Inflammation Update

Thursday, May 19th, 2016 12:40 am
flwyd: (intense aztec drummer DNC 2008)
As previously mentioned, I started the year with an autoimmune attack on my eye. This occurred after a month of over-extension: after a long day at work, I'd come home and spend a bunch of energy planning a trip to Australia and New Zealand, then not get a lot of sleep before doing it all again. The first sign of autoimmune inflammation, though I didn't realize it at the time, was soreness in the arch of my right foot. I chalked it up to old orthotics and added new boot inserts to the trip shopping list. I'd also been using a standing desk at work for two months in an attempt to reduce sitting-induced back pain and see if reduced slouching helped my esophagus's acid problem.

My eye recovered fully and my vision is back to 20/15; the only sign of the attack is a small "battle scar" blip on the iris. The only autoimmune blood test that came back positive was HLA-B27. This wasn't too surprising, since it's linked to ankylosing spondylitis, a condition which led to my uncle's fused spine. This antigen marker led to a referral from the eye surgeon to a rheumatologist.

After getting help from my parents to figure out all the causes of death in my family history, the first rheumatology appointment resulted in a diagnosis of psoriatic arthritis (a relative of ankylosing spondylitis), a prescription for meloxicam as needed, an NSAID (similar family ibuprofen, but with longer duration and more powerful per milligram), and instruction to get x-rays of my spine and pelvis. The x-rays showed signs of calcification of my spine and SI joint, so I had another rheumatologist appointment to talk about chronic disease management and treatment options. Basically, my immune system works too well, so it attacks various parts of my body like joints, skin around my scalp, and occasionally my eye. Biologics are the big-gun drugs for autoimmune diseases, which are expensive and increase the likelihood of serious infection. They sound pretty scary, so I decided to focus on "diet and lifestyle" and NSAIDs for a while to see how far I can get with adjusting my environment and routine.

So yeah, that was January. I averaged a health-care office visit every other day, but by the end of the month I wasn't feeling too bad. In February we spent two weeks in Maui, where I was able to do low-impact activities like snorkeling, scuba diving, hiking, mini golfing, and hanging out on the beach. Eating was still a bit of a challenge: the acid reflux and esophageal challenges in swallowing that were my main health problem in 2015 persisted, so there were a lot of rather slow meals. Then, half way through the trip and the day after a hike on the wet side of the island, I started to feel a bit sick, maybe a mild viral or bacterial infection. That night I had a crazy intense acid reflux experience, preventing me from sleeping all night. Around 3:30 I took a famotidine (Pepcid) pill that I'd been prescribed but hadn't really used. Two and a half hours later, we got on the ferry to Moloka'i. With only a few thousand residents, no stoplights, and a laid-back culture, Moloka'i is a great place to feel crappy. I started feeling better, and acid issues started to fade. Remarkably, I've had hardly any acid reflux in the three months since returning, though I've still got some swallowing challenges.

My mom gave me a copy of The Anti-Inflammation Zone by Barry Sears, the creator of the Zone diet. The book explained, to a moderate degree of satisfaction, how pro- and anti-inflammatory responses work (arachidonic acid versus eicosanoids and other long Latin names). Sears's primary recommendations, repeated over and over, are the Zone diet and high-dose, high-purity fish oil for EPA and DHA. I found his discussions of the diet kind of annoying, particularly since his extensive biography wasn't footnoted from the text, so I couldn't tell what was part of the diet plan because of sound science and what was present arbitrarily. The fish oil recommendation, on the other hand, seems to have solid science behind it. I've been taking fish oil for a couple months, currently around 2 teaspoons per day (~3 grams of ω-3 fats), and eating salmon and herring whenever I get the chance. The EPA doesn't seem to have done much for my foot/ankle/SI joint inflammation, but my psoriasis symptoms seem to have improved, perhaps from the DHA. During the winter I was drinking a lot of homemade chai, with the goal of increased intake of the anti-inflammatory ginger and turmeric. I even brewed a tamarind turmeric galangal brown ale. Keeping a crock pot of warm chai has been less appealing as the weather has gotten warmer.

