Nuclear Medicine

I had my first experience with nuclear medicine this week.

Recently, as I was explaining my medical history and ongoing issues with chronic pain to my new doc here in California, he seemed to actually do some listening. Although he didn’t quite buy into a diagnosis of fibromyalgia to explain my problems, he seemed to concede that my symptoms could be accounted for thusly. He suggested we rule out other explanations as well, though, so he ordered some tests.

One of which is a nuclear-med procedure called a whole-body bone scan. I went to the hospital yesterday to have it performed.

The process started with an injection (into a vein in my arm) of a gamma-radiation-emitting radioactive substance (technetium-99m , a metastable nuclear isomer of technetium-99) suspended in methylene-diphosphonate (MDP), a substance which can be preferentially taken up by bone.

I was told to drink lots of water, then come back for the actual imaging procedure three hours later. I went back to work and tried to keep my mind on some simple tasks for awhile. Upon my return to the hospital, and after making sure I went to the restroom, the technician escorted me back to the nuclear-med scanner.

I emptied my pockets and took off my belt, sort of like preparing for airport security, and was told to lie down (face up) on the massage-table-like part of the machine. Buttons were pressed, there was a whirring sound, and soon I found myself inside the device with a portion of the machine about four inches above my nose. I closed my eyes and reminded myself to keep breathing.

Soon she said, “we’re taking pictures,” and I realized that the table was slowly moving. It wasn’t long before I was brave enough to open my eyes and discovered that my head was outside the chamber.

I lost track of time, but the first part of the scanning procedure probably lasted about 20 or 25 minutes. After a short rest-room break (I had taken the water-drinking assignment seriously!), we did the second part, which the technician called “close-ups.” It was during this part of the procedure, when my head was turned for a time, that I was able to see an image of the bones of my head and upper body, from my cranium down to my ribs.

Weird!

Apparently the way this works, for diagnostic purposes, is that any increased physiological function, such as a fracture in the bone, will typically lead to an increased concentration of the technetium-99m. This can result in the appearance of a hot-spot on the image. Some disease processes result in the exclusion of a tracer, resulting in the appearance of a cold-spot.

It should be noted that nuclear medicine differs from most other imaging types in that the tests primarily show the physiological function of the system being investigated as opposed to the anatomical. Additionally, this differs from an x-ray procedure because instead of delivering the radiation source externally, this time it is internal.

I’m told this is a pretty expensive procedure. Luckily, it’s covered by my insurance. And I’m hoping for a totally-negative result, because for many of the kinds of things this test picks up, well, nobody really wants to hear that kind of news.

The Mayo Clinic website has an easy-to-understand discussion of the procedure, in case you’re interested.

Soundtrack Suggestion

Toe bone connected foot bone
Foot bone connected leg bone
Leg bone connected knee bone
Don’t you hear the word of the Lord?

(“Dry Bones” – Negro Spiritual)

You Can Observe A Lot Just By Watching

It was exactly two months ago today, July 2, that I arrived here in California to take possession of my apartment in Larkspur. I started packing up my boxes for this latest move the first week of June, and have been basically living from cardboard containers ever since…until last weekend, that is. I have finally unpacked the last of my things, put the artwork up on the walls, and reorganized my rented storage area. And I’ve had the apartment thoroughly cleaned by my new housekeeper for the first time. As of now, I’m officially “moved-in.”

I would like to say that I’m “settled” (as in: “Jim, are you all settled in yet?”), but that’s not really the case. There has been too much stress associated with moving to a different state and taking on a new, high-stress job to (in all honesty) say that I’m settled. But, being unpacked and moved in feels like good progress along that path, I must admit.

To be “settled,” I think I need a little more time to adjust culturally. The change I’m experiencing by moving from an ultra-conservative, economically-depressed community in southern Oregon to a liberal county with the highest per-capita income in the U.S. has been mind-blowing, to say the least.

And that’s not to say I’m not enjoying it here. Because I am. Believe me, living in a place that is on the liberal cutting-edge is quite refreshing. What an incredible relief that I’ve found my way here!

