Health issues: shingles and cardiac warning signs

 

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.

Shipping rest issue; re-trying a 2007 Bailong Jinggu sheng

I tried a 2007 Bailong Jinggu sheng pu'er not so long ago, an inexpensive version from Chawang Shop, reviewed here.  Part of that review theme was to taste the tea right away, just after getting it, without letting it rest, then to get back to it a month later.  This is that part 2.

I had liked the tea but it seemed a bit subtle, with a generally low intensity that would definitely be seen as a flaw in the character.  But then not letting the tea rest after shipping is said to cause that, which I have noticed before, but never reviewed in the form of doing a split review (like this).  On to it; I never will quote that earlier post, so if someone is interested they can read it too, or there is a summary take on it in the conclusions part.

Review:

First infusion:  a little rough; some dry mushroom and wood / cardboard mustiness.  On the positive side that dry character seems like it will probably fade and transition over the next two rounds.  The appearance of the tea could be a little clearer too, although it's not so cloudy, just not completely clear.  As for flavors beyond that some light molasses sweetness shows promise, and cleaner woody tones seem more positive.

To be clear I've tried this tea between the initial review a month ago and now so I know where this is going to go.  I didn't refer back to the old review notes first, but I have tried this in the last week so it's familiar.  It did improve; I'll mostly leave it at that.  As I remember it seemed like it might have room to transition positively with more age, or at least there was indication that might occur, which I'll add more about along with tasting details.

Second infusion:  much cleaner.  This will be in a more typical part of its cycle next round but it's much more positive that fast, which is a good sign.  I wouldn't interpret this as tasting anything like mushroom, although a woodiness close to aged wood or furniture picked up.  The main range is aromatic wood, cedar or the like.  That's close enough to cigar tobacco; an interpretation as that would also seem natural.

It's relatively clean in taste, although it will probably be even cleaner during the next round.  The main story of this tea will seemingly be how it will keep shifting over the next few years, finishing out age transitioning.  That and how someone relates to that aromatic wood or tobacco range related to personal preference; some people would probably really like that, and others would hate it.

It's my impression that it wouldn't be well-regarded by some experienced sheng enthusiast general convention, but I don't try to prefer what others like.  Such conventions seem to evolve based on both shared-experience preference development (influence within a group), and a natural pattern of preference evolution that occurs, so I'm mostly rejecting the former as important to me, but I must tend to experience the second, to some degree.

Third infusion:  that's even better.  It's completely clean now, with a much improved feel, only a little dry, but more along the lines of showing a pitch-like resin feel.  Tobacco and aromatic wood evolved a small step further towards molasses, matching the warm, rich sweetness and the warm underlying mineral tone.  The resinous feel matches up with a pine-bark woodiness in this round, missing that herbal sharp note in the pine needles but not completely unrelated.

As I remember a distinct lack of intensity was problematic in the first tasting, and that's not the case for this.  I'm using a high proportion (the usual, maybe 8 grams in a 100 ml gaiwan) and quite short infusion times, a bit under 10 seconds.  It's plenty intense at that infusion strength, and would work well using flash infusions at this proportion, or for using only 6 grams for the same timing.

on the green side for this age, normal for relatively dry stored sheng

Fourth infusion:  flavor range shifts a bit towards roasted chestnut, moving off aromatic wood a little.  The feel is nice, with a little room for improvement.  It's not thin but not as substantial as for many sheng versions at this age, with the resinous dryness giving way to a smoother feel, but one with only moderate structure.  Aftertaste is similar; it doesn't linger in a very positive fashion, or for an extended length of time, but the experience doesn't drop away either.

The most positive part of the effect (aside from the limitations) is the way the experience balances together.  The flavor is in a relatively positive range, with no negative aspects.  Intensity is good (reasonable, in a positive range), and feel works for me, even if it could have more richness and depth.  Warm mineral tone is a little towards struck-match character, but bridged between molasses and that; it works.

I get the sense that some of this aged wood, not so far off a greener version of aromatic wood, is close enough to or partly through transitioning to something else.  That fresh edge seems to be what some people value in dryer aged sheng, that it seems to never completely drop out, even though over a long time the sheng will keep transitioning.  I kind of get it; if this tea had spent the last 13 years here in Bangkok it would be relatively completely fermented, but the earthiness would quite likely resemble damp basement character or geosmin (like beets or dirt; with more on that general effect or aspect related to beets here).

