Last Will And Testament of Michael David Crawford, 2019-03-19 ROUGH DRAFT
After my online friend Azuma Hazuki MD suggested I have Agonal Breathing rather than Cheyne-Stokes Respiration
, upon further study I determine that at onset each day typically an hour or two after awakening, I at first experience no C-S but Ataxic Respiration
, eventually to degrade into Agonal Respiration
with Negative Myoclonus.
In the Summer of 2013, I dialed 9-1-1 to request an Ambulance for what at the time I regarded as Brain Seizures, then more recently as Syncope
- Fainting - but now clearly identify as the Negative Myoclonus.
Quite commonly, as I wait sleep in bed even while breathing otherwise normally I just about always experience severe quite-powerful twitches, at times of my entire body. This is Positive Myoclonus.May G-d Have Mercy On My Soul:
[Ataxic Respiration] is caused by damage to the medulla oblongata due to strokes or trauma. It generally indicates a poor prognosis, and usually progresses to complete apnea.
I shall revise this essay as a whole after I get a few hours of the sleep that always brings me sadly temporary relief from my Ataxic Breathing.To Wit:
That I have no Bananas nor the means to obtain them leads me to conclude that I shall die soon.Real Soon.
But do not feel bad for me, as we all must die someday.
Even so, that would totally just have to suck, so you could really help a Brother out were you to treat me to a Banana Split come morning, then a few grand when you get paid so that I can obtain the Professional Nutritional Counseling
that will set right, given that the onset of my Psychosis occurred at the age of eight, in the Spring of my Second Grade when I discovered - and convinced all my friends! - that I could predict the future in my dreams - what by now is my profoundly altered body chemistry.
That I am a Physicist lead me to ultimately conclude that back in the day, I did not experience time in a linear way. I'm no Savant anymore, but my whole entire life since then has been at times kinda weird.That Cheyne-Stokes Respiration is known to the medical community as "The Death Breath" has led to my being completely unable to convince a Physician to test my Blood Serum Potassium despite that Hypokalemia is a well-known cause of it.
If you've ever been by the side of a dear friend or loved one when their Brief Tick on The Material Plane timed-out, quite likely they were "Stoking" during their Final Hours.
Over the space of a couple of minutes my breathing gradually slows, as well as becoming increasingly shallow. This leads me at first to feel quite nice, as that same breathing occurs when one is drifting off to sleep, but upon my blood becoming Acidic due to its increasing concentrations of Carbon Dioxide, my Autonomic Nervous System's Central Chemoreceptors
advise my Brain's Medulla Oblongata of my blood's excessive Ph with my Peripheral Chemoreceptors reporting my blood's abnormally high Partial Pressure of CO2.
That leaves me gasping for breath; when I really do want to drift off to sleep that jolts me awake. Thus among my life's great many agonies is Chronic Insomnia.Our Brain Stem - the Medulla Oblongata as well as the Pons - is our very most-important part in that it controls Respiration, Blood Circulation and Digestion.
For my Brain Stem to Totally Go South would thus give me A Really Bad Hair Day.
While I do have the Washington Apple Health Plan - Medicaid - I grow increasingly concerned that I'll drop dead before I can obtain an appointment with my Primary Care Physician, let alone obtain the tests required, mostly of Blood Serum Electrolytes as well as of Vitamins.
Vitamins because for example such Vitamin B12 Deficiencies
as the Pernicious Anemia
that killed my Great-Grandfather Speelmon often cause quite-severe Brain Damage:
During the Winter of '12-'14 while chatting with one of the staff at the Portland Rescue Mission, he interrupted me to ask, "Mike - did you just say 'Insight'?"
"You actually said something else, but I could tell you meant Insight."
Not long after, I was puzzled upon re-reading that morning Kuro5hin Diary that I'd written "I liked Caltech because they had Sushi there". As an Institution Of Higher Learning, we were doing pretty good to dine on Chicken Pucks, while at the time I was in Pasadena, I did not eat Sushi as I regarded the consumption of raw flesh as Morally Reprehensible.