But I experience a good deal of preoccupation, and some degree of angst, about how different this place is, too. For one, I am continually reminded of the high cost of living: everything costs more here, and sometimes it’s way more expensive. Just this morning I went to the nearest car wash, for example, and paid $19.99 for the most basic service they offer. In Eugene, at what I think is the most pricey car wash in the city, the cost is less than half of what I just coughed up today.

And, of course, it’s the first of the month and I just wrote out another rent check. It’s a good thing I finally received a full-month’s pay: my rent is roughly two and a half times of what it was last year. Really, I can’t think of one thing that costs less here.

Additionally, one of the most interesting things that has been on my mind in the last few weeks, as I’ve been looking around trying to pay attention to my surroundings, is my perception that the residents of Marin County are a considerably better-looking lot than I’ve been around in recent times. I started out by noticing the much larger number of people sporting sun tans than are evident in rainy, cloudy, cooler Oregon. And then, as I kept reminding myself that “you can observe a lot just by watching,” I noticed that it wasn’t only the tans, it’s that people seem to look more attractive, more together, and just plain healthier here. For example, it’s my perception that there are significantly fewer obese folks around me now than there have been during the last few years.

So, it was with great interest that last Thursday I came across an MSNBC article that suggests ZIP codes are surprisingly accurate predictors of obesity. As I was able to learn, “in a study published in the September issue of the journal Social Science & Medicine, University of Washington researchers found that adults living in ZIP codes with the highest property values were the slimmest, and those living in ZIP codes with the lowest property values were the fattest.” The data presented in this study are entirely consistent with my informal, non-scientific observations of Marin County residents. With property values here that are literally off-the-charts, according to the UW research people here should be slim(mer). And they are.

My one last observation (for today, anyway) about the culture here is that the attitudes of Marin County residents tend toward elitism, entitlement & privilege. My opinion is that these Mariners know they live in an enchanted place among the rich and beautiful…and somehow these conditions give them a rather special place in society. It’s not really anything specific that anybody says…it’s just that the sense of entitlement here is palpable.

I imagine that once I’m more accepting (i.e., less judgmental) of the cultural values I’m discovering, then I’ll consider myself more “settled.”

“Chee” Whiz

chi
Variant: or  ch’i  also  qi  \'chē\
Function: noun
Usage: often capitalized
Etymology: Chinese (Beijing) qì, literally, air, breath

: vital energy that is held to animate the body internally and is of central importance in some Eastern systems of medical treatment (as acupuncture) and of exercise or self-defense (as tai chi)

A year and a half ago (February 2006), I wrote an entry entitled, simply, “Qi” (pronounced “chee”). At that time I speculated my “life force,” “vital energy,” or “spiritual energy” [rough English-language equivalents of the Traditional Chinese Medicine (TCM) term “qi”], was in decline – and I was just beginning to see an acupuncturist in Portland to determine whether or not I could address some of my body issues via the TCM route. I saw a practitioner there for about four months, right up until the time I had to move away. One of the things that always concerned me about her, though, was that she did not seem to subscribe to the philosophy upon which the practice was based: while she was a seemingly adequate technician of the craft, I don’t believe she believed. Ultimately, I didn’t really experience much benefit from those treatments. 

At the current time, of course, I have improved my health situation a lot. The TCM practitioner I found in Roseburg earlier this year was instrumental in helping me dramatically turn my life around. She was an all-around Medicine Woman: a true healer. I was fortunate to have found her when I did. Western Medicine was not helping, and in fact may have been hurting, me. This “alternative” approach very likely saved my life.

Alas, I had to leave my Oregon Medicine Woman behind and move yet again. (Don’t get me wrong: it was a good, good thing to leave Roseburg.) So, ever since I’ve been here in Marin County, almost two whole months now, my quest has been to find other healers who can keep me on my recovery path.

As of last week, I have found two individuals who fit this description, both as a result of referrals from my Roseburg miracle-worker. As it turns out, two of her primary instructors are from the Bay Area. The Lauren Berry Method (of bodywork) teacher she studied with lives in Berkeley; when I contacted that person she referred me to a colleague in Marin County who works a few miles north of here in Novato. The TCM guru she studied with lives in San Francisco; and he subsequently referred me to a practitioner even closer, just over in San Rafael.

