The last entry was about my rather ambitious level of physical activity during the weekend. Activity that came with a price. Silly me! As it turns out, there can be too much of a good thing. Since then, I’ve been dealing with the fallout from those outings. Oh, woe is me; my aches and pains have flared up.

Which has me asking, as always: what’s the deal with my body?

The medical establishment clearly does not have it together when it comes to understanding, diagnosing and treating this mysterious affliction called fibromyalgia. Theories about this disease (or is it a syndrome — who knows?) abound.

Right after the first medical opinion came in suggesting that fibromyalgia was the label for my condition, one of the first reference works I found was Fibromyalgia and Chronic Myofascial Pain (Starylanyl & Copeland, 2001). This book became the starting point in my search for answers to what ails this aging shell. The authors state that they “believe that there is often an initiating event that activates biochemical changes, causing a cascade of symptoms” (p. 11). There are many statements throughout the text that fibromyalgia “may be due to this” or “may be due to that.” And there is an incomprehensible preoccupation with the distinction between tender points and trigger points and their role in fibromyalgia and myofascial pain. The book is subtitled “A Survival Manual,” and that’s exactly what it is: a blueprint for living with chronic pain.

In an ambitious 2006 book (What Your Doctor May Not Tell You About Fibromyalgia), authors R. Paul St. Amand, M.D., and Claudia Craig Marek postulate their theory of “inadequate energy as the cause of fibromyalgia” (p. 32). They suggest that the bodies of sufferers do not produce enough ATP (adenosine triphosphate), which they label as the “currency of energy” (p. 31) in our cells. They claim to have “stumbled upon the treatment for fibromyalgia quite by accident” (p. 40). And that treatment, they say, is a substance called guaifenesin (an expectorant drug, often present in cough and cold remedies, and also available in pill form as a supplement).

In an equally-impressive analysis and argument, Dr. David Dryland (of Ashland, Oregon), just this year (2007), published The Fibromyalgia Solution. His hypothesis is that fibromyalgia victims suffer from fight-or-flight fatigue (an ubiquitous condition of modern living), which leads to sleep deprivation and a diminished supply of the neurotransmitter dopamine. In terms of possible treatment implications, Dryland suggests that two dopamine drugs (originally prescribed for Parkinson’s disease and/or restless-leg syndrome) are likely candidates to provide relief for many. These drugs go by the names of Mirapex and Requip.

What is going on here? Well, what I’ve just provided is a brief list of examples demonstrating that fibromyalgia remains a total mystery not only to me but to the entire medical world. And those of us who suffer with this illness, or think we do, are left to go from doctor to doctor, or one alternative practitioner to another, in order to find some relief from our ever-present pain.

This last week, in the space of three days, I revisited my Traditional Chinese Medicine practitioner and my body-work therapist. They are both very skillful and helpful in my quest for pain relief. I will keep seeking them out, especially when I’m in the kind of state I find myself in now. However, of all the approaches I’ve tried, in all the experiments I’ve performed on myself, the single most effective remedy I’ve found so far is the element magnesium (in the form of a supplement called Fibroplex.) I discovered this particular miracle because of an off-hand remark made last winter at a neurofeedback specialist’s office. He said, “Jim, you may want to try some of this” – as he went over to the shelf to pick up a bottle of the product. I purchased it, tried it, and I’ve felt much, much better ever since. Of course, it wasn’t the cure, it’s just the one thing that has made the most difference in my life in years. Since then, I’ve discovered much evidence to suggest that magnesium deficiency is commonly associated with a significant percentage of my current symptoms.

Now, another possibility has come along. A few days ago, good friend “V” in Oregon suggested that I take a look at the latest issue (November 2007) of Scientific American. In a persuasive article (pp. 62-72; the full article is not available online without a subscription) entitled “ Cell Defenses and the Sunshine Vitamin,” researchers Luz E. Tavera-Mendoza and John H. White outline the dangers to a human body without enough Vitamin D.

In short, the authors offer evidence to suggest the possibility of “widespread vitamin D deficiency contributing to a number of serious illnesses” (p. 64). And, as it turns out, fibromyalgia may be one of them. Yes, you guessed it: doing a Google search on the topic turned up several references, among them an article entitled “Vitamin Deficiency Causes Fibromyalgia!”

Who knows. Maybe this is the answer. At any rate, it seems easy enough to check out. I’ve now added 4,000 international units of D₃ to my daily regimen of supplements.

I’ll keep you posted.

For the time being, I’ve given up running and aerobics. Perhaps I am forever retired from the world of Jazzercise, who knows? Now I walk for my physical, mental, emotional and spiritual health.

I base my practice on a proverb in Traditional Chinese Medicine which says that…

Worms will not eat living wood where the vital sap is flowing; rust will not hinder the opening of a gate when the hinges are used each day. Movement gives health and life. Stagnation brings disease and death.

