The writing here is always so positive; why not communicate what goes well, and pass over what doesn't? If I try a terrible tea I would probably not mention it, and mediocre experiences all the less.
Recently I've been through some significant health problems, which I think might be relevant to others in different ways, so I'll break form and talk about that.
Six weeks or so ago I started experiencing pain related to shingles. It took a few days to make that connection, and that was right when I was traveling back to Bangkok from Honolulu, so it took a full week to get that diagnosed and start treatment. That's too long; you are generally in for a month or more of recovery if you get that late a start on treatment. And I was; nearly a month after that the pain had finally mostly dropped out, and I started an experience of chest and shoulder pain concerns that may or may not have been related (per my doctors it wasn't, but the coincidence seems unlikely, given the overlap in symptoms range).
So let's start back with what shingles is, and how it goes, and then move on to the cardio issues, what investigation of that was like, and what it all means (to me; maybe there is no general meaning).
Shingles
Shingles is the experience of skin problems (rash / small blisters), itching, and nerve related pain. It connects with earlier experience of chicken pox, from a long latent virus reactivating in late middle age at times of stress or reduced immune response. I had that. It started with low back pain, moved on to a rash on my leg, and then the pain moved to my leg. You go on antiviral meds for a bit to help with it, but it also has to run its course, and if you get a late start on treatment that will go long, maybe months long.
It expanded what I've ever got around to experiencing of pain. I always had a sense that when others described long term pain experience as profound and awful that I wasn't clear on forms of that. The pain really wasn't that bad; with pain killer medication it was fine. Without it sleep would've been quite problematic. Nerve pain is a strange experience, nothing like a burn or an injury. It runs deep, like a sharp cramp experience, that includes deeper pain effects, that just never stops. My own experience was probably limited. A more intense version would've been truly terrible.
Ramping up rest was one problematic part. That's what got me into that condition, that I was way too busy for a week or two, or a month really, back in Honolulu, setting up my kids' education and life context there. And I kept exercising. Exercise helps my immune response, it seems to me, but without adequate rest it all just crashes.
I tried to rest as much as possible during my shingles treatment, but a few hours of relative inactivity here or there was offset by staying busy just as often, for just as long. Then you always wonder if the balance shouldn't have been different, as pain effects continue on for a few weeks, instead of the week or so that most infections or virus experiences take. But a month later it all mostly cleared, only for something more troubling to start in.
Heart issues
Just as I was finally clearing the last of leg pain, after my skin had cleared, I started experiencing shoulder and back pain, and then chest pain. On the left side too, roughly centered around my heart. At first I wasn't very concerned, oddly, thinking this was just the next phase of the shingles experience. I went back to a skin doctor, a different one, since mine was unavailable that day, who assured me it couldn't connect, and suggested that maybe I'd injured myself while sleeping. I thought that myself at first, as I had about the back pain related to the start of the shingles. But it worsened quickly, and centered more on my heart area.
I ended up seeing a cardiologist, of course; deep chest pain and radiating shoulder, back, and arm problems naturally lead to that. After an initial EKG I did a stress test, a cool experience. They check your heart with a sonogram / ultrasound, and put an EKG on you while you walk on a treadmill, ramping up to an 85% of maximum heart rate. That worked out to 140 beats per minute, an interesting level assessment, to me, since I run, and track that while running. I tend to run in between 135 and 145 bpm, with brief maximum periods of 160. Of course I "aced" that test; they had to keep increasing speed and ramp inclination, until it was at 20% slope, going around 10 mph / 15 kph.
An anomaly turned up, an abnormal reading. I couldn't really place that, and cardiologists seem to not be able to map out everything that potentially might mean. Or maybe they just skip that part, since patients would listen to the worst of that range and think that they're dying. They scheduled a CAT scan, just to check further.
That was a fascinating experience. They don't just put you in that machine, like a giant tube; they use a "contrast media" injection to highlight what isn't getting blood flow in your heart. You feel that course through you, rushing up to your head, then down through the rest of your body. My results came back positive; I'm fine. My doctor seemed a bit dismissive at that point, as if I was somehow making the whole thing up, or overreacting, in spite of me actually feeling chest pain, and the stress test turning up an anomaly on a stress-test EKG.