My Expressive Aphasia - in each of my speech and my writing - while uncommon at first, during 2018 become so frequent and so severe as to for me to go to the ER on five separate occasions - three by Ambulance - as well as to convince the entire staffs there that I was experiencing a Stroke or Brain Hemorrhage, or that I had a Brain Tumour.
Despite that, four CT Scans, an MRI, and numerous Blood, Urine and Stroke Tests - Physical Exams to determine my body's Assymetry as for example shrugging both my shoulders, raising both my eyebrows and squeezing my examiners fingers with both of my hands - always turned up normal!That's just not right.
That last time in the Emergency Room I was finally referred to a real Neurologist, the uncommonly-astute Dr. Anne M. Hamburg
of PeaceHealth Southwest's Outpatient Clinic. Dr. Hamburg at first suggested Vitamin B12 Anemia but ruled it out after the Methylmalonic Acid Blood Level she ordered turned up normal, despite that the Methylmalonic Acid Test turns up roughly ten percent each of False Positives and False Negatives.
At the one appointment I've had so far with her, she as well ordered quite a thorough Electroencephalograph - "Brain Wave" - Test, that I had in late December. I expect that will confirm my own self-diagnosis of Temporal Lobe Epilepsy, but my most-desperate hope is that it will yield insight into my Stoking.
But even so, Neurologists are busy people: if you need a Neurologist, you NEED a Neurologist. Thus I won't receive Dr. Hamburg's EEG Report until April 1st, two weeks hence. Doubtlessly, I shall have to similarly wait for months for my next consultation after that.
While every Brain Doctor knows from Malnutrition, Nutrient Deficiencies are often complex and difficult to diagnose, and thus require specialists: the definitive test for all forms of Vitamin B12 Anemia is a painful and somewhat expensive Bone Marrow Biopsy, in which a Pathologist inspects under a Microscope the Marrow's Stem Cells and young Erithrocytes - or Red Blood Cells - for malformations.
While required by all of our Cells, B12 Anemia strikes our Erithrocytes first and most-severely as the Red Blood Cells are our body's shortest-lived, at but forty days.
While Cobalamin is among our most-vital nutrients, as it's required for our Cells to transcribe our DNA into the chains of Amino Acids of which our Proteins and Enzymes are composed, we require such tiny amounts - the US Recommended Daily Allowance is 2.4 Micrograms
- that it is in reality exceedingly difficult to diagnose Vitamin B12 Anemia, though quite miraculously easy to treat
, at first through "Liver Therapy" - just eat lots of it, raw! - but now by regular Methylcobalamin Injections.
Methylcobalamin is found in meat, seafood, eggs and such cultured
milk as yogurt and kefir, but not at all in any plant nor fungus.
Thus Strict Vegans who are unaware they must take daily Methylcobalamin Tablets
often suffer quite-severe Brain Damage too.
To the best of my knowledge, Methylcobalamin cannot be synthesized in a Chemical Plant, not Economically so anyway, thought it can be cultured, as it is a secretion of certain Bacteria. Thus the "Vitamin B12" found in common Multivitamins and Fortified Foods is the readily-manufactured Cyanocobalamin, two percent of which is released into our Bloodstream as Cobalamin by the Liver.
(Quite cool is that Hydroxocobalamin is a powerfully-effective Antidote for the powerfully-toxic Hydrogen Cyanide!
I am happy to report that my already tested-for quite-severe Vitamin D Malabsorption is readily treated by a regular regimen of twelve clams for fifteen minutes in a Tanning Bed!
Commencing with a Petit-Mal ("Little-Bad") Seizure in May of 2010 in which I quite suddenly and completely out of nowhere suffered such profound memory loss that my own experience was if G-d Almighty said "Let There Be Mike!" - with the result that the entire Universe sprang into being with me behind the wheel of an automobile, with no clue as to who's car I was driving, where I had come from, where I was going, nor even what my own name was!
