but the winter blahs? Not for me.

Things have changed. November is dreary. Long grey days and endless damp. The trees shed their leaves and colour leaches from the world, not to be replaced by white but by dismal browns and greys on land and black water in the river. I begin to long for snow simply so I can have the reflected light of sun in the days and streetlights for the 16 hours that don’t qualify.

December provides a bit of a break with Christmas trees and tinsel reflecting candle light. In fact as soon as it grows dim I close all the drapes and turn down the lights, filing the room with candles. Our candle bill gets quite staggering by March.

It seems the dark inside is better than the dark without. But it is the dark inside, really inside, that seems the worst. I know I don’t suffer much compared to some. I feel tired all the time and lack much in the way of ambition. I start later and finish sooner. It could be – it undoubtedly is – age. And it doesn’t take a lot to raise my spirits. For some, it is a heavy burden they carry all through the winter.

They even have a name for it – SAD: seasonally affective disorder – which reflects the way many people feel at this time of year.

Maybe that’s why in winter we fill our days with as much artificial light as we can. To call back the sun and stave off the darkness. It sort of works. But by January, the days are still short and the only relief is to pretend you like winter sports or to flee to the sunshine of Mexico and Cuba.

Or you can bury yourself in work and Christmas (or whatever light bearing holiday you prefer) and keep telling yourself in an ominous voice: Summer is coming.

And that’s ten minutes.

 

Breathing

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As easy as breathing. I’ve heard this expression all my life but never really knew what it meant. Having grown up with a father who spent many Augusts lying under an oxygen tent when his asthma and allergies were too much to bear, it sometime seemed as nothing could be harder. My brother, too, suffered from childhood asthma and I often saw him struggle with catching his breath – as if it was constantly running away from him.

I developed my own breathing problems in my late twenties though they never evolved into anything extreme. Still, I can remember times when I suddenly had to stop whatever I was doing, sit calmly, and slowly recover the rhythm of my life. It is a terribly frightening thing to fight to catch your breath.

Breathing problems are often an invisible disability. People who have them sometimes keep them secret – perhaps all too aware of the way asthmatics are treated in fiction and film. Kids in particular are portrayed as weak, as outsiders and as lacking in inner strength.  Children can be cruel; adults are seldom better.

I am struggling right now with the worst virus I’ve had in years and late at night, when all my airways began to close and I literally had to think; breathe in, breathe out, I thought – what an embarrassing way to die that would be: to simply forget to breathe like the subject of some dumb blonde joke. But I overthrew the lethargy of sleep and got up for a while until my breathing cleared, took some medicine that would assure me that things would be alright. And it was.

Still, it makes me think of all those people who struggle with their breathing – there are far more than you think. Some diseases – such as Cystic Fibrosis have been described as slow drowning – the lungs filling with fluid over and over until it finally overwhelms the victim.

Others develop COPD – what used to be called emphysema I think, a constant struggle for breath that puts pressure on all the systems. Then there is sleep apnea. Breathing stops altogether and then resumes – often with a loud barking snort. Funny unless it is happening to you. Over the long term is is debilitating, even deadly.

I’ve never heard anyone’ breathe their last’ though my wife has. Her brother died short of fifty of a multitude of illnesses – though lung disease wasn’t one of them. She was beside him as he died. Breathe, pause, breathe, breathe, pause, pause, breathe, stop.

It will happen to all of us one day. Something to think about in the dark of the night when your own breath comes slow. And you sit up and gasp. And think, keep breathing. As long as you do that everything will be fine.

And that’s ten minutes. From my sick bed.

Expensive Urine

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One of my favorite moments in all of The Big Bang Theory is when Sheldon describes taking a lot of health supplements as a recipe for very expensive urine. He is absolutely right. Most of the vitamins and other supplements people take are not only useless, some may actually do considerable harm. Excessive doses of beta-carotene (Vitamin A) can increase the risk of smokers of getting lung cancer. The ultimate risk-taker might be someone who chain smokes while popping Vitamin A tablets and skis down a hill blindfold.

Yet the supplement industry continues to grow at an amazing rate (roughly at the speed of the Brazilian economy – 6 % a year) and has now reached $34 billion in the United States alone. People who routinely decry Big Pharma see no problem in spending huge amounts of money in so called ‘natural health’ stores. They take vitamins and minerals and various pernicious weeds and not only claim their miraculous benefits but deny that it could ever do any harm. It’s a grassroots business they claim – connected directly to Mother Earth. Grassroots? $34 billion? I’m experiencing a cognitive dissonance. As I’ve said before, if alternative medicine can be proven to work, it is medicine. Otherwise it is bunk (though it might produce placebo effects).

I have no problem with people spending their money any way they like. But it is phenomenally annoying when they adopt a holier than thou attitude about it. You don’t see smokers and drinkers do that, do you? How often have you heard me tell someone with a cold, they should drink bourbon? A lot less than I get told I should take XYZ ‘magical remedy.’ To tell you the truth, alternative medicine fanatics sometimes display the same proselytizing zeal as annoying and blank-eyed folks who come to your door on Saturday morning asking if you’ve found Jesus yet.

Still, it is a concern when the same people who peddle this snake-oil to gullible, though apparently well-educated, individuals begin to make pronouncements about vaccines – pushing useless nosodes while claiming vaccines are poisonous. Personally I think they should be held accountable for measles outbreaks but, hey, live and let live, right? Well, except for the kids they kill.