I ran the next day, of course, based on him saying I could do whatever I wanted, and stress tested myself in a different way, running for 45 minutes (7 km / 4 1/2 miles), half of it around 150 bpm. I'm really ok. Exercise always seems to help me clear health issues; I ran after 7 or 8 days of having Covid initially, and recovered from most symptoms within 12 hours of that experience. That chest pain mostly resolved within 12 hours of running.
Did that issue connect to shingles?
Was it related to shingles? I think so. In researching shingles experience myself it can affect different internal organs, as it had also caused pain in my stomach earlier on. My first skin doctor said that there could be no connection, because it's not on the same "nerve line." But cardiac events and risk are said to be much higher after shingles outbreaks (not just Google AI's input; this is well established in mainstream medical background references, and research studies).
All throughout this experience of course it was problematic for me to second-guess doctor's input related to their conclusions. I thought the chest pain probably connected to shingles, and none of the doctors did. Then it wasn't clear whether it would matter or not. Looking back if I had chest pain related to a coronary blockage that would've been much more serious, and if it was just extra, somewhat mobile pain experience then it wouldn't necessarily mean anything, or be a concern. It had seemed that they should be able to test types and levels of antibodies to get a better feel for what was going on but their approach didn't work out like that. Maybe that could work, or maybe not.
The part about real heart problems, added risk, connecting to shingles is something else. Per what I'd read your risk of having a significant problem goes up by 30%; if you search just a little you'll see that number over and over. So maybe I shouldn't have tested if I would really drop dead, based on running at roughly their computed 100% maximum capacity for nearly half an hour? It was just my normal workout experience, which my doctor had okayed. But probably I shouldn't have did that.
Lessons learned
This is the first time that I've been sick for a month that I can ever remember. Maybe the first time? A flu might run a little long, and Covid took over a week to clear, but that was about it. So it has me re-thinking what longer term illness experience is all about.
At my age, 56, it's odd that I'm experiencing this only now. I feel fortunate to have not had the experience before.
One thing that stood out was that timing of response for medical intervention depends a lot on what you have going on, which may not necessarily relate to severity of symptoms. Shingles you want to start treating right away, within 3 days, if possible, and the skin rash part may not appear in that time-frame. They can test for random pain issues being caused by that using an antibody test, so they can start treatment earlier. But if your low back, or shoulder, experiences a bit of pain that's probably just related to pinching a nerve by sleeping in an odd position. If the pain keeps changing form and location then maybe not.
Chest pain is kind of an odd special case. My wife mentioned how her uncle had limited chest pain, or at least some sensation, then very pronounced pain in his jaw, and then he lost consciousness, all relatively quickly. He had experienced a heart attack. Luckily he lived, but not everyone having that experience does.
During my CAT scan experience they tested if the contrast media injection would work for the test, and found that it wouldn't, on my left side, the one I felt pain in. Later the doctor explained that maybe the vein injection site was only leaking, it wasn't necessarily that I had major blood flow issues. It wasn't comforting though, being there for a test to see if something was seriously wrong with me.
The subject of different types of pain comes up, at different levels, sharp or non-distinct, and in the odd form related to "nerve pain." All pain would be nerve pain, but a subset related to a nerve issue, versus an injury, or other typical cause, can feel unusual, deeper, and pronounced in a different way. They asked if the pain in my chest was like a squeezing effect, and I probably don't know what that's like just yet. It was just a deep, localized, minor and dull pain.
I suppose there is a lot more I could say about medical treatment options or contexts in Bangkok, where I experienced all of this. Back in the US it would have been a lot more complicated, and slower. The cost would have been astronomical. My work health care coverage is great, and treatment costs are moderate in general here anyway.
