I have been thinking about Ramadan.

Those religions. Judaism, where you don’t eat pork or shellfish. We do know the reasons: trichanosis and food poisoning. And possibly that paralytic shellfish disease: that would be bad, right? People die fast. So pork and shellfish are forbidden.

But Ramadan. I have thought about it for a long time. I think I will do it next year, the diet part. Because I think I have been doing it: in 2012 and 2014 and now. I change my diet to help kill whatever bacteria I have. I go ketotic and the bacteria that require sugar or glucose or fructose can’t grow. It kills them. Quite effectively, since I was sent home after 24 hours of hospital observation when I had strep A pneumonia and sepsis in 2012, after drinking only 4 liters of fluid and putting out ten liters of urine. This is not a good thing. If it goes on, my circulation would collapse, which happens to be the defining symptom of sepsis. Since I did not want my circulation to collapse, I drank 6 liters of water when I got home. With electrolytes and MgS04 because I had a very low potassium and magnesium when I hit the ER. The hosptialist just said that I was bananas in her discharge summary, but she failed to explain the potassium and magnesium and she didn’t even LOOK at the nurses record of the oral intake and urine output. This is not my standard of care. I think one should ALWAYS look at the test results. The usual urine output is up to 2 liters. Ten liters should have stopped her dead in her tracks. Unfortunately I think she had me labeled. Bananas or not, a crazy person can ALSO get pneumonia and sepsis. Really.

She did give me a penicillin shot. Unfortunately it was the dose for strep throat. Not very much penicillin. After I failed to improve from the antibiotics for a couple of days, I thought OH. THERE ARE TONS MORE BACTERIA WHEN IT IS A SYSTEMIC INFECTION. INADEQUATE ANTIBIOTICS. I pulled my sanford guide. For strep A sepsis you are supposed to treat with:

penicillin G 5 million units iv every 6 hours

and clindamycin 3 million units iv every 6 hours. At least, that was the treatment in 2012.

Damn, I thought. Bit hard to do that at home on my own, isn’t it? Now what?

So I called a local pharmacy. I ordered penicillin V 500mg one four times a day and clindamycin 300mg four times a day and then I hunkered down and ate NO CARBOHYDRATES for two weeks.

Penicillin tablets are horse pills and bitter. Yet the first one I put in my mouth, it tasted delicious. Super weird. But my body must have been saying THANK YOU THANK PENICILLIN and released a crazy high dose of dopamine in my brain.

After two weeks I hoped the damn strep would be dead. I took myself out to dinner, feeling like shit, and ordered food. It tasted like heaven, but…..sepsis symptoms once my blood sugar went up. Third spacing fluid. It feels like sand running out of an hourglass as the fluid leaves your arteries and veins. It also causes an instant and terrifying panic attack as your body tries to tell you YOU ARE ABOUT TO DIE GET FLUID HELP HELP HELP.

Which is why sepsis can get misdiagnosed as a panic attack or mania or what the fungk ever. It is by miles one of the most terrifying things I have ever been through.

Survived it. At home. While my fellow docs in my small town whispered about how I was bipolar. A physician’s assistant told me that the internist told her at a party that I am bipolar. Ok, I cried again. He sucks. How the hell does he know? He’s not my doctor.

Another woman doctor said, “I heard about you in a meeting. After all we aren’t really friends.” I didn’t say much. Afterwards I stared at the phone. I thought we were friends. Guess not. And ok, speaking of HIPAA, what the fungk did they say about me in a hospital meeting? Fungk them. Over and over and over, please. Spank them with a HIPAA paddle.

Next I read about strep A sepsis. Gosh, once you get it you are more likely to get it again. Damn. Power of suggestion. I got it again one year to the day from when I found my father dead in his house. Stress, you see. He’d left an out of date will, my sister was dead of cancer, it was written when I was nineteen. I knew what my father wanted. He’d said that I was the only person he know who could handle my sister, so I was the person he wanted to watch over her daughter. But the damn will didn’t SAY that.