My new bodywork person seems to be incredibly gifted in her craft. She is very intuitive and gentle, and after just three treatments seems to be making a positive difference with regard to my pain and energy levels. I can’t believe my luck that I’ve found someone with these talents so swiftly.

The TCM story is a bit different, however. Before calling the San Rafael practitioner, I first tried one in San Anselmo. This person had Saturday office hours, which I found desirable, and I had heard good things about him in terms of making a difference in people’s lives. Alas, after just two sessions I determined that he was not the one for me. When I reported to him little results from the first session, the second time he proceeded to get much more aggressive with his acupuncture needles…resulting in unwanted (and I believe unwarranted) pain. (“Holy shit!,” I shouted out, at least a couple of times.) I decided I needed to try something (someone) different, so I called the San Rafael practitioner I had been led to from my Roseburg contact.

I saw him for the first time last Thursday. When I told him, at the intake conversation, that I was turning 60 the next day, he reported that he had turned 60 the previous Saturday. He was very patient, listened attentively to all my concerns, carefully examined the Chinese herbs I have been taking for a few months, and very thoroughly explained his way of working. Fortunately, he was also quite skilled in terms of the actual decorating of my body with his needlework.

His assessment of me rang true…that I was “deficient in qi.” Of course, this is no surprise. This is a long-standing life issue and, as much progress I have made in recent months, I know I still have quite a long way to go.

In case you’re interested, I found a website that explains the five functions of qi (and what happens when one is qi deficient). These are direct quotes from that discussion…

1. Promoting function
Qi provides the active, vital energy necessary for the growth and development of the human body and to perform the physiological functions of the organs, meridians and tissues. If there is a deficiency of qi, its promoting functions are weakened…and growth and development can be affected or delayed, the organs and meridians cannot function properly and blood formation is hampered…

2. Warming function
Being a heat source, qi warms the body and keeps it at a constant temperature so normal physiological functions can take place. Deficiency of qi can lead to a lowered body temperature, intolerance of cold and cold hands and feet.

3. Defending function
In TCM, one of the main causes of disease is the invasion of “Evils”. By resisting the entry of “illness evils” into the body, qi defends against their attack and maintains healthy physiological functions. In western terms, this qi defending function acts like the immune system.

4. Consolidation and retention function
Qi consolidates and retains the body’s substances and organs by holding everything in its proper place…if qi is deficient, the consolidating function is weakened, leading to various kinds of health problems such as hemorrhage; frequent urination, premature ejaculation and stomach or kidney prolapses…

The promoting and consolidating functions work in a complementary manner. For example, qi promotes blood circulation and the distribution of body fluids, but it also controls and adjusts the secretion of fluid substances. The balance between these two functions is essential for maintaining a healthy blood circulation and water metabolism.

5. Transforming functions
Qi also possesses “vaporization” or “transformation” functions, which are important for the metabolism of fundamental substances. As suggested by these words, qi may “vaporize” substances in the body and transform them into essence or vital energy. For example, certain actions of qi allow food to be changed into food essence, which is in turn transformed into different types of qi and blood. Indigestible food and waste are also transformed by qi into urine and stools for excretion.

A lot of the description above is, really, the “story of my life.” Consider, especially, the “warming function.” As a chronically cold human being, nothing could be more profound evidence that I am qi deficient.

Through the use of acupuncture and herbs (as well as the aforementioned bodywork techniques), I am hoping to turn this qi deficiency around and be whole again…transforming myself into a physically-healthy person with a correspondingly healthy spirit.

Osmosis

Osmosis ( äz-mō'-sĕs ).

Function: noun.

Etymology: New Latin, short for endosmosis.

1: movement of a solvent (as water) through a semipermeable membrane (as of a living cell) into a solution of higher solute concentration that tends to equalize the concentrations of solute on the two sides of the membrane.

2: a process of absorption or diffusion suggestive of the flow of osmotic action; especially : a usually effortless often unconscious assimilation <learned a number of languages by osmosis — Roger Kimball>.

