Propecia and Me

I’ve been losing some hair gradually over the past 10 years. My affected region is the crown, or the top of my head. So with a doctor’s prescription I tried Propecia, or finasteride. I took 1mg of finasteride everyday (almost) for six months. I am well aware of its most conspicuous side effects which include impotence, abnormal sexual function, gynecomastia (male boobs) and other sexual symptoms.

So after subjecting myself to a self guinea pig test, I’d like to report the following symptoms. I did not experience any side effects of the sexual nature. However:

• More hair grew on my crown region
• My scalp was less itchy and less oily
•  No untoward side effect seen until 4th month, where I experienced unusual random muscle twitches and slight muscle pains all over my body. I also experienced pains in my ribcage, leading me to believe I had chest pains
•  Fatigue. I find myself sleeping a lot more than I’m used to. I got tired easily at the end of the day.
•  I did not gain any muscle although I worked my ass off at gym

After the six months I decided to stop treatment. My muscle pains and twitches and fatigue went away. Muscle mass noticeably increased after stopping Propecia, although diet and workout regimen had not changed. No despite what reports indicated, my hair did not immediately fall out. I wouldn’t take Propecia again for more than 3 months in duration given the side effects I encountered.

Helicobacter Pylori

For the longest time, I have always had a bad stomach. I am nauseated easily and my stomach feels bloated even after a small meal. It’s not caused by eating too much, because even after I put my fork down, my abdomen bloats up shortly later. Uncomfortable and debilitating, sometimes it takes hours to subside. The social embarrassment takes much longer.

I blame a few of my panic attacks on bloatedness. A bloated stomach leads to reduced lung capacity with leads to hyperventilation and thus panic attack. Another gastrointestinal related issue was that my stools were black, has the consistency of toothpaste, and could never form any condensed shape. It happens so often recently, I thought of having it examined.

In March this year, taking advantage of a Groupon offer, I went for a regular blood test which this time included a H. Pylori test. The pin prick was more painful than usual, but instead of a clean bill of health, I tested positive for the H. Pylori. It’s something I’ve read about, but my test results was astonishingly multiples of the maximum limit for normal patients. My count for H. Pylori IGG was over 80u/ml while the max limit was 10u/ml. I do not really know what it means, except that I’m probably infected with Helicobacter Pylori bacteria.

The Confounded Bacteria

Helicobacter Pylori is apparently a kind of bacteria, spiral in shape, which lives in the stomach and upper intestine. It attaches itself to my stomach lining and thrives in acidic environment of the stomach which in the past doctors thought nothing could survive.

Symptoms of Helicobacter Pylori infection include:
• Abdominal pains due to peptic ulcers
• Weight loss
• Loss of appetite
• Bloating
• Burping
• Nausea
• Vomiting (vomit may be bloody or look like coffee grounds)
• Black, tarry stools

More Tests

The next test that the doctors recommended was a Urea Breath Test. It’s a pretty simple test, I’m given a pill to swallow, several minutes later, asked to breathe deeply and exhale into a silver balloon bag. A Urea Breath Test is based on the bacteria’s ability to convert urea to ammonia and carbon dioxide. As if it was fated, I was tested positive, by a far margin.

The alternative is an endoscopy, the procedure where they insert a tube with an attached camera and a robotic arm down your throat all the way to the stomach. There they can look for bleeding ulcers, cancerous tumors and maybe take some tissue sample for biopsy. Compared to a Urea Breath Test, the endoscopy was invasive. And luckily I was exempted mainly because I don’t have gastric pains, and because treatment can start with the positive result of the breath test.

Treatment

My two week treatment regiment include a medication called a proton pump inhibitor. This medicine decreases the production of stomach acid, which allows the tissues damaged by the infection to heal, assuming I have ulcers. The proton pump inhibitor is combined with a pair of antibiotics, just in case if the bacteria is immune to one of the antibiotics.

I suffered an awful side effect of the antibiotic one morning, where nausea claim the better half of the day forcing a sick day. After that regimen I continued taking just the proton pump inhibitor for another two weeks. The follow-up appointment was 2 months following that that. On the whole, I was feeling pretty much the same, except the conditions of my stools were improving although still blackish in colour. So I didn’t think I was completely cured, and ready for another positive H. Pylori test.

Cure 

To my complete but pleasant surprise, the Urea Breath Test conducted during my follow-up appointment yielded a zero count, which is positively negative. Over the next few weeks, my digestive tract felt healthier, very few instances of bloatedness and my stools returned to solid and healthy light brown hue. This led to my hypothesis, that I have been developing bleeding ulcers over the past few years, if I had an endoscopy done, it would have shown up.

I don’t know where I contracted the bacteria, but it must have been when I was in school. I suspect I’ve been living with it for decades. Damn you school canteen!

Although the chances are slim, Helicobacter Pylori induced ulcers may develop into stomach cancer. So I feel lucky to have caught it before anything sinister developed. So I urge any of you who have the symptoms of H. Pylori infection to get tested, at least the blood test. It may save your life.