So I did what any sensible human would do. I took the stupid will to an attorney and did what he said. So then the interfering family sued the executor (me) on my niece’s behalf. Stupid interfering mean and actually not very bright family. After three rounds, I said give it to her.

Half the estate? said my attorney.

Yes.

But… how do you feel about that?

It’s good for me. I will be done with her and that part of the family. It’s not what my father wanted but my niece clearly doesn’t want me to watch over her. Ok, fine. Give her the money. Never mind that her mother extracted at least 1/3 of the estate before my father died and made him cry. I was pretty pissed at my sister for making our father cry. That is when my father and I started comparing notes on what my sister was doing. It was grim. Anyhow, let the dead lie. Sometimes they do when they are alive, too.

It’s not good for the niece. Handing her that stack of money is thoroughly dangerous. And she’s over 18, so, well. It is on my cousins’ heads, whatever happens.

Long silence. My attorney says: you are a really nice person.

Well? I said. Have you known any cases like this.

Yes, he said reluctantly. A 19 year old. He got half a million dollars. He was dead in five years.

Mmmm hmmm. I said. Well, I wish her the best.

Anyhow, second round of strep A sepsis/pneumonia. And third round of pneumonia. With the hospital physicians for the most part still insisting that I was a liar. I mostly handled it at home though I confess that when I started bleeding from my gums, I got scared and went in. The kale water, vitamin K source, kicked in and it stopped by the time I got there. The ER doctor said that he wouldn’t believe me unless the disseminated intravascular coagulopathy labs were high. They were only a little high, but he broke his word, told me I was nuts and sent me home. He also told me I was dehydrated, which was comic because I’d asked the nurses for a “hat” and urinated 4 liters while I was in the emergency room. I was keeping track. I WOULD have been dehydrated except that I was drinking fluid when he was not looking. My daughter brought in a water bottle and quietly went to fill it. I didn’t trust that moron ER doctor to take care of me if my blood pressure tanked. Stupid man.

Home again home again.

This time they don’t believe me again. This time I think it’s funny. Also I caught it early enough so that I don’t have sepsis, praise to (your deity of choice)! I have been here for 21 years, doing medicine in this town. I was one of the two doctors who took the lead in the opioid overuse crisis. The hospital didn’t break down and train its doctors until 8 years after I started. You’d think they might say, wait, she has weird ideas….. but you know, sometimes they are really GOOD weird ideas.

Back to Ramadan. I think spending a month being ketotic and only drinking water during the day has a purpose. I think that it kills bacteria that require sugar, and also yeast and fungi, and possibly some viruses, too. What is the mechanism for the virus killing? Well, the cells slow their metabolism in ketosis, because the lizard brain thinks that the person is starving. Some systems get shut down, like chronic pain. Acute pain is still on line because WE HAVE TO FIND FOOD. In ketosis, the body burns fat and protein to make just enough glucose to keep the brain alive, and the side product is ketones. If it is the body’s store of fat and protein, well, that is starving, right? The lizard brain can’t tell if it’s an outside source. FIND FOOD so vision is sharper, hearing is more acute. Fast twitch muscles burn too many calories, so they are decreased. The slow twitch are ON so that we can go for miles and miles if need, cross continents… and where did I learn all this? Not from medical school or residency. There was a brilliant article in the Atlantic Monthly, about fasting for over a month to lose weight. He wrote about the history of fasting and fear of it and about… ketosis. Thank you, Atlantic Monthly, your article helped save my life when my doctors would not listen and sent me home to die.

Maybe viruses can’t get into the cell as easily when the cells slow their metabolism. Or, better hypothesis, the cells are slower so they don’t make viruses very well. They are slow. They ought to ride the short bus.

Ramadan 2022 starts April 1, 2022 and ends May 1, 2022.

I think I will start three days early, on March 29. Because I want to end early. Because… something big is happening at the end of that April in 2022.

Blessings.