Display by Label: Health

I think I must have received a bad shipment. Which is enough to destroy any drug user's week. I have noticed the last couple of times I shot up, as that little mechanical plunger is pushing the stuff in my leg, it just hasn't felt the same going in. And I was beginning to wonder if maybe something was amiss. And then Tuesday I got this flare up of the AS. Which hasn't happened since ... September? And that sort of confirmed it. But that's a hell of a way to receive confirmation. Metal rod, creeping it's way up the spine. Concrete in the joints. And so I responded as any self-respecting chemically-dependent person would: by drinking too much and watching a great movie—twice—before passing out on the floor of our basement. Escapism through film and unconsciousness through alcohol are great American pastimes. And Tuesday I was a Patriot.

And I hope all it is is a a bad shipment. Because if it's not that. If it's something else—like maybe the Enbrel just isn't working any more—well, that would be bad. But I'm starting a new batch of blue pens on Saturday and hopefully there'll be more kick to them.

It's weird how the body forgets pain. I've gone along for the last 4-5 months feeling normal. And when you're feeling normal, you tend to forget not-normal. You take normal for granted. And you begin to thumb your nose at not-normal and call it really filthy names, like "ass muncher" and "goat boy." And I'm real good at that. Because I sometimes like to burn bridges. And my body was ready to burn that bridge with not-normal and say good riddance. And I thought not-normal had gotten the message. Because he wasn't coming 'round at all. And I thought finally that annoying little fucker has left me alone. And I even started wondering if not-normal had just been a figment of my imagination. Like the monster under the bed. And maybe I'd just grown up and had begun to see that not-normal was nothing more than a coating of dust and few stray socks. And since normal was around to back me up, I was feeling a little cocky about all of this, getting more rigorous at the JCC, up-ing the weights, speeding up the stairs. And so there may have even been some chest-puffing going on. And I probably even told not-normal to go fuck off a time or two.

But not-normal heard me, and he was a little pissed. And so he worked his way in—just a hint at first—but then by Tuesday afternoon a full-blown limp had set up shop in my legs and my spine refused to go straight. And my mind recalled what this was like, and it didn't like it. Because he knew what came next. And so he gave me the green light to binge drink and watch movies. And do a little of the forgetting one might usually reserve for a really bad break-up or a death or something like that.

And I hate whining, especially on a day like this. Because it's sunny and crisp and there are signs of life on the trees. And it's Easter weekend, to boot. So I'll end this on a positive note and talk about the movie I watched. Because it was the glaring bright spot of Tuesday: The Darjeeling Limited. See it. It's now in my top-five favorite movies list, and if somebody would like to buy this for me as an anniversary present, I would give that person lots of kisses. Owen Wilson and Adrien Brody are fantastic. And so is Jason Schwartzman, for that matter. I think I'm just kind of partial to Wilson and Brody, in general. But all three really play off each other well in this movie and there is just some really great dialogue. In fact, this is definitely a dialogue-driven movie and I'm usually a sucker for those when they're done right. And Wes Anderson, who also did The Royal Tenenbaums and Rushmore, has a good reputation for doing it right. Here's one of my favorite lines: "I love you too, but I'm gonna mace you in the face!" This is probably one of those movies, however, that you will either love or feel completely indifferent about. And so if you don't like it, you'll probably wonder what the hell I was thinking, and if you love it, well we'll be able to just kind of nod at each other one day and maybe quote a line from the movie and that'll really be all we'll need to do, because we'll just know we appreciate the thing and it'll be enough. I'll say one other thing about it ... when you watch it, make sure you watch the 15-minute short clip called Hotel Chevalier which co-stars a short-haired Natalie Portman along with Schwartzman, and serves as a prologue to the main feature. It's so filthy and entirely good.

Okay. So now I'm just going to count the hours until tomorrow arrives. When I can inject this fresh batch of junk and hopefully feel that rush of calm come over me and a bit of the fatigue that comes along with it ... because that will mean it's good and it's working and this concrete in my joints should start going liquid once again and normal will come back.

link to this | comments (9) | File:  Reviews  Movies  Health  Back  AS 

There's a new physical "feature" on my body. And I've been noticing it lately whenever I happen to be completely naked and looking down at myself or in a full-length mirror. And that tends to occur at least once a day. Some days it's more frequent, though. Like this weekend, for instance. For reasons I don't fully understand, there happened to be a slightly higher occurrence of nakedness than other days. And that's weird because we were in DC all weekend with a pretty packed schedule of meeting with friends and family, watching anime at the KC, and replacing sink faucets at our condo. Despite this, or perhaps because of it, I found myself needing to change clothes a lot.

