What I learned from 2 days in the hospital

[REMINDER TO FIRST-TIME VISITORS: Be sure to read the oldest posts first. The later posts, including this one, deal only with minor details. Start with the first post, which describes the problems I faced, and then read at least the second post, which describes my special diet as a solution.]

Friday evening about 7 pm, I sneezed and had a stab of chest pain. There was no follow-up pain. At 1 am I woke up with excruciating chest pain, right side. I recognized the symptoms: collapsed lung. (I have had 16 earlier pneumothoraces, through 47 years.) I grabbed my hospital bag and cabbed to the hospital (Good Samaritan, Portland).

I was treated respectfully and competently by every person in their huge staff: physicians, nurses, physician assistants, radiology experts, and all their assistants.

Here is what I learned or confirmed from earlier experiences:

GENERAL
- Always have a hospital bag packed, including a novel or two for the long, boring hours, and a list of contact phone numbers.
- Discuss issues with the medical people, to attain at least general clarity, remaining willing to compromise between their caution (stay longer) and my eagerness to leave (to cut my costs and get back to work).
- At age 65, my lifestyle has paid off: Doctors found no sign of heart disease, cancer, kidney problems, liver problems, or any of the other many problems that their older patients usually have. (In the section of the hospital where I was, all the patients were gray haired; perhaps this was a Medicare wing.)
- When I don't exercise, I need very little sleep. That was good because I was so wired up and tubed up that I could barely roll over; sleep was very difficult.
- The physicians and nurses were surprised to meet a 65-year old patient who uses no pharmaceuticals. (My roommate -- who had acid reflux, heart disease and other problems -- was taking six medications daily before he needed to come to the hospital for his latest emergency [mass sweating, nausea, fainting].)

WEIGHT
- As a result of following my anti-itis diet (fruit, vegs, and starchy roots), with 100% compliance, I have become technically underweight (BMI of 17, the lowest of my adult life). I was shocked at how little I weigh (when I entered the hospital, 124 lbs at 6 ft; 121 lbs when I left.) now compared to the last time I was weighed (about 135 lbs, several years ago).
- Despite being technically underweight, I have been fully functional and the hospital staff found no evidence (from a "full array" of blood tests, as well as CAT scans, x-rays, interviews) of malnutrition or other problem.
- I will need to concentrate on boosting my weight by 10 lbs or so -- perhaps with increased sugar consumption and with avocados, olives, and so forth.

FOOD
- Even from the beginning, during admittance, be very polite, clear, and assertive about dietary requirements: "Give me only fruit (any kind), vegetables (any kind), and potatoes." Simple and clear and easy for them to write down. Do not say "vegan" or "vegetarian" or similar terms, because they are too vague or confusing to most people.
- By explaining to the nurse on duty (12-hour shifts) what I wanted to eat, I received what I wanted. I tried to always make it easy for the people working in the kitchen (who are about three links removed from the patient). Keep it simple. Don't be picky. Always use the word "plain." Order whole foods, though I found I didn't need to use that word (which is confusing to most people).
- By keeping my requests simple and easy to fill, I got nutritious and delicious food at every meal; Two baked potatoes; two servings of green beans; a "fruit plate" (a mound of diced fresh fruit, such as apples, oranges, melons, grapes); half a cup of olives; and water. The amount of food was large. Even I --and I have a big appetite -- could barely eat it all.

All things considered, my brief hospital stay was positive -- as confirmation of my lifestyle.

Burgess Laughlin

Author of The Power and the Glory: The Key Ideas and Crusading Lives of Eight Debaters of Reason vs. Faith, www.reasonversusmysticism.com/

An expanded anti-itis diet?

[REMINDER TO FIRST-TIME VISITORS: Be sure to read the oldest posts first. The later posts, including this one, deal only with minor details. Start with the first post, which describes the problems I faced, and then read at least the second post, which describes my special diet as a solution.]

