Sometimes when people get disenchanted with the capitalist system and its inherent unsustainability, you'll hear someone say something like, "Before too long they'll be charging us for the air we breathe!" I've said before, a few times in these pages, that with the absolute screwing we line up to get from our various (but not various enough) telecom providers, the air is already being sold to us. Twice now, once last December in Sokcho and once yesterday I have felt like I may have forgotten to pay my air bill.
Those were my last two colds. While in Sokcho working for the scam school there I lived in the dorms. One night, the second or maybe third night of a cold, I woke up in my bed unable to breathe. I felt like one of the three companies in Korea that control the air, SK Telecom, KT, or LG, had found me delinquent in payment and shut off my air. I jumped out of bed to get upright, tried to concentrate on breathing while at the same time as suppressing the panic of suffocation, and take a very small breath which I used to cough. That cough got some of the crud that was blocking my lungs out so I could take a bigger breath. Then another cough and soon I was breathing again. During the coughing there was a period of dizziness and I saw a few stars but I didn't pass out. If I had, I would have fallen to the floor where I would have been in a lying down position and could conceivably have died.
The reason I immediately jumped out of bed, and the reason I say I could have died in a lying down position is reflux. GERD, excessive stomach acid, whatever. I've had it virtually my whole life. Burping in the trunk of a car while sneaking into a drive-in movie and stinking out the whole vehicle. An amusing anecdote courtesy of my gastrointestinal weakness. In my university days my girlfriend used to lay with her head on my stomach (my ripped 6-pack abs) and listen to all the action going on inside. Even in my tip top physical shape I had stomach issues. Over the years they've gotten worse but I'd say that I fit into the pattern that is pretty widespread: stomach acid problems have been on the rise. In the 70's, 80's, and 90's GERD (Gastroesophageal Reflux Disease) went up by half in western nations. I was just a part of that half. From the 90's to 2021 it doubled again and today there are over a billion people who suffer from GERD. Considered rare 35 years ago it's now the most common upper gastrointestinal disorder. Why?
Well the reason I brought up my super conditioning in the previous paragraph is the belief some people have that it's caused by obesity. The increase in obesity and the pressure it puts on the stomach causing acids to back up through the esophagus is impossible to discount, but it's not the only reason. Other changes in lifestyle have contributed as much. Our love of highly processed food, carbonated beverages, alcohol, late night eating, larger portion sizes, and some other factors come into play. As do modern chronic stress levels. There's even a bacteria, a good bacteria, that modern hygiene and antibiotics have killed. The H. Pylori bacteria used to damage the stomach's ability to produce acid. We inadvertently sanitized it out of our lives and replaced it with increased stomach acid.
It doesn't sound like too complicated a problem to solve, does it? Re-introduce H. Pylori, inhibit the proton-pump from pumping so much acid into our stomachs, regulate the overprocessing in the food and beverage industries... Oh now hold on there! They're just trying to make a buck. To regulate them would be unfair, wouldn't it?
Well, as you might expect, if you track the increase in GERD and its parallel rise in obesity, guess what else has risen right along side of them. Overprocessing. I don't think people realize exactly what this can mean. Using industrial fats, refined grains and sugars, genetically modified frankenfoods isn't the only thing we mean when talking about overprocessing. It's a bit more devious than that. One example is what is called "vanishing caloric density," which helps food break down faster so more of it can bypass fullness cues our bodies give us. That's right, food companies are making us eat more. So that accounts for a bit of the extra obesity... and stomach acid... and GERD. It also directly parallels the rise in type 2 diabetes.
Add to this the dramatic cultural changes like most women now working, inflation so bad that even WITH double income it's hard for families to make ends meet, brilliant consumerism technique advancement to make us NEED the latest Iphone or whatever, and the bazillion other things that add to general stress levels and, if any or all of them were contagious, you'd have a virtual pandemic in gut health/weight/diabetes. But they're only socially contagious so we can't call it that.
As tough as it is to tackle this problem by fighting the food and beverage industries, there is another massive industry that, by no coincidence, is profiting from all of this: Big Pharma. Why is it so tough for the medical industry to make a pill that regulates stomach acid? Is there a really great proton pump inhibitor out there? Oh there are dozens of pills that lower it for a while and there are some that need to be taken permanently, but I have yet to find a pill that works for me. I believe there is, and probably has been for a long time, a pill that can work for anyone. But I doubt it's on the market. The reason it's suppressed is probably because it's dirt cheap. In fact if you made dirt into a pill it might lower stomach acid. This stomach acid thing with all its drugs and procedures to treat it can get expensive. There's a great bit a comedian does about the endoscopy. He says that's when the doctors put you to sleep and they put a tube with a camera on it down your throat and look around your internal organs to see if they can find $3,000 in there.
How many of us have successfully gotten a doctor to prescribe a "prazole" or a proton pump prohibitor without having to go through one of these first? Every time I bring up my reflux to a doctor he/she immediately jumps right to the endoscopy. Those machines don't just pay for themselves! What they're searching for is polyps, blood, ulcers none of which I have or I would have died from them by now. My reflux is not short-term. But you can't reason with the doctors. They think they know your body better than you and they have to play with their expensive toys. I looked it up and there's nothing they can find that will make them say, "Well it's a good thing we did that endoscopy! Now we KNOW we can't give you a PPI (proton pump inhibitor)." But you have to pay the ferryman.