Anyway, I've been noticing this thing, but haven't been able to put my finger on what it was. All I knew was that something was different. Then, this past Sunday, when I was taking a shower in our hotel room at the Washington Plaza Hotel on Thomas Circle, it finally hit me. I was developing a bald spot, smack dab in the middle of my ... left thigh. (You thought I was heading someplace else with that?) Still ... left thigh? What's up with that shit? For real. What could it mean? I thought all my bodily changes were supposed to have occurred years ago.

The spot is about the size of a tennis ball. And the placement—so neat and precise. It's like coming across a corporeal Stonehenge or something. It sort of leaves you marveling. How did it get there? And when?

To truly appreciate this, you have to understand that there is a lot of hair on my legs. I'm fifty-percent Italian, okay? It comes naturally. Don't let my fair complexion fool you. It may be lightly-colored hair, but it's hair nonetheless, and there's a lot of it. I mean, back when I was a swimmer and would do a full-body shave before big meets, I'd have to take a freakin' beard trimmer to my arm and leg hair just to get it to a point where it could be shaved with a razor. And after that, it took two men, a push-broom, and some hefty bags to clean up.

It's weird, though. Because despite the veritable rug covering my lower extremities, I've always had a disappointing amount of hair on my chest. Well, it's disappointing for me. C doesn't really dig the chest-hair thing, so I guess it worked out well in that regard. What's funny, though, is she actually tells people I do have a "hairy chest" just because I have some random hairs sprouting here and there, mainly around my nipples. (I know, I know, ladies, stop swooning.) Obviously C never watched an episode of Magnum P.I. Because that there is what real chest hair looks like. Actually, if I'm going to tell you the full truth here (and why shouldn't I?) C has actually threatened to divorce me if the hair ever spreads to my back in any unruly manner. Cruel, isn't she? She says she never signed up for hair of that magnitude. And technically, she's right. There was some garbage about "sickness and health," but I don't remember anything about hair. So it's either divorce or the hot wax. Lucky for her, I'm a masochist.

It's crossing my mind that, quite possibly, I'm telling you a little more than you want to hear.

Anyway, I didn't really acquire the chest-hair gene, but I definitely got the rest of 'em, including the one that gives me the ability to grow a fairly respectable beard when I'm so-inclined. Though I have to say, my mountain-man beard is nothing like j's. I'm extremely jealous of his rock-star beard and he knows it. I think if I could grow a beard like j's I would join a Harley gang and roam the earth spreading enlightenment to the less-fortunate, hairless masses. People listen to you when you have facial hair. Jesus knew it. Believe.

Anyway, back to the bald spot. I've seen stuff like this happen to guys who wear long socks. They wind up with leg hair that starts at their mid-shin. Which is kind of humorous, really. But what was up with the thigh? After some head-scratching, I finally figured it out. I wear my wallet in my front-left pocket. Combine that with the fact that I tend to wear jeans with deep, low pockets—you know, cuz my wallet's fat, ya'll—and you can start to put two and two together. So, to test out my theory, I slid my jeans on and compared the positioning of my wallet to the positioning of the bald spot and, yep, that was it. Mystery solved! And so it got me thinking—maybe I should put this new-found hair removal device to work someplace where a little bald spot would be more welcome. Time to start wearing my wallet in my rear pockets again. Oh, wait, that won't work.

link to this | comments (5) | File:  Weird  Ho_Hum  Health  DC 

It's pretty much universally accepted that knowledge is power. But I'm here to tell you that's not always true. Knowledge can also leave you a quivering mass of gelatin on the hardwood of your dining room. And while jello is not completely devoid of nutritional worth (wait, maybe it is) "gelatinous" is indeed a pretty non-powerful state to be in. There's a very good reason I don't look up medical conditions on the Internet. I've learned that stewing over something in my imagination is much, much better than stewing over something in print on the screen in front of me. And what's even better than that is not stewing at all.

So maybe powerful isn't really the right word. But I understand what is meant by the expression. Knowledge allows you to take action. Otherwise, you're a sitting duck. And that's a bad thing to be.

I put the echocardiogram off for a little while. I considered not having it. Because even though, as I've said, I was sure things were fine, maybe I was just tad doubtful. The pounding I get from time to time. The recent chest pains. Probably stress. But still. Maybe I didn't want to know.

An echocardiogram is basically an ultrasound on the heart. The tech applies a slick gel on your chest and then rubs the cold end of what I believe is called a "transducer" — a sort of microphone-like device — all over you. It's all kind of kinky up until the point where you start hearing the loud, staticky-slushy beat of your heart coming from the machine next to you. It's an unsettling sound, your heart on an echocardiogram, healthy or not. I'm used to thinking of it as a thump, thump, not as a slosh-slish-slash-slush watery type of thing. But we're 78% water. So I guess I shouldn't be surprised.

