Thoughts on Ramadan

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.

The Introverted Thinker and the Extroverted Feeler Deal with Divorce

When my children were eight and thirteen, their parents were getting divorced. It had been a very long process involving hours of counseling and had officially started when they were five and ten. We paid counselors more than lawyers, which is a good thing. My Ex had pushed me to fire my first lawyer and to switch solo counselors. The final straw was when he decided that we needed to switch couples counselors.

“I don’t agree with anything he’s said.” said my future Ex.

I was flabbergasted but really it had been obvious. “We’ve been going to him for OVER A YEAR.”

“Yeah, but he’s on your side. I don’t agree with anything he says. I don’t want to go back to him.”

I found a new counselor and found that I had a new goal while filling out the paperwork: amicable divorce. We did one session with the children. The counselor introduced herself and talked about divorce and said that children often had questions. My extroverted feeler son went first.

“Why are you going to Grandma’s for Christmas, dad?”

Dad began to say that I was being mean to him, but the counselor intervened. “It’s not appropriate for you to tell your son about your disagreements with your spouse.” Dad argued, but the counselor stood firm.

Dad said, “I want to have Christmas with people who love me.”

The extroverted feeler just looked at him. “But we love you, dad.”

Dad stared back at his children. “Yes, you do. I am sorry. Next time I will talk to you before I decide what to do.”

My introverted thinker daughter went second.

“Mom, if you get divorced and daddy moves away, and if Auntie’s cancer comes back and you go to take care of her, who will take care of us?”

I think all the adults were stunned by the complexity of that question from an eight year old. I had left the children with their dad to go to take care of my sister for the week before her mastectomy over a year before. It was the longest I had ever been away from my children.

I replied. “If Auntie’s cancer comes back then I will not leave you to take care of her. Either she will have to come here to be taken care of or I will take you with me.”

That was it. She had only one question. She was quite clearly satisfied with the answer. I thought the counselor was amazing to make them feel safe enough to ask a big question.

Previously published on some obscure place on the internet 11/2/09.

The extroverted feeler and the teacher

For the Ragtag Daily Prompt: brace.

My sister was an extroverted feeler.

In fourth grade, she started getting sick a lot. My mother noticed a pattern. My sister was sick on Monday. She was avoiding school like crazy.

My parents were having difficulty figuring it out. EF’s grades were great. She was unhappy.

Then my parents went to a parent teacher conference.

My mother told this story: “The teacher said that EF came to her desk and asked to borrow a paper clip. Later, she came and asked to borrow a second paperclip. The teacher then produced the two paper clips. “Your daughter made braces with the paperclips. For her teeth!” The paperclips were bent.

“Um. Don’t you think that is sort of creative?” asked my mother.

“No.” said the teacher.

My mother would laugh telling the story and say, “After that, I pretty much let EF miss every Monday. I would not have wanted to go to school with that teacher either.”

The extroverted feeler and responsible behavior

My son is an extroverted feeler and my daughter is an introverted thinker.

When he was 12 and she was 7, their father and I were working out the details of a divorce. Their father moved out for a year, moved back in for a year, and now was out again. It had taken me two years of couple’s counseling to decide that yes, we did need to get divorced. Now we were in the year of hammering out the details.

One day he came over and was obnoxious and rude. I got angry and yelled and threw him out. I slammed the door after him. I didn’t usually do that and it felt both good and bad.

The kids were conferring. I wondered if I’d scared them, losing my temper. They both came to me.

“Mom, we don’t want you to yell at dad and make him leave.” said the EF, arms crossed. The IT stood beside him. “And no slamming doors.”

“But he was rude first!” I said, realizing as I said it, uh, lame. And where have I had this conversation before?

“We know that he was rude. But we aren’t talking about him. We are talking about your behavior. We don’t care what he does.” They both looked stern and fierce.

“So I have to behave no matter what he does.” I said. They nodded. “You are right. I apologize for yelling at dad, throwing him out and slamming the door. I need to behave anyhow. That’s what I tell you, right?”

“Yes, mom.” And then they both hugged me to comfort me.

I felt sheepish for behaving badly, but mostly proud. Proud that my kids felt comfortable confronting a misbehaving adult and the one with whom they were living, me. Right after a yelling tantrum, too. And proud that they were giving me back the message that I’d given them for years: I don’t care what the other kid did, that is not acceptable behavior. And overall I felt pretty good that I really had not yelled and slammed doors very often: we’d done the majority of our fighting in the counselor’s office and had tried to make it very clear that it was not the kids’ fault.

The photograph is of my son in Thailand. He was a Rotary Exchange Student, to Trang. I don’t know who took the photograph.

Previously published on everything2.com.