(For a continually updated look at my most recent diet details: http://anti-itisdiet.blogspot.com/2010/07/what-do-i-eat.html)

STATUS REPORT. My skin continues to improve. It is becoming thinner, free of itching, and very slightly oily (not chalky). It remains very sensitive to abrasion. E.g., shaving (with an electric, rotary shaver) still causes inflammation and subsequent peeling if I press too hard or if the razor becomes hot. I continue to be pain-free (no arthritis, tendonitis, or bursitis, except for occasional muscle pains due to posture problems. (My right shoulder still slopes down, but I am working on correcting that.)

EXPANDED DIET. 1. In the meantime, using the standard test, I have reconsidered a few foods that had given me unclear results in earlier tests. I can now regularly eat dried figs and canned tomatoes (diced). I had avoided both because of the prevalence of seeds which I could not conveniently remove.

2. Helena Kloosterman, who is neither a nutritionist nor a physician, has provided a short list of foods, rated for Potential Renal Acid Load (PRAL), a subject I have discussed elsewhere. Her list is based on calculated values, not laboratory results. Consequently, I have been reluctant to even test (one serving per meal, six meals in a row) some of the foods she says are alkaline-producing. The list, accompanied by a formula for the calculation of PRAL, appears on her weblog, Bitter Poison, here:

http://www.bitterpoison.com/archive/calculate-acid-alkaline-with-pral-formula/

Most of the foods rated as alkaline-producing in her list are not surprising: fruits and vegetables. Others were a surprise. For example, from my own tests of corn, oatmeal, rice, and wheat, I had tentatively generalized that all grains (indeed nearly all seeds of all kinds) were acid-producing and therefore to be avoided. (Production of an acid condition, in the kidneys, is not the cause of my inflammatory problems, apparently, but it has been an infallible "confounder" or "co-incident" indicator or "proxy" predictor of inflammation.)

Kloosterman's calculated list shows the grain quinoa (pronounced "KEEN-wah" or "key-NO-ah") to be alkaline-producing. I hesitantly bought a 26 ounce (737 gram) bag of quinoa from a chain grocery store (Fred Meyer, Kroeger) that carries Bob's Red Mill products. I ran the standard test and got no adverse reaction in the skin on my face. I now eat it regularly, about one serving per day, on average, while continuing to eat most of my starch (the core of my meals) from "roots" (potatoes, sweet potatoes, rutabagas). I note however that Wikipedia lists quinoa as technically a fruit, not a grain. Apparently quinoa grows on a bush, not a grass stalk. Perhaps its "fruitness" is why it is not acid-producing. I don't know. I am ignorant about biochemistry.

The fact that at least one grain (if that is what quinoa is) is (slightly) alkaline-producing, and thus okay for me to eat, does confirm one pattern: There are exceptions in almost every category. For example, generally beans, nuts, and grains (all seeds) are acid-producing; however, green beans (string beans), hazelnuts (Filberts), and quinoa are exceptions to their categories.

Kloosterman's list also shows some beans -- such as pinto beans -- as being alkaline-producing, but she states that for the raw form, which no one eats. Does cooking making them acid-producing? I do not know.

FEB. 25, 2010 UPDATE: In the last few weeks I subjected pinto beans and lima beans to the standard reintroduction test (eat one serving per meal, six meals in a row and look for a reaction -- in my skin, in my case). I got no reaction. I then began eating beans (cooked, about 1/2 C per meal) at two meals per day. After about 10 days, my eczema returned in mild form.

I threw out all the beans and I returned to my regular diet of fruit, vegs, and starchy roots. Within 12 hours the eczema began fading! The beans probably were the cause of the problem. Perhaps they have a long-term, cumulative effect that doesn't show up in the standard two-day test.

This result shows that I cannot automatically trust the Kloosterman list, which shows merely calculated, not lab-tested values, especially where the list says "raw" and I don't eat the food in raw form.

Summary: Limiting my diet to fruits, vegs, and starchy roots (and possibly quinoa) works.

Burgess Laughlin

Author of The Power and the Glory: The Key Ideas and Crusading Lives of Eight Debaters of Reason vs. Faith, www.reasonversusmysticism.com/

Last dermatitis stopped!

[REMINDER TO FIRST-TIME VISITORS: Be sure to read the oldest posts first. They describe the "-itis" problems I have faced and the main solution. The later posts, including this one, deal with details.]