Another thing that's unsettling is when the tech keeps pointing out that, "Yep there's your murmur alright and and what's up with that, anyway? Were you sickly as a kid?"

Well, not really, Ms. Tactful. But since you brought it up, I'm of course wondering what it is you know and why the hell you asked. Here, let me try one on you: Were you insensitive as an adult?

Test. Done. I went home.

My rheumatologist's office called at 7pm that evening to discuss the test. Not my Doc, but an intern. The caller ID said "Doc" and I was already interpreting the timing of the call as a bad sign before even picking it up. Good news can usually wait until the morning. Bad news, comes during dinner, in the middle of a great repeat of Scrubs. The intern talked about the results and used words like "aortic regurgitation" . . . blah, blah . . . "bicuspid valve" . . . blah, blah . . . "insufficiency" . . . blah, blah . . . "need to monitor this closely." She was going to refer me to a cardiologist and wanted me to go ahead and make an appointment soon. I scribbled what I could on the back of a piece of junk mail. I was trying to uncover the deeper meaning, here. It all seemed rather rational and cut and dry from the tone in her voice. But the meaning, woman. Come on, what are you trying to tell me?

So I did some fishing, trying to get her to gauge the seriousness of this thing she was referring to. But she just used some vague, equivocating language and said I should definitely get a cardiologist's input. I tried this one out: "I have a penchant for hypochondria, should I be concerned, you know, of dying anytime soon." Comfort me, dammit. Say something positive.

"Well, I'd say the fact that you're asymptotic is good."

What the fuck? Do you not understand the meaning of the word "hypochondria?"

She was not damning, but definitely not comforting. I didn't even know what "asymptotic" meant in this situation.

I hung up the phone, strangely calm. C was on the quiet car on an Acela back from Jersey, so I couldn't call her. And so I was standing there alone, letting it all sink in. And it didn't take long for my brain to draw the obvious conclusion of the conversation that had just transpired: I was going to die. Tonight.

Panic set in. I opened a Pale Ale. Then another. I called my dad. Because he can be rational under situations like this. And I needed rational. He picked up in Dallas. He was on his way to dinner. "Can I call you back?" he asked. I said yeah, but he could tell by the tone of my voice I didn't mean it. "What's wrong?" he said. There was some babbling and crap and finally I managed to utter the words, "Going . . . to . . . die." Then I clarified: "Sometime tonight, I think." Thankfully, my dad's business philosophy has always been to have several clients that are doctors. It's a good strategy, not just in business, but in life. Befriend doctors. It's a philosophy I've come to appreciate.

After about 10 minutes I got a call from my dad's Doc. By this point I was feeling the effects of downing that first beer. I'm not even sure, looking back, if I physically swallowed it. I think it just went straight down my throat to my stomach. My biggest question was: What the fuck is "regurgitation." Because I have a feeling it doesn't refer to the way I feel right now. He explained that it meant the valve wasn't closing all the way and blood was flowing back into the heart. He said there are varying degrees of it and he'd need to see the tests to know more. He said most of the time, the condition is just monitored. What they get concerned about is enlargement of the heart. Until that happens, the main strategy is to just wait and see. I might need to take action someday on it, but I might not. And there's no way of knowing when that could happen. The downside, is it most likely won't get any better, the upside is that it may not necessarily get a lot worse. The other upside was that it could be fixed if it needed to be, with a replacement valve. This made me feel a little better, though heart valve surgery has never been on my list of things to try in my life.

This past week I saw another doctor here in Baltimore. I call him "Doc Scales" because he liked making "The Scales Gesture" — you know, the one where you put both your hands out in front of you, palms facing the ceiling, and then shrug your shoulders. I asked him if there was any way of knowing whether or not surgery would be necessary. The response, not only to that question, but to just about all of them, was: "If you were to ask me will the valve last another year, I'd say: very probable. Another five years? Again, probably. Another ten? Scales Gesture. Another twenty or thirty? Scales Gesture." So I asked him if there was any argument to be made for a "preemptive" approach: replace that sucker now while I'm young and healthy. This, refreshingly, got a definitive "Absolutely not." Followed by head shaking. You want to wait as long as possible because the replacement valves don't last forever and chances are you'd need to replace it again in the future.

Okay, Doc Scales. I got it. Preemption is a bad idea.

I now know that the regurgitation is, in fact, "mild to moderate." There is no enlargement of the heart, which is good. And I got a glowing "A+" on the stress test. No irregularities, and it took me forever to get up to the desired 170-180 beats per minute, and by that point I was basically running on the treadmill. So the approach is as was expected: "Monitor it." Doc Scales prescribed blood pressure and cholesterol lowering medication, saying there was some evidence out there that it could help prolong the life of the valve, so I might try that. But I want to get a second opinion before I do. I'm already taking enough drugs for the elderly, I don't want to add two more unless it's really necessary.