I started out my academic life as a chemist, so the term “osmosis” (defined above) is not entirely unfamiliar to me. I can just bet you’re wondering, though, what it is I’m going to say in a blog entry on this topic!

Well, as you likely surmised, I’m not going to be talking about that kind of osmosis, but rather “Osmosis” as it applies to steps along my path toward personal health and well-being…

This story starts with my search, last winter, for alternative health care in Roseburg, Oregon, as my fibromyalgia symptoms were becoming more and more problematic (and as western medicine continued to come up short in its ability to help me). The miracle-worker medicine woman I found there locally was trained in a variety of traditions, including massage therapy, Traditional Chinese Medicine, and craniosacral therapy. And, as it turned out, her massage therapy education also included time within the Lauren Berry Method of bodywork. Her unique skill set led to a miracle turnaround for me, bringing me “back from the brink” (as we came to characterize it).

When I moved from Roseburg to Larkspur, I needed to find someone else (or, more likely, other people) in the Bay Area to tend to my alternative health-care needs. I immediately sought out such providers after arriving here, and through a series of cross-referrals I was led to a bodywork person in Novato, CA, who is also trained in the Lauren Berry Method; so far I’ve had two sessions with her. During my first visit, she recommended that I seek out a unique enzyme-bath treatment available up in Sonoma County, at the Osmosis Spa.

Now, I had never heard of an enzyme bath, so I was curious to learn more. I found out (from their brochure and web site) that this enzymatic process stems from a centuries-old Japanese tradition of harvesting fruits, vegetables, herbs, mushrooms, seaweed and other life forms when they are at their peak and preserving them with saccharides. Then, during the (what is a dry-) bath experience itself, large wooden bath tubs are filled with finely ground cedar, rice bran, and these plant enzymes. This mixture heats up naturally, by fermentation, creating a biologically-generated warmth. The “bath” is an experience of being entirely (your whole body) covered up with this (slightly moist) mixture, up to the chin…much like being “buried alive” in sand at the beach.

This all sounded pretty mysterious to me, but I also read that the reported benefits of this treatment include: relief from joint and muscle aches and pains; reduced tension and fatigue; cleansing of the skin; stress reduction & calming of the nerves; improved digestion; detoxification; and improved circulation & mobility. Without a doubt, a pretty impressive list of possible outcomes! All of which I could definitely use.

I decided to give this approach a try, and after exploring the Osmosis website thoroughly, I made a reservation online for last Friday (the last day the college was closed on Fridays for the summer).

So, mid-morning I drove the hour or so up to Freestone, California, my trusty GPS guiding me all the way. I arrived a little early (of course!), and was greeted courteously at the front desk with a cup of tea and the information that I had about 12 minutes to wait before I started the process. A little bit later an attractive, smiling young woman called my name and led me through the sliding doors, while commenting favorably on the John Lennon t-shirt I had worn for the occasion.

I was shown to the men’s dressing room, relayed instructions about finding a robe, and told where to meet my personal bath attendant when I was ready. After changing and being seated in (what they call) the Japanese tea garden for a few minutes, “V” (my personal attendant, a very pleasant, articulate and well-informed young woman) arrived and we exchanged first names. First, she served me a tea mixed with enzymes made from more than 25 different organically grown plants. As she explained, the tea is a digestive aid, and works in conjunction the metabolic processes that occur during the bath. V then outlined the entire bathing process for me so that I would know what to expect. I had informed her that this was my first visit and that I was totally clueless!

Now, the literature about the bath process indicates that the bath may be done with, or without, a bathing suit (that is, nude. Yikes!). I had changed into a swim suit and was so attired underneath my robe. Of course, my in-bred Midwest Modesty was obviously in play here, and believed I might be a little hesitant to do the bath Full Monty in the presence of a young, female, total stranger. When she asked if I had any questions, I brought up this topic, wondering if I should do this with or without the suit. She very tactfully handled the topic, and explained that the more surface area of skin exposed to the enzymes, likely the greater the benefit. She then entirely left the decision to me, depending on my comfort level.