I've been back and forth on the meloxicam. The side effects so far haven't been too bad&endash;mostly mild dehydration from my kidneys working hard–but stomach issues and intestinal bleeding are possible. When I take it for several days, my ankle/foot pain is a lot less, and I think it may help my esophageal troubles. After taking it all last week and experiencing very few choking incidents, I stopped taking it over the weekend. The last two days have featured moderately increased foot pain and some distressingly intense swallowing problems (leading to unpleasant regurgitation), so I'm taking the drug again in the hope that my eating challenge can be addressed by reducing inflammation.

Emotionally and intellectually, I've been adjusting to a lifestyle focused on eliminating stress, reducing voluntary commitments, and enhancing physical health. My natural tendency is to overcommit and prioritize tasks over sleep, exercise, and hygiene. That's a good recipe for accumulating inflammation, so I'm learning to say "no" and prioritize my own health over being helpful all the time. I've also been riding my bike (yay springtime!) and more regular about stretching on the floor and not sitting still for hours, though I've been in basically the same position in my hammock for the last two and a half hours of blogging. The nice thing about chronic illness is that if I don't do things right today, I can get back on target tomorrow.
flwyd: (intense aztec drummer DNC 2008)
This TED talk by Rodrigo Canales draws parallels between prominent Mexican drug cartels and more ordinary businesses. Brand, markets, and social involvement all play a key role. Canales describes Los Zetas as a franchise business for ex-military members and local gangs. They're credited with many of the most gruesome killings in the drug war, and part of that is their brand. There are parallels here with Al Qaeda, which is also a franchise organization with an interest in tooting their own horn about how destructive they are.

Los Caballeros Templarios Guardia Michoacana (Knights Templar Cartel, successor to La Familia Michoacana) control some very important transit territory. They operate on a very local basis with social programs, and are loved by many in the communities. They portray many of their killings as community defense (petty criminals, local drug dealers, outside organized crime) and have played a significant role in local politics. This sounds to me a lot like Hezbollah, which operates schools, hospitals, and other social capital-building enterprises along side their long-running battles with Israel and arab governments. Other paramilitary organizations have had similar success with social programs and local support including the IRA and loyalists in Ireland and the Basque ETA. It's very hard to destroy an organization like this; they have the benefits of guerrilla warriors plus the financial resources of a major corporation.

The Sinaloa Federation operates a lot like a multinational corporation, including an executive on the Forbes billionaires list. They innovate in product delivery technology, they have executives (aka family members) supervise new ventures, they outsource tasks that would damage their brand, and so forth. In addition to parallels with legal corporations like oil companies I think they also bear a striking resemblance to historic organized crime groups like the Mafia and Yakuza. The salient feature is the organized part moreso than the crime. The latter is only present because the business's products happen to be illegal.

I think it's helpful to think of these groups as companies with violence as one of their business methods rather than a grand version of random street violence. It also suggests that tourist fears about travel in Mexico may be unnecessarily elevated: would killing you further the business interests of the cartels?

A TED blog post about this video links to a few others on similar topics, including a suggestion that the best way to fight these organizations is to devalue their brands.

One interesting twist in the Mexican drug war is that the Americans are funding both sides. The cartels make most of their money by selling drugs to the U.S. distribution network, not to mention side businesses like smuggling migrants for the labor market. Meanwhile, the U.S. government subsidizes the Mexican government's anti-cartel activities, with gun manufacturers from the States profiting from sales to both sides. Not to mention the money spent on border enforcement and anti-drug efforts north of the border, a chunk of which also goes to American arms dealers.
flwyd: (requiem for a dream eye)
With the exception of alcohol, I'm a pretty anti-drug kind of guy. Not that I think other people should be prevented from using drugs, I just prefer to have an unaltered experience.