It brings up the subject of how medical care is a for-profit service industry in different places, in the US and here in Thailand, so how they treat you relates to the profit potential. You being sick is a positive thing for the hospital, and quick recovery or resolution kind of isn't. The hospital I visited, Bumrungrad, the main expat and medical tourism hospital, sells lots of "extra" medical care services, like longevity related treatments, bordering on or overlapping with spa themes. You can buy someone a million baht gift card there ($30k USD, per an ad there), or download their app to manage payments. In general people would probably want to get some limited treatment and get back out of there.
Another tangent; a social media podcaster's case
This leads to considering another person's case, the health issues experienced by Chris Williamson, a podcaster, described here. He has experienced something I think of as mystery illness, for the last year and a half. His version relates to feeling low in energy, with mood impact, and other general malaise symptoms.
My brother, sister, and a close friend have different kinds of hard to interpret conditions; this theme seems more common than ever now. My brother's case might be the most serious, involving lots of mixed health disruption, maybe mostly related to catching a lyme disease case late. That friend might've experienced his condition being triggered through Covid (not "the jab," he had it before that came out). Or he'd had a seemingly genetic condition that included sensitivity to different chemical inputs before that, to artificial fragrances and pollutants, and it could all connect. My sister probably just had hard to interpret and treat digestion issues.
The running theme I'm trying to address here is that although modern medicine can resolve some issues others seem to keep coming up.
Back to Chris Williamson's case he listed what seemed to be 8 or 9 potential causes, including lyme disease, mold contact, liver fluke parasites, and a longer list I'd have to rewatch that video to cite. The specifics of his case weren't the interesting part, it was that someone in the relative peak of health might experience significant decline that they can't identify, even after a year and a half of relatively unlimited, in-depth review.
A doctor's comment stood out to me there (in "the comments," not part of that content): he suggested that it could just be stress related, and that a busy work schedule combined with a busy medical treatment schedule could be compounding his problem. Of course a general audience can't guess about that, but it's an intriguing possibility, that seeking out a lot of seemingly valid health care may be making his problem worse, adding more life stress input, when that could be a main cause.
He didn't mention if he had tried taking a break. It had seemed not. He described his viewer count escalating, and at different points mentioned aspects of his very busy schedule. That complex video, with references and clips in many locations, including those from a half a dozen health care professionals, and a few business associates and friends, would have taken months of input to put together, and maybe a few man-months of effort.
He tells stories, so describing that one in detail would seem a natural step. But there seemed to be an irony to him taking what must have been at least 100 hours of video to tell a story that's probably in part about him being overworked. It has drawn 1.2 million views in 9 days, while an interview with Matthew McConaughey drew less than 800k, in two weeks.
What that one doctor suggested, indirectly, is that maybe we all experience lots of negative health inputs that are simply the background condition we live with. The parasites might be an exception, but viral load, some mold and other contamination contact, sleep disruption, stress, mixed diet inputs, and so on might be completely normal, even in partly negative forms. Adjustments could be positive, but chasing down the last negative health input might be a secondary negative factor. People really need to moderate stress, and get enough rest.
I'm not saying that feeling chest pain is something that people should just accept, or really closely connecting this to my own experiences. But my mother made a good point, that to a very healthy person any random pain might seem anomalous and concerning, while for many people a list of aches and pains may just be a normal background experience. If something new were to hurt that might not seem odd.
Chris Williamson doesn't seem to be overreacting to low energy or a bit of extra pain; as he frames it something is seriously wrong. It would be odd if that's a reaction to long-term stress and being overworked, and something is very off, but it mostly relates to being really busy for years on end.
It made me also consider if maybe there aren't other inputs at play, that are not mentioned in that video. Plenty of people are into "biohacking" now, or at a minimum leaning into something like Adderall (stimulant) use to promote productivity. Many people take a broad stack of supplements, to offset aging, support exercise recovery, limit effects of inflammation, or whatever other goals they pursue. Maybe long term exposure to a mix of inputs finally "caught up" with Chris, and it's hard to walk back their negative effects, or even harder yet to identify what's not working out.
Of course I wish him the best. He's among the best of that kind of information and entertainment source, as I see it. Whether he just needs a long break or if one or two main inputs is a cause I hope he gets it worked out.
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