And speaking of drugs for the elderly, the really good news in all of this, is that the Enbrel is working like a charm. I've been taking it, along with a smaller dose of daily anti-inflammatories, for a little over a month now and I'm feeling better than I've felt in probably a year. Mobility is good. I can actually do things like run up a flight of stairs or get into a car without wishing somebody would shoot me. The sciatica has subsided. Strength is back in my calf. The b-boy limp is gone (tragically). And I've gotten used to the injection thing. I put it in my leg, once a week. Easy.

So in the case of the AS, knowledge was good, I guess. But I'm still not sure if knowing about this heart thing is good or not. Sure now I can take some steps to "prolong" the life of the valve. But on the other hand, knowing about it is only going to lead to worry. Which leads to higher blood pressure and stress. Which is not good for said condition. So is that good? Is that powerful? Maybe with the swimming and the exercise and the eating relatively well I would have just lived a regular life not knowing about this thing and would have been fine. And maybe now I'll "think" myself into an early surgery, a premature date with a pig's valve.

Maybe. Scales Gesture.

One thing is for sure: I'm going to take steps to change the way I deal with stress. Now. Today.

And, yeah, I guess that's power.

link to this | comments (9) | File:  Heart  Health  AS 

More heart later. First there is this: Ankylosing Spondylitis. It's got some good alliteration, doesn't it? To pronounce it just do this: Say "ankle." That one's easy. Now say "closing" without the "C" — "osing." There you go. You've got it. Ankle-osing. Now, "spondil." Like music, isn't it? And the icing: "Itis," like Titus, without the "T". Spondil-itis. Put it together now. Ankylosing Spondylitis. Something with that kind of ring deserves a soundtrack.

It got bad this summer, the AS. And sometime in late August I learned what it could do, and that what had come before was just a warm-up. Here is some truth, brother: this little fucker has got a sadistic streak. And while that's normally something I can respect under the right set of circumstances, this isn't one of them.

The starch-free diet I tried back in January, didn't really do the trick. Not much of a difference in the symptoms. And it just led to other problems. Like constipation and bad breath. The former was no fun for me, and the ladder was no fun for . . . well, anybody really. (Let this be a warning to anybody who's thinking of dating somebody who might be on Atkins or South Beach or one of those diets. It makes you breathe fire. The bad kind of fire. Believe.) So I went back to carbs. I'm still cutting out the wheat and gluten, but that's a different story.

Sometime around our trip to Japan, inflammation became a daily thing. There stopped being good days and bad days. It was just all bad all the time. And on that trip, I invented a new hunched over waddling kind of gait, which I believe all the Japanese school girls are doing now. Because they're always on the cutting edge, you know. Of everything.

Then there were moves and home improvement projects. And a never-ending supply of shiny little anti-inflammatory meds. Like little white and yellow candies. And just as devoid of value: increasingly, that stuff did absolutely nothing for me.

I saw my rheumatologist in June. And by the way, this guy is great. Truly. Honestly. Great. C and I love him, and if you ever have the need to see a rheumatologist in the DC area — and I hope you don't — but if you do, I will be more than happy to give you this guy's name. Anyway, saw the Doc in June and told him things were not good. He gave me a soft pitch on Enbrel. (One of the things we like about this Doc, is he doesn't really force you in any one direction, which isn't to say he doesn't express his opinion. He's also incredibly patient and informative and he returns your phone calls personally!) Anyway, he said that while it didn't work for everybody, Enbrel would most likely drastically cut my symptoms. And he emphasized that we really needed to get the inflammation under control or it would lead to other problems, like heart or lung issues. Crap. This is an easy one, right? Take the Enbrel. But there was a downside. Two of them. First, Enbrel is a drug you have to inject and, I'm not a fan of sticking myself with a needle. I mean, I already make an exception for the heroin and, you know, I'm kind of running out of good locations to put the stuff. I know, problems, problems, right? Second, Enbrel works by blocking a natural substance produced by the immune system called TNF (Tumor Necrosis Factor). As I understand it, the body uses this stuff to fight infections and — what else was it again . . . oh yeah . . . cancer cells. Shit. The options were: more pain and increasing lack of mobility with a body chock-full of stuff that'll fight nasty viruses and cancers for me. Or a more normal daily existence where I can move around without wincing, but suppressing my body's Superman-like production of TNF, thereby increasing my risk for certain types of cancer. Of course, Doc maintained that cases of lymphoma being reported were "very, very rare" and he'd never actually known of one himself, personally. And I believed him. But somehow, when it's applied to me, I tend to read words like "rare" as "highly probable." And "never" as . . . well, just don't say that word . . . ever.