While I have since recovered the memory of writing a http://www.kuro5hin.org/story/2010/3/7/02928/54028
">Kuro5hin Diary - but not of actually posting it - as well as have been pulled over by the Oregon State Patrol for a busted taillight - but not cited! - despite that I quite clearly recall that I wrote that Diary while seated at a table at the Medford, Oregon Shari's Restaurant And Pies
, in by now almost nine years I have no memory of arriving there, being seated by the waitress, or ordering, of eating my meal nor of paying for it.For all I know it was Dine And Ditch.
While uncertain, that Stoking causes Fatigue suggests that I've experienced it since 2005, when several times a day - and for the entire time since: Fourteen Years!
- it's not been as Frank Herbert so astutely observed in his novel "Dune" that "Fear Is The Mind Killer" but for me, Fatigue is, in that when I suffer An Attack Of The Wearies I have no choice but to lie in bed quietly until the feeling passes.
Coffee Doesn't Help.Neither Does Sleep.
I am certain that it was Cheyne-Stokes Respirations during the Summer of 2013, when I called for an Ambulance after repeatedly Fainting - Clinically "Syncope" - in Old Town Portland's Backspace Cafe. My Attending Physician at Legacy Emmanuel's Emergency Room diagnosed me as a Non-Compliant Bipolar - I was not, and so remain puzzled - then prescribed Ativan, a powerful sedative, so I could sleep.
Upon my awakening I was discharged with no followup referral.
My name is Michael David Crawford. That some Americans name their daughters "Misha" or "Sasha" cause no end of confusion to the Slavic Peoples: "Mikhail" or "Aleksander".
- a Physicist
(Ricketts House - I'm an "Old Scurve")
-- the University Of California Santa Cruz
- a Software Engineer
- largely self-taught
- an Electrical Engineer
- self-taught as well
- a Writer - Caltech Literature
(yes, really!) of...
-- Non-Fiction Essays
-- Technical Articles
-- Experimental Fiction
-- Semifictional Novels
That I'm such a smart guy would lead most to figure I would earn good money through my work, and there have been times that I've done so, but as in my actual experience, not only does money not purchase happiness, to be well-to-do often results in one failing to aid those who are Cold , Hungry
or - as I - Insane
That I Swore A Vow Of Poverty in 2009 that I may Serve The Public
- mostly through my Writing - turned out to put me in this awful fix.
Upon experiencing quite severe Respiratory Distress around two in the morning on Tuesday, the fifth of this month, I called 9-1-1 to request an Ambulance.
Being so severely Mentally Ill and thus having their Frequent Flyer Card, American Medical Response's
Emergency Medical Technicians have always been Real Gems to me, but the hospital's Triage Nurse made plain she regarded me as a Hypochondriac and so demanded I go out to the Waiting Room, whereas my Emergency Room Nurse was openly hostile!Surely there is some reason?
While my Attending Physician there at Vancouver, Washington's PeaceHealth Southwest Emergency Room quite reluctantly agreed to test me for the Hyponatremia that for me, as a profoundly Mentally Ill man is chronic due to the raging, unquenchable thirst not of Diabetes but of Psychogenic Polydipsia or "Water Toxicity" - quite a poorly-understood and so as-yet untreatable symptom
of my Bipolar-Type Schizoaffective Disorder
as well as Schizophrenia, despite his promise to do so he did not order a Hypokalemia test!That does not make a whole lot of sense:
The single-most vital Chemical Element required for human survival is not by any means Oxygen, but Sodium with Potassium closely following. Most of us can survive - unharmed - without Oxygen for four minutes. But One Second
not without Sodium, but merely modestly depleted Sodium will strike us dead of Cardiac Arrest
; similarly for depleted Potassium.
The Partial Federal Government Shutdown led as well to the cutoff of all Federal Benefits. Our President, fearing the loss of his base's support ordered that February's USDA Supplemental Nutrition Assistance Program Benefits - "Food Stamps" - be issued on January 20th. I myself feared that March's Food Stamps would never come so I bought no fresh fruit nor vegetables, rather I stockpiled such nonperishables as beans, rice and pasta, canned foods as the diced tomatoes for my own special pasta sauce recipe - try this yourself, it rocks! - and frozen foods as ground beef.
"So no Bananas. What's so special about Bananas?"Potassium!
