I realize the title of this post sounds rather epic. But, when you have been struggling with pain for 12 years it can feel pretty epic too.
I was actually writing a blog post on my current situation but realized it required some context so that you understood where things were coming from. So, I’m writing this blog post so that I can write another blog post after it.
I know … its annoying to me too.
For those of you who prefer watching over reading, I summarized a lot of what I talk about in this blog in my recent vlog. Here is the video:
And for those of you who prefer the written word … here you go. 🙂
Chapter 1: My what a big pill you are
Let’s start at the very beginning (a very good place to start) where I was a young child suffering from a rather chronic case of tonsillitis.
Around the age of 8 or 9, I started experiencing regular high fevers accompanied by swollen glands. Almost like clockwork, I would get a high fever (100 to 105 F) each month. This accomplished two things:
- I became extremely sensitive to knowing exactly when my body was getting sick. I could sense a fever coming on as if it was accompanied by a brass band. I still have that ability to this day. So … thanks, I guess?
- I became really good at swallowing large pills. Due to my condition, I was given a lot of very large pink pills filled with penicillin to fight the infection. I’m still pretty good at taking medication or supplements.
When I was 10 years old I finally got a tonsillectomy to take out my ineffective tonsils. But by that point, I had had enough antibiotics tossed into my system to make a mess of things. It is something that would play out rather uncomfortably later in my life …
Chapter 2: I Kneed a Break
At the age of 25, I started practicing wushu — contemporary Chinese martial arts — and really fell in love with the sport. So much so that I would eventually tear my right ACL in 1998 and then my left ACL and meniscus in 2003. I probably made a mess of things with my ankles and shoulders too.
The knee problems were really more from me being overweight while practicing martial arts. Two things that don’t go well together. At the time I was a good 30 or 40 pounds heavier than I should have been, and unfortunately, I would not really lose the weight until this year. (But more on that later …)
The second knee injury in 2003 allowed me to use my insurance to pay for an ACL cadaver-graft reconstruction, as well as a meniscus repair.
The doctor did a bang-up job. (Perhaps not the best word choice to describe it.) A year later I was walking and moving around like normal. But, my knee really never got back to “like new” status. I later figured out that surgery wasn’t the only option and that I could have worked on healing it naturally.
I mean … I never had my right knee cut open and it is my strongest knee by far. Go figure.
So, this whole episode would also contribute to the later issues that came up in 2006. A banner year for living abroad and experiencing new levels of pain.
Chapter 3: The Joys of Chinese Pharmacies
China was an intense experience. And by intense I mean … intensely stressful.
In August of 2005, I moved to Shanghai, China to work for Jet Li. It was
rather extremely stressful. More than I even realized it at the time. Not because of Jet, but because of the culture and environment, I was thrust into.
Shanghai is not for the faint of heart. “Hustle and bustle” is an understatement in a city of 25 million people. For the first 6 months I lived there I hated it. After a while, I acclimated, made some friends, and got into my own groove.
However, that acclimation didn’t come until after my first bout of joint inflammation in my knee. I didn’t know what it was at the time. In fact, I wouldn’t know what it was for another 12 years.
I was given some anti-inflammatory medication (NSAIDs = Non-Steroidal Anti Inflammatory Drugs) by one of the team doctors at the Shi Cha Hai Sports School (home of the Beijing Wushu Team) and that seemed to do the trick.
But another month or two later it happened again. So I took the medicine again. And this continued for the following couple years while I was in Shanghai. It wouldn’t always be in the same joint. Sometimes it would move to my ankle, but most of the time it was in one knee or the other.
By the time I moved to Hong Kong in 2007 I came to the conclusion that it might be gout. Based on what I read about gout it seemed consistent.
It turned out I was wrong … sort of.
Yes, I actually had gout. But that wasn’t the whole story. In fact, my actual gout episodes were pretty infrequent and what I called “gout” was, in fact, something else.
Hong Kong was super stressful for me. Even more than Shanghai. I was pretty much miserable 99% of the time. I didn’t like to show it (because who wants to hear a whiner complain about stress?) but Hong Kong was probably one of the lowest points in my life.
And it turned out that stress contributed to my joint inflammation in a major way. A lot of the time I was either using a cane or crutches to get around. Often times I would have inflammation in multiple joints at the same time. Imagine having something that feels like gout but in both knees and both ankles. It was extremely painful and I was miserable for most of the two years I lived there.
A lot of the time I was either using a cane or crutches to get around. Often times I would have inflammation in multiple joints at the same time. Imagine having something that feels like gout but in both knees and both ankles. It was extremely painful and I was miserable for most of 2007 and 2008.
One time, when I was experiencing a fever, I went to a doctor who prescribed some antibiotics. Much to my surprize the antibiotics did a good job of clearing out most of my inflammation too. After a second course of the medication it cleared out completely.
It was then that I realized that my joint inflammation was a bacterial issue and antibiotics were the key to fixing it.