So I wasn't ready to do the Enbrel yet. But then August came and brought with it this big mobster of a flare-up. He was mean, too. He came complete with crushing fatigue and chest pains. And there was a healthy dose of sciatica that began radiating in the right leg, causing my calf to sort of stop working, and giving me a nice limp, which of course I just played off to the girls with a "there's nothin' wrong with my leg, I'm just B-boy limpin'" kind of nonchalance. If you believe nothing else, believe this: Beastie Boys is more than music; it's a way of life, ya'll. Shake. Your. Rump-a.

So I went back to the Doc in early September, well ahead of my next scheduled visit: "Enbrel, Doc. I want it. Now. Can you mainline this stuff?"

While I was there, Doc listened to my heart, as he always did. In the past he had heard things but used words like "benign" when he described them. But this time he really spent a long time listening. Then he said he thought he heard something he called an "insufficiency" and wanted me to go have an echocardiogram to check it out. My feeling was, yeah whatever. My heart is good, Doc. But okay. For you, I'll have the test.

Part three tomorrow.

link to this | comments (3) | File:  Heart  Health  AS 

Yesterday morning, around 10:30 am I was struggling under the lead weight of a caffeine-low headache. Sitting in the doctor's office waiting to have, of all things, a cardiac stress test. I had been instructed not to drink caffeine before-hand. And that was unfortunate. Because 10:30 am is no time of day to face head-on without at least two cups of strong coffee. And yet there I was. Floating low and heavy like a hangover, plotting the fastest route to Common Ground on the Avenue when I was done.

But the real question I was asking myself, right, was how did I end up being this person having a cardiac stress test? At age 33. Me — who swam twice a day, 6 days a week in junior high and high school. Who still exercises regularly today. Who's anal about what he eats. Who, okay, smoked on and off for several years. But who was always ridiculed by "real" smokers for my pack-a-week or for a while there pack-a-month habit. Bottom line: the heart should be strong. And I guess I've always kind of felt a little flip about it — a sort of "yeah, whatever" attitude — because I figured of all the organs in my body, it was sure to last the longest. You know, for all the above reasons. But apparently I have a murmur. An "aortic insufficiency," which was found on a recent echocardiogram (another test I'm surprised to have had), and which was probably brought on by the AS. Or it could also be because I have a bicuspid aortic valve. Most people's aortic valve is tricuspid. The bicuspid variety tends to become leaky. It tends to break sooner than one with three, um, cuspids. So they sometimes need to be replaced. Like Arnold Schwarzenegger's did about ten years ago.

And I'm really skirting the border of my comfort zone with this one. Honestly. Because with people dying of things that are difficult to imagine and getting legs blown off and just bad, bad shit, I find it hard writing about my health without coming across as whiny. Or melodramatic. Or both. But what is a writer, after all, if not naked and shivering in a transparent sheet of his own melodrama? I mean, we sport it well, don't we? Like professors in tweed. Like farmers in overalls. Like gym teachers in warm-ups.

So fuck it . . . here goes. Except, since this is a long one, I think I'll do it in three parts. Because one thing I've learned about the blogging is it's not a medium for length.

So . . . more tomorrow.

link to this | comments (2) | File:  Heart  Health  AS 

Okay, call me over-reactionary, but I'm throwing away my Centrum as I write this . . . (via Laundro)

link to this | comments (1) | File:  Health 

Please. I beg of you. Any kind will do, really. It doesn't have to be sugar sugar. It doesn't even have to be sticky sweet. Honey, molasses, brown sugar - sure, these would be nice. But how about, oh I don't know, a nice bowl of cheerios, maybe. It's only got one gram - one stinkin' gram - of sugar. But it's got 20 glorious grams of carbs per serving. And that's how hard up I am. Okay, no cheerios? How about bread? Plain old bread would be divine. You see? I'm not asking for a lot here. It could be a chunk of baguette, or some ciabatta, or just some sliced whole grain stuff in a bag. Some jam on top. Smother me in that shit. Of course, if you're feeling especially generous, I could go for a nice tall glass of Cap City Pale Rider Ale, full of hoppy, grainy goodness. I'll tip my head back like this, see? - Hold on, let me just tie back my hair. - Okay. We're all good. Now let me get into position. There. Na, ja pu ii eun ma oen ouw . . . sorry . . . I guess it's kind of hard to hear me like that . . . I said, just pour it right into my open mouth. You might hear me make some unpleasant gurgling sounds. You might think I'm choking. But don't let that stop you. Please.