Bananas have been a staple in my diet since fellow "Kuron" - or Kuro5hin Member - and Buffalo, New York Emergency Room Resident "mariah kills chickens" (dissecting them rather, so as to obtain entrance to her Pre-Med Studies) diagnosed my Psychogenic Polydipsia the day after she treated a Schizophrenic man who quite desperately, urgently and repeatedly demanded he be permitted to Urinate, which in the Emergency Room may not be easy to facilitate.
Dr. Kills Chickens was by then intimately familiar with my own Bipolar-Type Schizoaffective Disorder, so called because it's much like having Manic-Depression and Schizophrenia, I used to say "at the same time", rather they're independent of each other, in that the symptoms I share with those who suffer Bipolar-Affective Disorder
as well as those of Schizophrenia
For their symptoms to be "Co-Incident" - for Mania or the most-severe Depression to as well cause Psychosis - is Bipolar Affective Disorder With Psychotic Features.
As you would expect, because one must be observed by a Mental Health Professional over a period of at least a few months, it's largely impossible to distinguish them in an Inpatient Psychiatric Unit.
Even so, we all take the very same Happy Pills, in my own case the Antipsychotic Trilafon (perphenazine) and for each of Bipolar Mania as well as the Seizures of what by now I am quite certain is Temporal Lobe Epilepsy, as TLE usually causes such Hypergraphic Writing such as This Gem Right Here, the Mood Stabilizer and Anticonvulsant Trileptal (oxcarbazepine).
(Following the discovery in I think the late eighties that the Anticonvulsant Tegretol (carbamazepine) was as well efficacious for the treatment of active Mania as well as its prevention, there followed quickly an explosion in the treatment options available to Wingnuts like me. While not all Anticonvulsants are also Mood Stabilizers - to the best of my knowledge, Dilantin is not - most of them are!)
That it's been by now two solid months since I've eaten so much as one Banana has left me, I am convinced with Hypokalemia, thus leading me to fear Imminent Death.
"An entire bunch of bananas is a dollar sixty-nine, seventy-nine for organic," you quite reasonably protest. "But a hundred grand?"
Bananas so I can survive to see the Sun rise tomorrow.One hundred thousand so I can put a permanent end to this.
With your kind help, I shall seek diagnosis and treatment as an inpatient at such a top Teaching Hospital as Portland's Oregon Health & Sciences University
, Palo Alto, California's Stanford Medical Center
, Boston's Massachussetts General Hospital,
Rochester, Minnesota's Mayo Clinic
or the University Of California San Francisco,
which teaches naught but Medicine.One Last Word:
As an Engineer, I Solve Problems
As a Scientist, I elucidate the impenetrably inflexible frameworks within which such Solutions must be arrived at as well as with which they must be implemented.
As a Madman, I want to Stop The Madness
As I Writer
, I shall do all three by using some of your kind contributions to self-publish a popularly-accessible account of my experiences since the onset of The Wearies in 2005, each of my above experiences since then but in far more detail as well as through - I Pray To G-d Almighty Himself! - my diagnosis, treatment and long hoped-for cure.
Said book I shall publish under the Creative Commons Attribution-NoDerivatives 4.0 International License - no Derivative Works as it will relate my own experience, Attribution so as to finally obtain my long hoped-for Nobel Prize - Medicine Or Physiology would set me up just right, it need not actually be Physics.
But not the "NonCommercial
" variant of said License, in that once I publish my original text on my website - I expect in DocBook XML Markup,
conceptually similar to the Web's HTML, but for Technical Publications - any publisher may reprint it, without paying me nor so much as requesting my permission to republish it.
And when I do, I shall return to the Emergency Room at Vancouver, Washington's PeaceHealth Southwest General Hospital, where I shall hand-deliver three copies of my Hot Off The Presses Memoire of Bad Doctor Syndrome...... With Great Force!
Thank You For Your Attention, And For Your Great Kindness.
Mad Doctor Mike Crawford, BA Physics
Saturday, March 16, 2019
"He's not really
a Doctor, just a sort
of a Doctor."
-- Charles Kelly "Chuck" Lundquist