So sometimes it takes me a while to remember that when I'm sick and have a nasty headache, ibuprofen can allow me to function much better.
flwyd: (requiem for a dream eye)
At the P-Funk concert last night, three people asked if I'd "Seen Molly." Since I'd already bumped into a friend of my brother's I didn't recognize, I had to stare at the first girl who asked and think "Do I recognize this person? Why would she be asking about my friend without introducing herself?" I answered "Not here" to see if she would ask a follow-up question.

In case you're keeping track, more people asked me for drugs at George Clinton & Funkadelic than at The Chemical Brothers. I don't remember anyone asking me for drugs at Michael Franti & Spearhead or Kraftwerk (all shows at the Fillmore). I don't think anyone's ever asked me for drugs at the Boulder Theater or the Fox Theater. P-Funk is also the only show I've seen where somebody (two, in fact) tossed a joint to someone on stage who then lit up. Caveat: I've never been to Reggae on the Rocks. And in a reversal of stereotypical roles, a black guy with corn rows secretly reached over and touched my hat. Oh, and Maggot Brain is totally awesome.

One of my favorite Onion articles ever was Clinton to Parliament: It's Time To Drop DA BOMB On Iraq.
flwyd: (Om Chomsky)
Americans who posture about immigrants and drugs crossing from Mexico into the U.S. ought to consider what moves in the other direction. It's easy to get drugs in Mexico. It's easy to get guns in the U.S. Drug smugglers want guns to protect them from law enforcement. Guess what they can trade?

Incidentally, it's not just a North American Secret Trade Agreement issue. It's easy for soldiers to score heroin in Afghanistan. Soldiers have some even more impressive technology to trade for drugs. I wonder how many steps it takes for the Taliban to get their hands on American military toys.

Drugs, guns, and gems form the tripod upon which international crime stands. They can be mutually exchanged without tax or easy tracing, easily concealed and transported, and are highly desired by the those who use them.

Dealing with the problems of weapon, drug, and diamond smuggling is not easy. I suspect that legalizing drug use and possession would take a lot of power away from the criminals: nobody packs heat and smuggles fruit into the U.S. because it can be legally imported or grown locally. The expenses of growing marijuana in California, shipping it to Missouri, and paying sales tax at a strip mall probably are probably lower than the cost of growing marijuana in Guatemala, shipping it to the border, bribing officials, smuggling it through the desert, and letting every dealer it passes through take a cut. Legal drugs may be safer and healthier.

Demand-side changes could also affect the profitability of diamonds, and therefore their usefulness to international criminals and African warlords. If diamond consumers chose man-made diamonds on the grounds of price, social responsibility, and environmental impact, the (cartel-driven) artificially high price of diamonds would drop, making them far less lucrative as a black market currency. As a side effect, it might make your computer faster, too.

But I don't think a purist market approach is a complete solution. Guns are readily available in the U.S., but they still cause problems where they're legal and illegal. Just as the mob moved in on legal gambling in Nevada, I don't expect well-armed, well-paid drug smugglers to take undercutting lightly. And sudden legalization of drugs, especially easily overdosed ones like heroin and cocaine, without a simultaneous public health and education outreach could easily kill more folks than smuggler/DEA conflagrations and drug dealer turf wars.

Undercutting the diamond trade isn't so simple either. A significant portion of the value of a diamond is its price. People buy diamonds to show that they can afford to buy diamonds. If everyone could afford to buy diamonds, rich people would buy something else hard to find. And if it's hard to find, criminals are probably willing to kill for it.

Lethal Injunction

Wednesday, April 26th, 2006 11:50 am
flwyd: (requiem for a dream eye)
I heard on NPR today that the Supreme Court is hearing a case related to an appeal that the drug cocktail used in lethal injection is Cruel and Inhuman Punishment.

Perhaps they should change the substance to an extra large dose of pure heroin. The executees could then enjoy at least the end of their life, the justice system could unload some confiscated contraband, and for convicts involved in drug-related murder the punishment would suit the crime.
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