As I explained in my oldest post, a series of "itis" (inflammation) problems have appeared during the last 47 years of my life. Four were skin problems (eczema, rosacea, scleroderma, and seborrheic dermatitis). My "anti-itis diet" (which I now humorously call the "prelithic diet") has stopped the arthritis, bursitis, tendonitis, iritis, colitis, and three of the four dermatitis problems.

I discovered recently in talking to my dermatologist that the cause of my fourth skin problem, seborrheic dermatitis, is unknown. (Stress, which is notoriously difficult to measure and track, is one suspect, either in the emotional form or the immune-system form.) Not surprisingly, there is no cure for it.

Apparently the sebaceous glands produce too much oil. The extra oil makes the skin scale--making the skin look chalky and dry. Itching accompanies the scaling, and the skin is very vulnerable to abrasion (which causes redness, swelling, itching, and peeling). Rubbing from an electric razor, a hat brim, or a large, stiff collar are examples of abrasion. I have not been able to shave with an electric razor for many years. (I have been using a hair trimmer set at the lowest setting, on my face and scalp.)

Last week, my dermatologist suggested a treatment program that has eliminated the symptoms. Following is the program, but be sure to consult your own physician. Your situation may be different. I am naming the particular brands I use, but there might be others equally effective.

FACE: Daily, apply a small amount (perhaps one-third teaspoon) of Hydrocortisone Lotion, USP 2.5%, Qualitest, available by prescription. Use it like a moisturizer. A little goes a long way, covering all of my face and front upper neck, that is, all the areas that had rough patches from scaling skin. I apply it about 15 minutes after taking a shower in the morning, when my skin is clean and dry. (I have not used plain soap on my face for fifteen years, but it was very irritating to my skin problems.) The prescription suggests applying it twice daily for the first week and then once daily after that. How long will I need to use it? Perhaps forever, if the purpose is only to suppress symptoms. I may experiment with cutting back the frequency, after a few weeks.

SCALP 1: Every night before bed, apply--throughout the scalp but especially in scaly areas--a small amount (perhaps 1 teaspoon total) of Fluocinonide Topical Solution, USP, 0.05%, 60 ml, TEVA Pharmaceuticals. This application is easy for me because my hair is extremely short. The nurse who told me how to use it has long hair; She said she soon learned to use the squeeze bottle to apply it efficiently and then use her fingers to spread it around the scalp.

SCALP 2: With a medicated shampoo, wash scalp (not the face) every morning. (Be sure to leave it on for a few minutes before washing it off.) Rotate the daily shampoo among the following five medicinal shampoos. I assigned each to a day of the week, for simplicity's sake (and I wrote the day on the bottle with a bold felt pen).
- 1. Monday: Prescription Ketoconazole shampoo, 2%; Perrigo.
- 2. Tuesday: Over The Counter (OTC), RiteAid "Dandruff Classic Clean" shampoo, containing pyrithione zinc 1%.
- 3. Wednesday: OTC, RiteAid "Therapeutic Shampoo," containing coal tar, 2.5%.
- 4. Thursday: OTC, RiteAid "Dandruff Shampoo," containing selenium sulfide, 1%.
- 5. Friday: OTC, Neutrogena T/Sal Therapeutic Shampoo, containing salycylic acid, 3.0%.
- Saturday: repeat shampoo from Wednesday.
- Sunday: repeat shampoo from Thursday.

With this approach, the scalp condition is medicated by a series of active ingredients in the hope that at least one of them will reduce the symptoms. Perhaps the various shampoos work individually to reduce different aspects of the symptoms. I do not know.

What I do know is that the treatment program outlined above works for me, and after only about five days of application. (My doctor cautioned me to continue even if the symptoms disappeared.) For the first time in 47 years, I am symptom-free!

This is not a cure, but it is a way, if applied regularly, to eliminate the symptoms.

I am very glad I live in a country that still has a little freedom of choice for doctors and patients.

Burgess Laughlin

Author of The Power and the Glory: The Key Ideas and Crusading Lives of Eight Debaters of Reason vs. Faith, www.reasonversusmysticism.com/