So you get one and the doctor says there's nothing, being sure to add that there COULD HAVE been. Then what do they do? They prescribe a pill. A PPI. Usually people go through several before they find the one that's right for them. I'm on omaprazole now but I stopped taking it cuz it just makes me shit. I wouldn't even believe it WAS omaprazole if not for the other symptom, a symptom a lot of proton pump inhibitors have, it's called RAHS but it's nothing to cheer about. It's rebound acid hypersecretion. That is... when you take these pills, you gotta keep taking them cuz if you stop - bam - even more stomach acid. So you have to take these little things forever. That too can get expensive. But nothing compared to the alternative.
I've already mentioned the link between GERD and diabetes but did you know that everything the pancreas produces is burned off by stomach acid? All the digestive enzymes and insulin just get burned up. When food doesn't get digested properly the body doesn't get the nutrients it craves so guess what it does - it makes you crave more. The previously mentioned "fullness cues" are not just given when the stomach is full. They also depend on sufficient nutrients.
I don't know if Big Pharma is quite this evil... YES they are... but treatment for type 2 diabetes is expensive and it just never ends. I've been undergoing it for about 6 years and in all that time only one of my doctors gave me a pill that stimulates insulin production in my own pancreas. HOW THE FUCK is that possible? And as yet exactly ZERO of them have mentioned this connection between GERD and diabetes even though I told them all about it. Most ignored it while others said I'd need to talk to another doctor who without exception wanted to snake the 3 thousand dollar tube down my throat.
I just need a good GERD drug. I can almost guarantee there's one out there for me. Until I can find that elusive, unicorn doctor that can just fucking prescribe me what I need, things like the following are going to continue to happen to me:
I woke up feeling like shit Oct. 8 but went to work anyway. I had worked security at the Oct. 4 Sarnia card show where the Polish hall was crowded to capacity (300) for hours and pretty full the rest of the time. I was there walking around amongst all the people from 8:30 to 5 and probably caught something from one or more of them. I had been dreading my next cold for a while. In fact just Sept. 27 when I called my brother Jeff on his birthday we were complaining about doctors who don't listen and I told him about the time I nearly died in Korea. I told him already I'd been told by my family doctor, three of his proxy docs (he's never there in person), and my diabetes doctor that I'd need to make an appointment with a doctor to get him/her to make an appointment with a doctor who will give me an endoscopy and THEN (and only then) we can talk about my GERD. I told one of my family doctor's proxy docs about 4 months ago that I need to do that and he said he'll get it arranged. Later on my next visit to my family doc, who again wasn't there, I told a different proxy doc, who said the same thing. On my most recent visit I told yet another proxy doc the whole story of Korea and almost dying there and she said we'll get an appointment set up. That was over a month ago. Still nothing. They keep sending me to Life Labs on the guise that they need to give blood work to a prospective gastrointestinal doc and I keep going but I don't know what becomes of these bloodwork reports. Or all the blood! They take a LOT!
Anyway, I said to Jeff that if I get a cold and can't breathe I may have to just die or go to the hospital cuz the doctors around here are treating my more fashionable problem - the diabetes, but they don't seem interested in the MUCH more serious and life-threatening problem I have. It was just shortly before that cold in Korea last year that I basically gave up trying to sleep lying down. I just wake up, cough, go back to sleep, wake up, cough, go back to sleep, about 30 times a night. It's not good quality sleep to say the least. In fact, when I first got back from Korea I visited Jeff and he told me that when I was sleeping on his couch I was making "muppet noises." That's what he called it. When my airway gets blocked by what my stomach pushes up into it, it makes musical noises in various keys all night.
Anyway anyway, I wasn't sleeping or laying down, I was walking to work Oct. 8 and coughing, wheezing, and making those noises. Luckily it was a vessel shift where I don't have to walk the full patrols, just up and down the dock checking the moorings and such. But I still did a good 12,000 steps during the shift. Normally it's 25,000. I had bought a bottle of Buckley's and it was keeping me from coughing too much, but I had sneezed, blown my nose, and coughed up buckets full of clear liquidy crud during the shift. I knew I wasn't bringing up the good stuff. I wanted thicker, yellow or green stuff and got none. A few times I was talking to people from the ship or to my cross-shift and couldn't get the air out to talk. Many times I tried to unclog my nose or spit and couldn't produce enough air to get the projectile where it was desired. Instead it just ran down my face or nose. Two hours before the end of my shift in my personal record book I wrote "Can hardly breathe." Then when I was relieved at 7 PM Jessica, my relief, was saying that she had the same thing and had trouble breathing.
I had decided to stop by a drug store on the way home and get some kind of expectorant like Mucinex so I could cough up the lumpy crud. I didn't even make it to the drug store. I got to Centennial Park, only a few steps off the Cargill property and was having such a hard time breathing I actually saw a few stars. I thought again of passing out and being in a non-upright position unconscious. It would be the death of me. So I panicked and dialed 9-1-1. As the operator talked to me I was reminded of Malcolm In The Middle. "911 What is your problem?"
