Potassium

Since deciding to exercise more I have been experiencing some minor leg cramps; charley horses usually at night. Now we all know that a healthy potassium level often prevents those nasty knots in the calf. So I thought I should make a quick surf to find some high potassium edibles.

The banana is the most obvious. Ripeness being the primary component of a good banana.

Papaya is another good source, I often combine them with other yummy fruits in a mid-morning Jamba Juice breakfast.

Don't you really enjoy finding out something you like is also good for you. Once again ripeness is a key with the avocado.

Next on the potassium hit parade, my favorite legume -- lentils, in all hues.

Spinach - just don't cook it, give it to me tender and raw.

But for me, it's really hard to get past the banana for a perfectly delectable source of K. Besides there are so many great banana pictures.

That's a laser engraved banana.

This is actually an eraser but nice colors!

In case you missed my words of wisdom the first few times - it really is all about the ripeness. 

Yes that is a statue, a life-size piece of art, 

well life-size for the woman not the banana.

Paying Attention to All the Wrong Clues

Ah life, sometimes it sneaks up on you when you least expect it and other times you least expect it to sneak up on you. For over three months now I have had in my medicinal arsenal some fairly strong pain medications for my slowly recovering back. Growing up as I did in a pharmacy, I am well aware of the multitude of side effects drugs of all varieties can potentially have. I also know that just because you have taken a pill or a potion for days, weeks or months does not mean it will not suddenly have unforeseen and previously absent consequences.

So the other day whilst traveling on mass transit here in San Francisco, I was noticing an uneasy feeling. I wasn't exactly ill but neither was all together okey dokey. When the metro passed into a tunnel I realized I was hallucinating. Nothing too outlandish but hallucinations none the less, I grew up in the sixties, I can identify a good visual cortex non-sequitur. The train emerged from the tunnel and I got off at my intended stop and took a seat on a bench. I could perhaps walk a few blocks to my prior destination, where several friends could help me with this dilemma or I could get back on the train going in the opposite direction and head back to the safety of a comforter, a cat and some sleep. 

I was sure I knew what was wrong, my diagnosis was that single pain pill earlier this morning had just taken a wrong turn somewhere around the medulla oblongata. I took the train back through the phantasmagoric tunnel and made it back to the safety of my temporary cave. 

However . . .

You knew there was going to be a 'however'.

It wasn't a drug reaction at all. I was genuinely ill with something akin to the 24 hr. or less flu. Felt fine, if tired, after a long nap and right as acid rain the following morning. Good decision-making based on a completely false diagnosis. Not that 'head for bed' is not a wise panacea for many if not most of the twists and turns of daily life.

--

The Art above is way over the top for what I experienced but I found it on a medical site I searched for the potential side effects of the meds I am taking, so at the time it felt appropriate if mildly excessive.

Spinal Confession

There are only two ways of telling the complete truth -- anonymously and posthumously. -Thomas Sowell

One of my very closest friends once commented that he had learned more about me from this blog than he had from nearly twenty years of face-to-face conversations. I plead guilty to being circumspect about my personal life. Another friend observed that I never actually avoided any conversation but after an evening of discussion I may have spoken in depth on how early Aegean cultures felt about a certain issue but he still didn't know my personal feelings on the subject.

Today I make a leap of self disclosure. I am doing this is response to a confluence to two factors. First, I have had conversations with both friends and family in the last two weeks in which I have hidden my current physical condition from them. Second, several of my dear friends have pointed out that such behavior may be less than optimal for everyone and with the deepest respect they told me to knock it off. After much reflection I have come to believe them to be much wiser than I on this issue, therefore I am going to change my behavior. So here goes:

In the fall of my sophomore year in high school it appeared that I had suffered a back injury while playing football, I was 14 at the time and the problem was misdiagnosed. The x-rays were read without my age being attached and the assumption was made that I was an adult male instead of just barely a teenager. For several years I took many aspirin a day for severe rheumatoid arthritis; a disease seldom found in young adults. Later in college I was reexamined by an orthopedic surgeon and father of a close friend and received my true diagnosis.

I have a congenital malformation in the small of my back. A teenage growth spurt and not football had been the aggravating factor. The facet joints at L4 & L5 (lumbar) on my right side are not well formed and do not perform their structural function of providing full range of lateral motion. I have been aware of this problem every day for the past 48+ years. Mostly I have kept this information to myself but the problem has become more acute in recent years. 