So far here in Marin, most of my daily walking-time has been spent on one particular bikepath near my apartment. It’s a good route and very accessible. It quickly became known to me after I moved here. And it quite rapidly evolved into my routine.

And, of course: now it has become boring as well. I have been caught in a rut with no new scenery, no variation from the norm.

So, this last weekend, I decided to change all that. You know, mix things up a little bit…and live on the wild side!

On Saturday I drove down the road a little ways to the Natalie Coffin Greene Park in the Town of Ross – and actually found a place to park this time. Spots are very limited there (24 spaces or so), so on my previous visits, I had always ended up turning around to find someplace else to park and hike (namely my old standby path).

The trail leading from this park goes very quickly into the woods and splendid isolation along Phoenix Lake. It’s a beautiful place, rather hilly and secluded (except for other like-minded outdoor folk), and I fell in love with the place immediately. I suspect that from now on I’ll wait my turn to park in the lot, just to be able to enjoy this amazing little getaway place so near home. (Perhaps it’ll be my new “Mt. Pisgah” – the favorite hiking spot of all time for me, right outside Eugene, OR.)

Then, on Sunday, I did something I had envisioned myself doing ever since I entertained the thought of moving to Marin: I walked the length of the Golden Gate Bridge. It was a cloudless and balmy afternoon, and I figured: it’s time! I discovered directions on the web about where to park, so I found my way to the Vista Point lot on the north side of the bridge. I walked the bridge from north to south, wandered around the visitor’s facilities at that end (i.e., the gift shop and café), then walked the span again back to my car.

What a totally perfect day to do this! I’ll have to go back again soon, though, when the photos will turn out with more “mood” associated with them.

Soundtrack Suggestion

I’m walkin’, yes indeed and I’m talkin’ ’bout you and me
I’m hopin’ that you’ll come back to me, uh uh.

( “I’m Walkin’” – Fats Domino)

Is it acceptable for a sixty-year-old like me to label another person “elderly?”

I wonder…

Anyway, whatever possessed me to make a trip to the grocery store on a Saturday afternoon, I’ll never know. But that’s what I did. I traveled over to San Rafael late today to pick up a few things from Trader Joe’s. It was very, very busy — and it took about 15 minutes to check out of the “express lane.”

Then, after I got back out into the parking lot, I started the car and proceeded to wait and wait just to back out of my spot. The traffic surrounding the store was totally ridiculous!

While looking in my rear view mirror to watch for an opening, I noticed an “elderly” guy (80ish, I’m guessing) exit a vehicle across the way. After he got out of his car, I could see that he glanced my way. Then it seemed as if he was staring at something in my direction.

It turned out he was. When there was a little break, and a car stopped for him so that he could safely cross, he walked directly over to me and tapped on the window.

When I rolled it down a notch (he looked harmless enough, but I was still suspicious of his motives), he immediately asked, “are you a Beaver?”

This is a rather strange question, of course. And, for many of you out there, I’m sure it could be a tad offensive. But, for me, given that I have an “Oregon State Beavers” license-plate frame and a “Member, OSU Alumni Association” sticker on the rear of my car, the inquiry was a pleasant surprise.

“Yes I am,” I answered. “I have two degrees from OSU and lived in Corvallis for twenty years.”

“Did you see the game last week?,” he asked.

“Yes I did! Was that amazing, or what?!” (OSU toppled the Number 2-ranked team in the country last Saturday, defeating California, at Berkeley, 31-28.)

We traded names, shook hands, and then continued on with our respective Saturday afternoons.

So I found another member of the Beaver Nation! (Or rather, he found me.) Right here in Marin!

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)

In keeping with the Boy Scout Motto, Marin County has initiated the “Get Ready Marin” campaign in order to raise awareness about how to best prepare for the next earthquake, flood, fire, landslide…or whatever other kind of disaster you can imagine. Hundreds of these bright yellow signs, such as the one above (shown here attached to the Larkspur Fire Department building), have been appearing all over the place to alert us to the effort.

Even though evidence of this campaign is difficult to avoid (there are tons of banners, signs, posters, Golden-Gate-Transit-bus advertisements, cocktail napkins, cable-television public-service announcements and, I’m told, even an airplane with a trailing banner), I hadn’t really been paying much attention (nor had I visited the website) until I read the article in the Marin Independent Journal this last weekend which explained the program. Finally, I got it: pay attention, TechnoMonk!

Apparently, there are free, two-hour-long disaster-preparedness classes that we can now sign up for to help us “get ready” for the Big One: all funded by a huge grant from the Department of Homeland Security.

I suppose I should attend. After all, what did I do when I decided to live in one of the most earthquake-prone parts of the world?

I rented an apartment located on the side of a cliff.

Soundtrack Suggestion

Well, shake it up, baby, now, (shake it up, baby)
Twist and shout. (twist and shout)
C’mon c’mon, c’mon, c’mon, baby, now, (come on baby)
Come on and work it on out. (work it on out)

(“Shake It Up Baby” – Isley Brothers)