I was wrong though. The joint inflammation had nothing to do with bacteria. Actually the bacterial infection was being caused by the same thing that was causing my joint inflammation, but the cause and effect of things was still a mystery to me. In fact, I wouldn’t realize what was happening for another 10 years. It was just the conclusion I came to at the time. After all, antibiotics fight bacteria, right? It made sense, I thought.
In November 2008 I went back to the U.S. to visit family and get away from Hong Kong and the stress I was feeling. It helped. My joint inflammation died down and I started feeling much better. I could train wushu again and even went to Beijing in the summer of 2009 to train with the Beijing Wushu Team.
But the respite from the joint pain turned out to be temporary. After I got married in September and moved to Xi’an I started experiencing the inflammation again.
This is also when I discovered that pharmacies in China sold antibiotics over the counter. #boom #gamechanger
My four years in Xi’an I was essentially in “maintenance mode”. Since I could get antibiotics and NSAIDs over the counter, I would use them whenever I had a flare up.
By paying attention to my environment and how the joint inflammation occurred I was convinced of a few things:
- It was clear that stress was a factor because I would get much worse when I was stressed out.
- It was clear that diet and food was a factor, but I couldn’t figure out exactly which foods triggered it.
- It was clear that it would come about when my immune system was compromised by a lack of sleep or bacterial infections. When I didn’t get enough sleep I was much more prone to get the joint inflammation.
I continued believing that my problem was a version of gout caused by bacterial infection brought about when my immune system was lowered through stress and lack of sleep. I was partially right, but at the time I was pretty convinced that I had it figured out.
When I moved to Hawaii in 2013 the full picture would finally come into focus. But not for another 4 years.
Chapter 4: Increasing Clarity in Hawaii
After moving to a relaxing, slow-paced tropical island in the middle of the Pacific Ocean at the end of 2013, my condition improved quite a bit. Instead of getting a bout of “gout” every month or two, it slowed down to once every 5 or 6 months.
I was also in an environment where I had access to health care (thanks, Obama) and could see a doctor who would offer his opinions on what was going on. (Turned out he was wrong, by the way.)
Blood tests showed that my uric acid levels (a key indicator of gout issues) were high, which led my first doctor to believe that I had gout. They gave the typical recommendations: don’t eat red meat, lower my salt and oil intake, and eat more greens and less seafood. I later found out that none of those recommendations are actually relevant to what I was going through, but more on that later.) for gout, but that is a different story.)
Coincidentally, it turns out that none of these recommendations were actually helpful to my condition, but more on that later.
It was around the end of 2014 when I was having a particularly bad episode of joint inflammation was received a prescription for steroidal anti-inflammatories. Specifically methyl-prednisone. Of course, the doctor didn’t tell me what steroidal anti-inflammatories did to your body (they suppress your immune system, I later learned) but when you’re in a lot of pain you just want relief. Playing 20 questions with your doctor takes a back seat.
It helped for sure. But I wouldn’t find out the real reason why until a few years later.
In the end of 2015, I changed my primary care physician (PCP) to a younger doctor who practiced integrative medicine. This was also around the time that I first heard the term “autoimmune disease”. My wife’s step-father, who is a nurse, mentioned it one time. He said that it might be my immune system attacking itself. My new PCP mentioned the same thing after our first meeting. I didn’t know much about autoimmune diseases (and didn’t bother looking it up since I thought I knew what was wrong) and when he suggested that I see a rheumatologist to get a diagnosis for arthritis I balked.
Arthritis?? I was only in my 40’s. How could I have that? Of course, I didn’t know at the time that there are different types of arthritis, and he was talking specifically about Rheumatoid Arthritis. Or “RA” as it is more commonly known.
Every six months or so the doctor would prescribe some colchicine (anti-inflammatory medication for gout) and occasionally either an antibiotic or some prednisone. But I received the medication because I was convinced that I was experiencing bacterial gout infections.
Oh, you foolish young man, you.
The Last Bout
After I moved to Oahu at the beginning of 2017 I took on quite a bit of responsibility. I was going to school full time, I had 3 jobs, was a head coach for the Hawaii Wushu Center, was chairman of the Honolulu Local Spiritual Assembly, and was commuting back and forth between two islands. Plus, the place I was living was rather challenging.
My stress levels increased and, as you could have guessed, by the end of May I experienced another bout of joint inflammation.
This time, however, it was different. The pain was like the pain I experienced back in Hong Kong. For some reason, it was only in my left leg (knee, ankle, and foot), but I still had to stay bedridden for several weeks. Even medication didn’t flush it out of my system.
It was then I made the decision that this would be the last time I would ever experience this problem again. I was going to take drastic action to completely remove it from my system.
No more band-aids of medication or these temporary solutions. I was going to change everything about what I ate and how I lived until I got rid of this problem once and for all.
Little did I realize that this was a decision that would completely change my physiology…
To be continued …