Last week the pain became so severe that I had to make my third trip to an emergency room for narcotic induced relief, the previous ER visits were in 1974 and 1986. Other than these three occasions I have managed the discomfort with exercise, pain meds and bed rest. I have missed scores of social events, dates, even intimate encounters over the years and used a variety of excuses other than the truth about my back to cover my absences. With the helpful yet still annoying prodding from several friends I have decided to stop deflecting sincere concern from those in my life, that process begins with this disclosure.

I won't bother with a complete history of my back pain, instead I will focus on my current situation. The most recent ER visit was two weeks prior to the date of this posting. I had been unable to stand upright for about 36 hours, getting out of bed was a full ten minute ordeal, any activity below knee level was simply out of the question. I had spent the better part of one entire day on the floor. Many thanks to M for getting this bound up old man to and from the hospital. As an aside, I apologize to anyone I spoke with on the phone that first week; I probably do not remember what we spoke about and I just wasn't ready to talk about all of this just yet. 

Once the ER physician heard the clinical details of my history and recognized my depth of understanding of the problem, we concurred in our diagnosis. The short term solution was to break the cycle of pain and spasm with major drugs. I was given injectable Dilaudid and Valium. Twenty minutes later the doctor returned to find me standing, back against the wall, a position that offers some short term relief, with obvious surprise he said: "I have never seen a patient standing after that much Dilaudid." I mention that part of the story because in the realm of silver linings, it appears I can now tolerate high dosages of pain medication without the buzz usually associated with them. And while that doesn't sound like much fun . . . I am now able to use Oxycodone on a regular basis to minimize the pain without being mentally altered.

One week later (a week ago today) I met my new primary care physician and fortunately found another doctor who recognized that I really am an educated adult able to understand and articulate my somatic issues and we rather quickly agreed on a course of treatment. I now have pain pills, pain patches and muscle spasm prescriptions with refills and liberal dosage limits as needed. Also I have a referral for physical therapy and once I am past this critical period we will go for a complete physical and perhaps even an MRI peek at my lower back before reassessing my condition.

For now, thank you for listening. I shall attempt to be more forthcoming about my condition, including public updates here on the blog, perhaps once a month in the near term. I would make one point from my decades of experience with a persistent medical condition -- anyone who has a chronic condition literally lives with it every day; talking about it is often simply tedious and annoying for us. I will try to be more open in conversations with my family and friends, if you will try to remember not to see me as merely a degenerate spine or a weak back. Illness, chronic injuries, syndromes are only one aspect of a person's being, but quite often the sickness becomes an all-encompassing label and the person begins to fade away.

My sincere appreciation for your concern, prayers and invocations; yes I will be availing myself of the myriad of interventions not found behind a medical school diploma. I am as open to a shaman's smoke as I am to a doctor's prescription pad.

Bacon, Baklava and Barium

You know the story of the blind but wise persons put into a room and asked to describe the animal in the room with them using only touch to identify the beast. One person touches the elephant's trunk and another the tusk, the tail, the ears etc. We end up with a lot of very different descriptions of the elephant, none of which resemble the actual creature. There are several morals to that tale about insufficient information, anecdotal evidence, knowledge versus description, getting the whole picture, turning water into wine and not cutting babies in half to satisfy competing parents. Teaching parables have been used since dolphins could first communicate.


Imagine this twist in the tale, the wise persons are not blind, they are all put in front of a huge salt water coral reef tank in one of the wonderful aquariums we have built around the world. Their task: describe one of the tropical creatures they see. Of course you would expect to get a wide range of reports with all of the brightly coloured sea life on display. But then I tell you that at least one of the reports came from a man wearing those blu-blocker sunglasses, another from a women who turned her back to the aquarium and described only what she heard murmured by others and finally, one of the reports came from a man paid to describe only the yellow and white, heavily spined pufferfish. What distorted moral would you draw from this tale?


An article this month in The Atlantic suggests that this little fish story is the moral equivalent of medical research today. Lies, Damned Lies and Medical Statistics reports via meta-research that the data being given to doctors and patients about diet, exercise and in particular pharmaceuticals is terrible flawed and potentially bought and paid for by the drug manufacturers.