Fifth infusion:  balance keeps improving slightly, but it hasn't transitioned so much.  I like the overall effect.  Warm underlying mineral stands out quite a bit, and decent sweetness, with the rest just shifting in relation to proportion of other flavors (pine bark or resin, tobacco, roasted chestnut, molasses, aromatic wood).  Feel isn't really dry, as it had been in the first three rounds, with that remaining more moderate resinous feel matching a seemingly paired flavor coating your tongue, and showing up as feel aspect in the rear sides of your mouth.


Sixth infusion:  this might be fading already, moving back to a slightly drier woody tone that's closer to where it started.  Or it might just be that feel and flavor effect vary by infusion strength, and dropping timing a little doesn't seem to work as well for me.  I'll check one more round and let this go.  Late rounds do tell a different part of the story, and I don't get the sense this is remotely close to the end.  But it seems like enough for this purpose, identifying how it changed due to resting for a month.


Seventh infusion:  I didn't really let this run longer, still trying it infused for around 10 seconds, to keep that consistent.  Intensity may be dropping off slightly but it's far from finished, and isn't into late-round transitions just yet, it would seem.  The same profile applies, not even really shifted in balance much from 2 or 3 rounds ago.  The character transition I had mentioned in the last round did seem to relate to using a slightly shorter infusion time.

Conclusions:

Again the idea was to compare the character to what I thought of it a month ago, reviewed here.

It didn't seem all that different related to flavor and other aspects description, but it did seem a lot more intense in this review session.  I've tried it again in the middle and that was my take then too; it didn't seem as muted as initially.  Feel intensity seemed to pick up a decent amount; per that description and my recollection it was a bit thinner then.  Of course interpretation is hard to pin down; what I've been drinking recently might set a standard benchmark, so whether it's in the better or worse range of what I own might matter.

Beyond flavor intensity ramping up just a little this might have picked up a trace more depth, a little more warm tones and underlying mineral.  This review mentions richness that borders on roasted chestnut, and that earlier version only talked about light cured wood tones, pine resin, and tobacco range.  In late rounds that shifted to root spice range in the first review, but I've dropped taking notes prior to that point here.

Within another year or two those warmer, more complex tones will probably pick up, as the green wood and lighter tobacco notes transition.  Or it could just go to straight tasting like a cigar; it's not as if the transition patterns are that familiar to me yet.  Often even faded flavor in more-aged sheng can pick up a cool root-spice effect, a depth that's not necessarily intense (in terms of flavor) but that seems pleasant anyway.  It's not completely unlike roasted bamboo flavor, mild but with pleasant depth.


It seems like people might use "menthol" in different ways in descriptions (and some even describe themselves doing so), as a way to place what isn't necessarily familiar, or to capture an unusual range that is as much feel as flavor, or in a strange place that relates to both mapped together.  I tend to not interpret aged sheng as tasting like menthol.  It's completely possible that I'm not drinking good enough aged sheng, or that I've not experienced some of the most positive range of potential age transitions.

That's going to keep being a limitation as I progress through more experience.  I won't be buying the standard, well-received, favorably stored $150 aged cakes that draw attention for combining good value and positive character.  My tea budget just isn't there to support that.  For that limitation this almost seems like a good place to leave off most exploration of aged sheng range.  The subject will come up again but all of the most obvious next steps I won't take, escalating quality level and expense of versions.

I really don't mind; it has been interesting to get as far as I have.  I have a bit of tea around, just not much as pu'er enthusiasts go, so I'll keep seeing how it changes over time.  That probably won't relate to doing many "progress check" posts, unless something triggers that.

There's more sheng on the way now, if it ever actually makes it here (transit time is drawing out), and there are always samples as an option, so I'll keep doing reviews.  The general point was more that a typical next-level direction seems to keep coming up, but I don't plan to escalate spending to pursue it.  Cakes like this are nice for enjoying variety and basic range, also covered by a few 2006-range CNNP versions I have, and a good bit of Xiaguan and Dayi cakes and tuos, and an occasional Yunnan Sourcing in-house production cake.

Pandemic theme photo sharing:

On a completely different subject I returned to working in my office (versus from home) at the end of last week.  The pandemic experience was interesting, but we're down to wearing masks a lot, and reducing group activities, with local restaurants facing an odd mix of restrictions that make it hard on them.  Bangkok malls aren't re-opened but that seems next up.  It's been different, and we've been really lucky that impact here has been minimal.  I'll share a few photos that cover what that was like for me.

beating the heat in a kiddie pool

me too

Kalani didn't let being shut in get in the way of looking fabulous

Keoni with a chalk image of me

growing a "pandemic beard" was a nice sub-theme

abstract chalk art

they made it back through a lot of their old toys, with focus on Duplo and also smaller Legos

visiting a grocery store in a closed mall

PPE overkill; I'm walking around like that when out now myself

that cat has mixed feelings about all the extra attention