I'm sorry. I know I sound desperate. Or slightly deranged. I've got a little bit of the sugar withdrawal going on. So please excuse anything I say. See, Sunday I started a low-starch, low-carb (read: low sugar) diet. This might sound absurd for those of you who know me, that is, those of you who see me on a regular basis. I've never been one who needed to 'diet,' and I'm still not. I'm not exactly sure what my 'recommended weight' is, but I'm willing to bet I'm under it. This has nothing to do with pounds. It's got everything to do with sugar. And did I mention I kinda like that stuff?

Actually, it's not that I really love sugar or anything, I mean not any more than the next guy. It's just that, well, try to get through a normal day in America without eating something loaded with sugars. It's hard as hell. Let's begin with my usual breakfast: cereal, toast, maybe some jam, yogurt, and orange juice. We're not exactly talking about Cocoa Puffs here, but you know what? It's all still loaded with freakin' sugars. Even things that don't really have to contain sugar - like the yogurt. Okay, how about lunch? A sandwich. Deli meats. Maybe a bag of chips. Perhaps a tasty oatmeal cookie from Potbelly's. All sugar, brother. Even most deli meats have sugar in them, so getting rid of that bread doesn't mean shit. Potbelly's calls it 'skinny' with half the bread. My ass. Okay, let's move on to dinner. Great! How about a pizza? Sure, that's my favorite! You really know how to charm a guy. Okay, well how about 100 grams of starch? Aw, come on. You're no fun.

What this means is that, in a typical day, without even trying very hard, I might as well be main-lining starch and processed sugar into my system. And I don't even eat a lot of 'sweets.'

So what's the deal, Dave? Why have you become this big no-sugar zealot? Good question. If you've been reading this blog for any amount of time, you probably know that I have some recurring back issues. They're not consistent back issues, though. The issues tend to shift and change shape and move from one part of my spine to the other. I have also had a previous operation in which I had a portion of disc and bone removed. So this, combined with the ever-shifting focus of the pain usually leads most doctors to write my complaints off to 'general back pain.' They pat me on the head, give me some anti-inflammatories, and send me home. But lately, the pain has been something different. Deeper, and more alarming. I know I'm a borderline hypochondriac, but even I could tell something was seriously not right when I would wake up in the morning barely able to move, back and chest tight with a deep uncomfortable stiffness and a stomach full of lead. So I did some research and found something that just about perfectly described me: low-back pain that is worse at night, in the morning, or after inactivity, stiffness and limited motion in the low back, hip pain and stiffness, limited expansion of the chest, limited range of motion, especially involving spine and hips, shoulders, neck pain, fatigue, chronic stooping. It's called Ankylosing Spondylitis, which is as fun to say as it is to talk about. If you're wondering where you can sign up, you can't. There's no waiting list. You have to have a specific antigen present in your blood called HLA-B27, which is hereditary. So if you want in on some of this fun, don't come whining to me, take it to your mom or dad. HLA antigens also happen to be found in about 7% of the population, so just having them in your blood doesn't necessarily mean anything. However, if they are present and you wake up each morning with the sensation of a giant steel meat hook inserted into your spine, your chances are pretty good. So I asked my doc for the test. She gave it to me, a bit begrudgingly, not convinced. She actually seemed a bit surprised when it came back positive. Sometimes I wonder if doctors ever lift a medical reference once they're out of med school.

AS is a type of arthritis, so I'm seeing a rheumatologist next week. But in the meantime, I've been doing some research, including scouting out all the different AS sites that are out there, which is about as great a way to spend a Friday night as you can imagine. While it isn't officially recognized as a treatment, one thing that seems to keep popping up again and again from various people is that cutting back on starches helps alleviate symptoms. One doctor has done some research and even published a diet. It hasn't proven effective for everybody, so it's not universally accepted as a treatment option, per se, but some people have found it to be really helpful.

So I'm going to give it a couple of weeks of very low carbs and starches and see what happens. While I'd love for it to work, a secret part of me hopes that it doesn't. Then I could go back to my old sugar-infested dreamworld where I lounge in a pool of syrup while women in French maid outfits hand feed me powdered-sugar coated crepes. But if nothing else, this will force me to eat a little better for two weeks, and maybe some of it will stick, even if there's no great reason to do it other than the whole 'better overall health' thing. I really do think Americans eat too much starch. Period.

Already, I've noticed some positive results of the low-starch diet. For one thing, it's made me appreciate food in an entirely different way. I never thought my response to a broccoli and cauliflower casserole mixed with chicken and bacon and smothered in cheese would be, "Hell yeah! Pile me up some of that." If you mash it up, cover it in cheese, and close your eyes, cauliflower can seem a lot like potatoes. Yum.