Here some excerpts:


Can any medical-research studies be trusted?


That question has been central to Ioannidis's career. He's what's known as a meta-researcher, and he's become one of the world's foremost experts on the credibility of medical research. He and his team have shown, again and again, and in many different ways, that much of what biomedical researchers conclude in published studies--conclusions that doctors keep in mind when they prescribe antibiotics or blood-pressure medication, or when they advise us to consume more fiber or less meat, or when they recommend surgery for heart disease or back pain--is misleading, exaggerated, and often flat-out wrong. He charges that as much as 90 percent of the published medical information that doctors rely on is flawed. His work has been widely accepted by the medical community; it has been published in the field's top journals, where it is heavily cited; and his is a big draw at conference. Given this exposure, and the fact that his work broadly targets everyone else's work in medicine, as well as everything that physicians do and all the health advice we get, Ioannidis may be one of the most influential scientists alive. Yet for all his influence, he worries that the filed of medical research is so pervasively flawed, and so riddled with conflicts of interest, that it might be chronically resistant to change--or even to publicly admitting there is a problem.


No here comes the scary part--Dr. Ioannidis is not being scapegoating or attacked, nearly everyone segment of the medical research community agrees with his findings, but they are not sure they should tell--us!


The question of whether the problems with medical research should be broadcast to the public is a sticky one in the meta-research community. Already feeling that they're are fighting to keep patients from turning to alternative medical treatments such as homeopathy, or misdiagnosing themselves on the Internet, or simply neglecting medical treatment altogether, many researchers and physicians aren't eager to provide even more reason to be skeptical of what doctors do--not to mention how public disenchantment with medicine could affect research funding.


I strongly recommend reading the entire article. After I finished it I thought about the several medical newsletters I regularly read online and wondered how much of that information is flawed. Never mind, how much has changed, even completely reversed the health advice we received in the recent past. I thought I would offer up some of my favor current bits of medical wisdom with Dr. Ioannisdis' caveat that it is likely to be flawed, wrong or bought and paid for.


*Hair loss before age 30 is associated with a lower risk of prostate cancer later in life, according to a new study that contradicts some earlier research.


*A new study shows foods high in fat and refined sugar can create a cocaine-like addiction that leads to obesity. Persons so addicted should be treated for their addiction before attempting to address the weight issues.


*That daily baby aspirin for heart health, you know the one that suddenly became a full 325 mg tablet a couple of years ago. Well now it may not be such a good idea, particularly if you have a predisposition to stomach bleeds.


*Water--yes water! It seems those eight glasses of water a day are not such a universally good idea. Not only are there kidney issues for some individuals but when you drink the water can have an absorption/dilution effect on many medications including your Flintstone vitamins.


*Sex remains a good outlet for nearly every one. For the very few who might have serious life threatening consequences -- you got a better way to go?


**Yes I know that's a rhinoceros not an elephant, but a cool sculpture none the less.

---
photo/sculpture: wirelady.com

Open Post to My Boomer Buddies

On my travels this year I have spent quality time with many friends old and new, family too. I have observed what I believe is a silly and yet serious affliction among many of my friends, all of whom are charter members of the baby boomer generation. I admit I am a member of this club, so I am outing everyone including myself. The one and only trait we all share to qualify for membership is silence.

Silence about our health.

Why is everyone so reluctant to talk about the afflictions of the inevitable aging process? Yes, I know we have all, at one time or another, joked about family gatherings where the "olde folks" sit around and share their latest diagnosis. We aren't "that old" yet, are we?

Maybe this is a manifestation of the cult of individuality which we all grew up in. Perhaps it is just not wanting to inflict our decrepitude on our friends; but quite frankly it's also a potential killer. I may know something about your syndrome, symptom or affliction that you do not. We all run in different circles of health, education and treatment. But we can't share what we don't know exists.

So my friends, speak up. Talk to your friends, your loved ones, your physicians, healers, shamans, herbalist, medicine women, sorcerer, medico and/or witch doctor. If none of them are available, I am.

Please speak up. There are lots of adventures still to be had, stick around and share some of them with me.