Well, I decided that it was rather ridiculous to let my old-guy conservative-Midwest reservations get in the way, especially after paying all this much money for a new adventure; after I was led into the (private) bath room, I shed both my robe and bathing suit and entered the scooped-out place in the center of the tub totally stitchless. (And totally California, don’t you think?!)

After getting situated and comfortable in the bed of organic materials, V covered me up with huge handfuls of the mixture from the sides of the tub. As it turned out, the nudity thing turned out to be a total non-issue. I was mildly warm right at the beginning, but quickly became more heated as the minutes ticked by. V left the room for a bit, then re-entered with cold towels for my face and neck, as well as water to sip (through a straw). The twenty minutes went by incredibly quickly, and I suspect I entered some type of mildly-altered state for a portion of the time. At any rate, V took excellent care of me, leaving and then re-entering a couple of times, and before I knew it, the time was up and I was out of the tub, outside the room (outdoors), having my back brushed off (of the moist sawdust-like mixture) by V. I brushed off my front and then entered my private shower where a towel and my robe were waiting for me on the other side.

I perspired a lot during my time in the tub, but the warmth felt totally wonderful. If it would have been allowable, I could have stayed in that environment much longer (I thought). But, with heat treatments, 20 minutes is the suggested max, and I held to it. As it turns out, even that may have been overdoing it for me, since that night I discovered that I had a significant rash on my backside. The rash is precisely where I have most of my chronic lower-back pain, so that seemed rather coincidental. However, it is probably less so when you take into account the fact that that is the area where I apply various lotions and creams to help ease the spasms in that region. Although I did not apply anything to my body that day, likely there was some kind of enzymatic (or merely heat) reaction with some residual lotion on my skin.

After the bath, I continued on with another option they offer in conjunction with the bath; I had a massage. V left me at the bottom of the stairs, and I ascended to the second floor waiting area until “J” came to fetch me. Now, I’ve had many massages before in my life, so finally I was back on familiar ground. J was very talented – she had very good hands.

After the massage, I changed back into my street clothes and checked out at the front desk. (After waiting for two women who were, for some reason, giving the attendant a difficult time about their scheduled massage appointment…they were very abrupt and rude – quite in contrast to the serene nature of the place.) I was treated very nicely at checkout, though, and offered a cup of tea, with the suggestion I visit the meditation garden (which I did for about 15 minutes or so).

It was a little difficult to face the prospect of driving the hour back home and facing the “real world” again, but here I am. I made it. I’m back at it.

I’m not sure yet what this experience has actually done for me: how much benefit it has actually provided. What I do know is that I have not worn my back brace for the last two days (mostly to avoid the possibility of aggravating the rash), with my lower back feeling quite a bit better than it has in recent times. I would very much like this to continue!

After I recover from the rash, I’m pretty sure I’ll be thinking about how soon I can do the whole thing all over again.

If you’re ever in my neighborhood, for now I’m suggesting you just might want to take in this little bit of California while you’re here.

Deep, Restorative Sleep

Ah, the joys of moving continue…

Despite my previous rave review of the Marpac SleepMate (a white-noise device), ultimately it just wasn’t enough to resolve the dilemma of having moved into an apartment that’s located directly above a couple who have a TV in their bedroom and play it all hours. Sooooo…although I was initially kicking and screaming at the thought of expending all this energy, I spent the last two days dismantling and then entirely rebuilding my bedroom and office spaces, exchanging the contents of the rooms, one for the other. My sleeping space is now in the “second bedroom” and the office is in the master bedroom. Honestly, I had intensely resisted this as a solution because, for the first time ever (for me), the master bedroom has a master bath…and the occupancy, now, of the second bedroom, negates its (the master bath’s) advantages.

But: getting sleep is the primary consideration here. Deep, restorative sleep is essential for good health (especially for someone with fibromyalgia), and the lack of it “deprives the body of its opportunity to replenish its supply of dopamine” (Dryland, p. 54). Having recently read The Fibromyalgia Solution, I now know that I must continue to work on the sleep issues I’ve had for years and years if I have any hope of eventually conquering this condition. Hence, all the work to change my sleeping space around: short-term pain for long-term gain.