That's honestly how I was talking! The ambulance was taking a while and 3 times I had to talk to the operator and RE-describe where I was. "I'm at... Centennial... Park. At... the... sign." "So you're at the intersection there on front street." "No... I'm on... Ex... mouth... Street." I saw the ambulance turn onto Exmouth down the street, then turn OFF Exmouth and go down another street. I called her back after going to the parking lot abutting the park. "I'm in... the Sar... nia... chiroprac... tical par... king lot." Anyway they finally found me and it was two young girls. By the time they got there I noticed I had started breathing a bit better. Probably because I'd stopped walking. But I figured maybe I could get something in an inhaler to clear my lungs like asthmatics use and MAYBE if I'm super lucky I can get a doctor at the hospital to give me something for my GERD.After untucking my uniform, shaving my chest like the 40-year-old virgin, hooking up monitor cables, clamping something to my finger, testing my blood pressure, testing my oxygen, getting my health card and a list of meds, and asking loads of questions, we drove to the hospital. The EMT's were actually good. They figured it was a chest infection, old pneumonia, or reflux complications. They also had me inhale albuterol from an inhaler. It was really slow and made talking difficult but it may have helped. Throughout the whole ambulance ride I sounded like a set of bagpipes but by the time I got to the hospital I was breathing better.
When I got there I HAD to go into a wheelchair. Rules. They checked me in by asking the same questions the girls had already asked. I was doing another 4 hits of albuterol. Might as well get it while I can. Still wheezing and droning though. Then they sent me into a room close to Emerg where I was put on an almost flat table (heavily reclined) and a lady put a bunch more of those stickers on me to which they attach the wires. I think it was an EEG. It was fast. Then I got wheeled to a room. Then I finally met my doctor. I'll call him Dirk Clutter MD. He had some kind of accent I couldn't place. I probably could have figured it out if we talked but all he said was take off the shirt, pants can stay on, put on the gown, we're going to give you a chest x-ray. Then he disappeared. A little while later another lady came in. She was a Filipina I'm pretty sure. She took several vials of blood. Then another lady took me for chest x-rays. I waited quite a while for the doctor to come back. I was all ready to tell him my medical history like I had done with the EMT gals.
I reckon the whole procedure didn't even take two hours. When the doc finally came to the room to talk to me he said, "It's just a virus so we won't need antibiotics. The virus is pushing your lungs together and restricting your air. Here's a script for more albuterol." The pushing lungs together was almost verbatim what I had told the EMT's when they (unlike Dirk Clutter) asked me to describe my symptoms. So I think he talked to them rather than to me.
I said, "Well I've had hundreds of colds, only one was anything like this and that was in Korea last December. That's when my reflux started getting really bad. I can't even sleep lying down any more. The cold complicated by reflux caused the respiratory issues. Are you saying this has nothing to do with my reflux?"
He said, "Nope. They are completely unrelated." Then he started inching his way out of the room. I was saying that I was hoping maybe he'd prescribe a proton pump inhibitor like (and I was looking it up on my phone) ... he was out of the room before I could say, "Prevacid." As he walked down the hall in a voice that was trailing off in volume he said without turning back to look at me, "You'll have to arrange with your family doctor to see a specialist and get an endoscopyyyyyyyy..."
Okay. Well. I sat on the edge of the bed in the "room" which was just one of a few made with curtains in a bigger room. Now what? Do I go somewhere to get this albuterol? Does this hospital have a pharmacy? Can I put my clothes back on? Which way to the exit? What hospital am I even IN? (Cuz remember I was brought to the hospital in an ambulance so I didn't see where we were driving.) I got dressed and went out into the hall looking as confused as I could and an orderly or hospital employee of some sort asked if I needed help. She told me I'd have to find a pharmacy to get the prescription filled but it was 9:30 or 10 PM so that was out. She also directed me to the nearest exit. It took a quick Google Map search but I figured out that I was luckily at the hospital close to my apartment. However, the walk home from that hospital was longer than the walk that had triggered my suffocation. I decided to start walking and if the breathing got too laboured I'd call a cab. Luckily I made it home without passing out on the side of the road.
Hampton et. al. (1975) and Peterson et. al. (1992) are classic evaluations that show medical history alone accounts for 76-83% of final diagnoses. Exams, labs, imaging tests, bloodwork, etc. account for only 9-13% of competent medical diagnoses. In the first paper a physical exam was useful in only 7 out of 80 patients (11.4%) and by getting the patients' medical history alone doctors were able to offer proper diagnoses. It wouldn't have taken me more than a few minutes to offer Dr. Dirk some information that could have improved his diagnosis and helped me considerably more, but he was not interested. He seemed in a hurry. This is the same fast food, assembly line medical treatment I have received from every doctor I've seen here except for Shetty my diabetes doc. I'll be visiting him in 10 days and you can bet I'll tell him this tale. With a bit of luck, he might be able to give me what the vaunted Canadian medical system is too abysmal to manage.
As always, I guess we'll have to wait and see...