---

Cartoon by Liza Donnelly in The New Yorker

Life Gets In the Way

[Content Disclosure: Illness, Life Interruptus, Stamina]

It wasn't a swarm of hornets, the swine flu or a drunk driver but merely a morsel or two of food but that was enough to remind me again how fragile a little creature we can be. I awoke in the middle of the night about sixty hours ago with a full blown case of food poisoning. I have not eaten now in 66 hours and have no immediate plans to end that fast. I should note to my perhaps not as frequent readers that I have an aversion to scatological references and deeply descriptive accounts of passing maladies. so you will be spared discomforting details but not personal reflections.

At first I thought it was the flu, probably because of the sound and fury on the news the last several days and secondly because when you wake very ill in the dark of night, you tend to focus on physical symptoms and not mental acuity. Besides being sick, I was also thinking in start-up mode with no peripherals connected. Friday and Saturday, I spent in bed. Sleep was on the top of all agendas, so I slept. The "no-details" interruptions of sleep were followed by cold towels and more sleep.

Today, I can type but I am guessing my wit, wisdom and insight are running without enough coolant. What I have noticed is how fortunate I am to have a life that I was able to simply go to bed. I wasn't going to be fired, no pressing corporate proposal was going to be derailed, no deadlines would be missed. I admire and pity those individuals who literally would have slugged through this illness by keeping up with their appointed rounds. Parents come to mind, particularly parents who are caring to kids who have the illness too. Small business owners--you don't go to work, the business doesn't open. I grew up in a family like that, I know my dad went to the store many times when he should have stayed in bed. I admit when I ran the business for several years after college that was the only job I have ever had where I would and did go in feeling like something nasty warmed over.

Now, well I am fortunate that when life gets in the way, I can pull a comforter up over my head and wait until the dark cloud moves on. Right now, I think I need a nap.

View from the Back Seat

[Content Disclosure: Existential Angst 67%; Illness 9%]

The most compelling metaphor I have ever heard about illness was told to me by my best friend Tom. This was in his sixth or seventh month of being sick and tired every day. He told me that being around the rest of the family was like viewing the world from the back seat of a car. While we were all up in front having a life, enjoying the day or not. He was stuck in the back, unable to engage with the world without his "illness filter". He was already always the sick person. The world was up there and he was always in the back.

What struck him most profoundly about this view was not how others treated him. They were entitled to their own reactions and fears. No, what haunted him to the very core was that this was indeed this reality. His world was a world of illness and deprivation and that was not going to change. I remember just a week or so later, he told me that he would give anything to just have one more normal day. Twenty-four hours without pain, fatigue or side effects. He was willing to trade days, even weeks for that singularly normal day.

He never got it. Think about it the next time you have a couple of lousy days in a row. You know you have another plain, old every day just around the corner. At least I hope you do. I hope we all do.

A Year of Living Tediously

[Content Disclosure: Illness, Malaise, Tedium, Life and a wee bit of poker]

I should like to warn all readers that this post borders on complete self indulgence. Indeed, the only saving grace may be my own struggle with the level of personal disclosure I can tolerate on this blog and the admission that I may now have reached beyond my own capacity for public disclosure. Be thou duly warned. You may now surf away without any punitive karmic damage.

Twas one year ago that I first noticed the signs of what I thought was just a cold. My nephew was visiting in Vegas and carrying with him a spring break rhinovirus, which I thought had latched onto me as its new host. What followed was first three months of the flu, then the lingering symptoms of the malingering crud and still today diminished ear function, nasal irritation and overall energetic malaise. In the words of some great philosopher: This sucks!

I missed a huge portion of the '08 World Series of Poker because I literally couldn't hear in a room full of 2,000 players shuffling millions of clay chips. I was able to make it to both of Mike's final tables and railed him for all six days of his run in the main event due only to the advances in modern pharmaceutical science. In addition, I have had three courses of antibiotics and several rounds of steroids. My ENT physician and his staff all know me by name; I am the large guy who paces the hall rather than sit in the waiting room crawling with three year olds irritable from earaches.

While I am in Northern California, I am having acupuncture and therapeutic manipulation for these symptoms plus my more acutely discomforting back and spine issues. Ah to be healthy again or at least to find a Ronco back machine on late night television that will fix all my problems and bring me wealth, happiness, love, peace and ripe fruit.

All right! Enough wallowing. Chin Up. Carry On and all that stiff upper lip bullshit. What's next?