I'm also learning new smoothie recipes. Plain yogurt (no sugar added), plain soy milk, blackberries and strawberries mixed up in a blender makes a crazy good breakfast treat, and helps wash down those cholesterol-filled eggs and bacon that you're substituting for cereal.

Finally, as Barry Schwartz and Daniel Gilbert have suggested, having fewer choices in my diet has, in many respects, made me much happier. No kidding. For instance, when I'm at the store in the soda aisle, I no longer have to decide between the Pepsi brand of dark carbonated sugar or the Coke brand. Also, when I'm at RFD or Brickskeller, I no longer have to torture myself over which of the hundreds of beers I should drink. In both situations, the answer is simple: water. In other words, none of the above. Which is a wonderful answer in that, since there's only one choice, I can never make a wrong decision! Moreover, I can never really be disappointed with the outcome, unless the water smells funny, or has ants floating in it.

The same choice vs. happiness principal applies with food. I no longer wonder what I'm going to eat for dinner. The answer is always simple: not starch. This narrows down the options considerably and makes me much happier with what I do end up eating. In fact, since yesterday, I've discovered I'm not so much concerned with what I'm eating as whether or not I'm eating at all. I guess you could say that my lack of food choice has made me much happier with the concept of food in general. Of course, I'm not sure if this really has to do with my lack of choices, so much as with my ravenous hunger.

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The data is a little out of date, but it looks like if you're from LA, you might start investing in a new lung now . . . Also, I was happy to find out that moving to DC from Dallas brought me one step down on the ladder of smog pollution. (via Laundro)

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So . . . how about them Broncos Monday night? It was so great to watch them play at home at Invesco field in that cold rain. Football always seems to be more fun to watch when it's played in the cold . . . or the rain. And it's even better in the snow. It's kind of like beer and pizza. The two just go hand in hand. Then again, for me, life itself seems more fun when played in the cold and wet (and with plenty of beer and pizza), so maybe I'm a bad judge in this regard.

Anyway, after three quarters of a tied game against Baltimore, Plummer finally got in gear and started completing some passes and, after a second great field goal from Jason Elam, made a game-securing touchdown pass to Rod Smith to bring the game to it's 13-3 conclusion. Sorry Baltimore. I know you're one of my local teams and I should be rooting for you and all, but I will always pick the Broncos over the Ravens. It's just that simple, Hon.

As in many cities, the quarterback situation in Denver is a controversial one. Despite the fact that Plummer has just come off one of his best seasons, in which he helped lead the Broncos to the AFC Championship and went some 12 or 13 games without an interception (I don't remember the exact number, but it was impressive), he's getting off to a rough start this season and word is that Coach Shanahan is itching to put in somebody else, possibly rookie Jay Cutler. But Shanahan is too smart for that. He's got to know it's a little soon for Cutler. Still, this might be the last season we see Plummer wearing a Broncos jersey and I, for one, think that's a shame.

Fans are extra fickle when it comes to quarterbacks. In Denver, this behavior seems to be compounded because of a phenomenon known as "The Elway Factor" - people are always going to make the comparison of any quarterback to the mile-high legend John Elway. But people forget that in the early years of Elway's career, the fans of Denver would call him "El-wood" after a bad game (like the three Superbowl losses of the eighties.) Now, Plummer is not Elway; this is for sure. But I do think Plummer is a "great" quarterback. In addition to having the skill and talent, which Plummer clearly does, he has that fighting attitude of always wanting to be in the game. He doesn't over think. He acts. And it allows him to pull out victories.

So I'm going to bring this back to the surgeon post from yesterday now. And after this, I'm going to stop this riff of health-related crap, because it's depressing the hell out of me and it can't be doing much for you either. But here it is: I think great surgeons should have those same qualities as great quarterbacks. Most of all, they should always want to be in the game. My last surgeon was this way. Usually very quiet, cool, and reserved to the point of rudeness, he was animated and cracking jokes the morning I went under. He was ready for the game. Over the several years that I saw him for my first disc issue, he never tried to force me into surgery, but he always maintained that it was the best course of action and that he could fix the issue. Optimism: he had it. Of course, nobody wants surgery, so I exhausted other avenues first, but it never did get better, and when I finally did the operation out of necessity, which was about 4 years after my initial consult with him, I was glad I did.

So that's why my gut feeling now is, let's get on with it. Let's cut to the chase, so to speak. I've already been through this. I've tried the conservative route and it doesn't work.

Dr. Smith's point is that I had a good experience last time, but that's not always the case with back surgeries. There are risks. I might not get better. I might get worse, in fact. Okay, great. That may be the case, and I definitely want to know those things and be aware of them, but I don't want my surgeon to be thinking about risks all the time. I want him to be thinking positively about fixes.