How to Survive a Panic Attack

I’ve had frequent panic attacks or anxiety attacks in my life, and it wasn’t until the last one in 2008 that sent me to the emergency ward that I actually knew that I’ve been having them. All this time I thought I was having a heart attack or a mini stroke or whatever. But it was an unexpected Godsend, because the ER doctor diagnosed me with having the hyperventilation syndrome – a common cause of panic attacks. And despite the embarrassment, panic attacks are 100% survivable, although it may feel like a near death encounter.

People’s reaction to it is terrible to say the least. Some people think you’re socially weird, you get shunned, and some just don’t care. And for something that seems out of your control. Well, it’s time to control it. I’ve learnt how to prevent my hyperventilation induced attacks, but after 27 years I’ve had more than a few episodes. I am sharing six of them below.

One of my earliest panic attacks I could remember was when I was in my baby crib. I must have been 2 or 3, but it’s traumatic enough for me to remember it. I woke up in the middle of the night, my unnerving nightmare dragged into the waking. My perception of reality became distorted. Objects I looked at became large in my mind, and the next, and the next. It made my heart beat fast and hard.  The only thing my parents could do is watch me uneasily sit upright in my crib, anxious for no apparent reason.

Another nightly attack happened many years later. This time the whirring sound of the ceiling fan messed with my dreams. I was actually trying to count the revolutions of the fan. Being a human counter made my heart palpitate, and in my mind I was stuck in a weird obsession with counting up to the millions. That took some time to calm down.

Another attack came when I was at a school assembly when a performance took place. Then it came to a comedic act of some kind, and caught up in it, I was laughing my ass off, with a price. I became short of breath, and dizzy, unable to recover at all. I was carried off to the sick bay by my surrounding classmates. I followed up this episode with a visit to the hospital, gave me an ECG test, I have an irregular heartbeat but was that the cause? Even did an echocardiogram, do I have mitral valve prolapse? Inconclusive.

By then I could identify the common symptoms that characterize a typical attack, heart palpitations, constricted chest which leads me to unknowingly hyperventilate, tingles and numbness in my fingers and toes (and eventually arms and legs whole) and dizziness which can almost lead to fainting. Sometimes I may have mental obsession on some issue and a distorted sense of reality, but not always.

One night, during a mamak stall dinner with friends (which I don’t really like) , I was drinking the teh tarik and chatting. Soon I slid into another attack, this time I heeded some advice about putting my legs between my legs to get more blood into my brain. But it didn’t work. Another embarrassing episode in front of friends, no wonder they don’t call me. This time I went to hospital again, I got an electroencephalogram (EEG) test. This is the test where they glue electrodes to your scalp and measure your brainwaves; they can really tell if your eyes are open, you know. But this test said I was perfectly normal.

The reaction to this next incident was just plain insensitive. I was in Form 4 and I had a terrible case stage fright when my English teacher made me read out a story essay I had written to the whole class, my judgemental class. I got the numbness and tingles fast. “Oooh he’s numb now.”  Soon the chest constrictions came. My teacher had the nerve to make fun of my condition. I went back to my seat, while someone else read my story. My stage fright led me to a partial panic attack and loads of embarrassment. But over the years, I learnt how to control my stage fright, so no worries.

My last and hopefully final bout with panic attacks happened during a team dinner with colleagues. I ate a bit more than usual, and was bloated by the end of dinner. Then it came with all the usual symptoms, but this time in front of all my colleagues. I was crying out things like “Is my heart still beating?” “I feel faint” while lying flat in the car park. My boss and a couple of colleagues drove me to a clinic which then sent me to the hospital. They gave me a drip, and recovered slowly after. You see, we were supposed to have a teleconference with people on the other side of the world. And they had to cancel because of me. And when the doctor said I had a panic attack, mercilessly, my colleagues laughed their heads off. I was the joke for the whole year after that. 

But that visit to the emergency ward was a blessing in disguise. Their treatment for panic attacks involves breathing out of a paper or plastic bag. When a panic attack takes place, in my case, there is apparently excessive oxygen in my blood and low CO2 as I was hyperventilating. To counter that, breathing out of paper bag lowers the amount of oxygen taken in, and would relieve the symptoms. But using a paper bag is terribly embarrassing in public. So the best way, when you feel the onset of a panic attack, is to BREATHE SLOWLY AND Deeply and FOCUS on SOMETHING TANGIBLE, hold it even, in case the giddiness is too much. But emphasize on the slow breathing, your heart may be racing but you must breathe slowly.

Now the only panic attacks I fear are the ones that come in my sleep, because those, I cannot control. Make sure that it is not caused by asthma, or heart problems first. Check with your doctor first. Panic attacks tainted my childhood and my social life with many unwanted and unnecessary traumatic episodes. So I sincerely hope that my advice can help you end your struggles with panic attacks once and for all.