It’s not that some supplements aren’t required for people who have specific medical conditions. B-12 is an important treatment of pernicious anemia, for example. But in all those cases, there is sound scientific evidence proving their effectiveness.

All the rest is just people trying to make money.

And that’s ten minutes. From my sick bed.

Lightening Up

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My horoscope today told me to lighten up and take it easy. Apparently big changes are coming and I need to relax and conserve my energy in advance of the demands this will bring. Probably good advice. See. This is me smiling and, yes, dancing around the room blowing bubbles. Light enough for you?

Seriously though I am a bit winded. Bad knee is on the mend just in time for me to come down with the virus that has kept my wife under the weather for two weeks. Sorry. Forgot. What does not kill me makes me stronger – written on a blackboard like Bart Simpson, such mantras are bound to make me feel better.

Still, it is hard to supress the constant outrage. This morning as I listened to The House – a show about Canadian politics – I heard James Moore explain he is leaving politics to take care of his young son, recently diagnosed with a serious illness. His reasons were apt but despite the appeal of his personal story he couldn’t help being partisan. He claimed that Stephen Harper quite understands because in 1996 he left politics for a while because he had a young family. Harper left politics because he had a big fight with then Reform party leader Preston Manning over who would control the right wing agenda. Mr. Moore, at 39, may be too young to remember the facts or too stupid to think others might but… Sorry. See lightening up can be a real chore when you pay attention to things.

So, let’s think more pleasant thoughts. The House of Commons has risen for the summer, signifying that Festival season has begun in Ottawa. Really, this is a party town. This weekend alone we have The Jazz Festival, The Fringe Festival and something called the Glow Festival – which until yesterday when they shut down traffic on Bank street, I had never heard of. And of course it is also Father’s Day and National Aboriginal Day.

That’s nice. We took their land and tried to destroy their culture but at least we gave them a day. It’s a start I suppose. Meanwhile in Calgary they are going to change the name of a bridge as a symbol of reconciliation. Folks – reconciliation is not achieved with symbols. Until we seriously address the damage caused by centuries of colonial oppression and actually allow Aboriginal people an economy and control over the basic decisions of their lives, they… sorry. Injustice always makes it hard to be light hearted.

Maybe I should think of other things, other countries. I’ve always wanted to go to Greece –I wonder if it will be cheaper after they are forced out of Europe…

The USA is beautiful at this time of year. Flowers are blooming everywhere. Good thing too. They’ll need them for funerals caused by racist gunmen… I mean, there must be a solution to all this heavy heartedness – a better one than arming everyone as proposed by the old sad white men of the NRA who cling to their guns the exact same way 4-year olds cling to their security blankets while… Happy thoughts!

Yes. Happy thoughts. I do have them. Maybe I’ll even be able to express them tomorrow.

But that’s ten minutes.

Thrombosis

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Ten minutes of words are running a bit late today as I had to get up and out of the house early to go to the Ottawa Hospital Thrombosis clinic. Say what?

Let’s step back a bit. About a month ago I tore the meniscus in my left knee. Nothing dramatic, it just decided to pop. I did a few rounds with the doctor before deciding on a mild course of treatment involving physio and pain killers. All was going well and I was well on the road to full recovery when, while in Alberta I climbed over a fence and twisted my knee once again. Sigh.

Back to physio last week. During the exam, the therapist noticed a little swelling around my knee – water on the knee as they used to call it. No worries. The treatment proceeded and while my knee was still pretty sore, I felt I was on the road to recovery.

Then on Saturday, I was a Prose at the Park – lugging books around and sitting a lot at a table to sell them. It was a fun day but by the end of it, I was pretty sore. When I got home I noticed that the swelling had increased.

On Sunday morning my entire lower leg from knee to ankle was swollen to an ’impressive’ degree according to a couple of doctors and nurses. The calf was sore to the touch and painful to walk on. The swelling persisted and on Tuesday I went to my doctor to have it checked out.

By three o’clock I was told that I might have a blood clot in my leg – deep vein thrombosis is the medical term. I was sent to find injectable blood thinner that I was to, well, inject myself with before going to the hospital the next morning bright and early.

Strangely, the seven pharmacies I tried couldn’t fill the prescription but since I just assumed they were taking precautions I didn’t worry. I certainly didn’t intend to spend my night in emergency to get a little needle.

So I go to the clinic and get checked in. A doctor does the examination and says – yeah, it’s a high probability that you have blood clots.

A blood test specifically designed to test for clots gives me a score of 1250 (anything above 500 is considered risky). So it off to imaging I go for a full ultrasound scan of my left leg. The techs make suitable soothing noises combined with expressions of concern.

I am sent to wait some more. Then the doctor returns and tells me that I’m clean as a whistle – no sign of clots at all and no indication that I need to be re-tested anytime soon. Life, as he said, will ‘return to normal.’ Three hours in and out and, for my US friends, it was all covered by the government.

The explanation: a ruptured fluid sack in guess where? That’s right, my knee. Turns out it was that after all.

So, despite my initial expectations, I won’t be on rat poison for the next six months. That may disappoint a few people but it has put a fresh spring in my step. Which is too bad, because my knee still hurts.

And that’s ten minutes.