Now before you think I'm just pretending to be brave in front of the Internets, let me go ahead and put that to rest: I'm a huge baby when it comes to the propsect of somebody cutting a hole in my back and then sticking a number of instruments into that hole, including one that is extremely sharp and will be used to cut something that very near a nerve that happens to deliver sensation to my entire right leg. This does not rate high on my list of enjoyable activities. At the same time, the alternative - an indefinite period of time living with burning/stabbing nerve pain, and consuming inordinate amounts of anti-inflammatories and painkillers, does not seem all that appealing (or safe) either.

My last surgery gave me six years without sciatica. It was comforting to hear Dr. Smith make the case for no surgery earlier this week, but my personal experience is telling me that, while my current nerve pain may subside it's probably never going to go away, until I'm in my 70s and all my discs will begin to disintegrate, anyway. But by then there'll be other issues to deal with.

The main point is this: I feel like the game is going to happen, whether I want it to or not, it's just a matter of when. And when it does, I want to send in a quarterback who's going to pull out that 4th-quarter victory no matter what, who's going to keep his head in the game and not play conservative. I want to put in Elway. You dig? I haven't ruled out Dr. Smith as that guy yet. He's been mentioned in Washingtonian and comes highly regarded. However, I would like to see a little more of that fighting spirit.

Then again, maybe I'll just give in and become addicted to pain killers. Aside from the weight gain, it's not a terrible way to live, is it? Okay. That is all.

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"It's really bad when I sit. Pain here," I jabbed fingers just above my right buttock, "and in my foot. Underneath, not the top." I lifted my foot and pointed to the ball and then ran my finger along the center line down to the heel. "Sometimes some numbness here, too," I added.

Dr. Smith* nodded and scribbled something on the back of a piece of paper that was in my file. He held the pen like you might hold a paint brush and made a sort of circular drawing on the page. Then he looked back up at me expectantly.

I described some more symptoms, and occasionally Dr. Smith would jot down more indecipherable marks on the back of the piece of paper. What could they mean, these strange symbols? Being a writer of English prose, I know that people who speak Latin-based languages normally scribe from top to bottom, left to right. Also, and this is perhaps more important, they tend to write words, consisting of distinct letters, normally taken from the alphabet.

Dr. Smith's notes radically resisted this tradition. He would scribble some symbols here on the left of the page, some over here on the right, some in the middle. Sometimes the symbols went diagonally across a portion of the page. He jotted things down the way you might write a phone number left on your voicemail, which you then go back and stare at, hoping you will somehow be able to discern what you've written. There was no obvious order; the symbol placement seemed arbitrary. I use the term "symbol" because the things he wrote couldn't really be described as "words." I suppose "hieroglyphs" might be a better label, but even that would imply some degree of semiotic structure. These might best be described as "doodles." Dr. Smith was doodling while he listened to me present!

At least that's the way it appeared to me, a mere mortal. As you may or may not know, surgeons have special powers of written expression which to the untrained eye manifest themselves as simple doodling. Perhaps they learn to write this way because writing the normal way puts undo stress on their fingers, which are, after all, the tools of their livelihood. Whatever the reason, this is truly a higher form of composition, with many rich layers of meaning. What's so impressive about surgeon doodles is that meaning seems to be conveyed not only through the shape of the drawing and the context of the drawing within the page, but from the weight of the marks on the paper. Heavier markings have different meanings than lighter ones. It's strange, impressive stuff, the scribblings of surgeons, and some day I hope to learn this higher form of expression, though I expect doing so would mean I'd also have to learn how to slice open the human body, which doesn't seem likely, or appealing.

After hearing me out, looking at my MRI films, and doing a brief physical exam which required that I do various things with my legs, Dr. Smith confirmed I had a disc bulge and that it was indeed the cause of my recent pain. He didn't think the disc was "ruptured," which is good. This is where the inner fluid actually breaks out of the hard outer shell. That isn't fun. Moreover, he advised me against surgery, at least at this point. While on one level, this was a relief, I was also a bit chagrined. But why? you protest. That's great news! Right, right. I know. But not exactly. There are two reasons I feel this way. One is this: I've been through all this before. It was at a different vertebrae level, but the same issue. I tried everything - for many years - because I hated the idea of surgery. (I was chicken). But finally I had no choice because of muscle weakness. It was a good success, and that issue got resolved. "Fixed." And it sort of changed my mind about the whole surgery thing. Maybe I shouldn't have resisted it so long. So, part of what's still making me feel anxious is that I think I know where this thing will ultimately end, whether it's now or in five years. And it sort of seems better to get it out of the way than to have that hanging over me.

The second reason I'm troubled over Dr. Smith's assessment has to do with football, specifically the quarterback situation in Denver. But I'll get to that tomorrow . . .

(* not his actual name)

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