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grandalf

I suggest the following:

- Go to the rural coast of Costa Rica

- Every day spend an hour or two swimming in the ocean, surfing, etc.

- Eat only fresh tropical fruit, beans, and rice w/ no added oils, etc.

- Try to run 15-45 minutes per day.

- No coffee, tea, alcohol, etc.

- Minimal sunblock, deodorant, etc.

- Drink > 1 gallon of water each day.

- Do 30 minutes of yoga per day.

- Read for pleasure for 30 minutes per day.

- Plan nice projects/surprises for people you care about. Spend 20 minutes per day thinking about these plans.

Follow this for 3 months. The food will cost < $2 per day and lodging may cost $10-15 per day if you live like one of the locals.

It's your life. Follow these instructions to the letter and I suspect you will feel more healthy and vigorous than ever before.

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Hey Grandalf, while I'm sympathetic to your life-style I think when someone lists a bunch of very serious symptoms that apparently have an underlying clinical cause giving them 'life style advice' that includes traveling to another country and a bunch of mumbo jumbo (plan nice projects/surprises and think about them ?) and to do so for an extended period of time may cause his disease to advance unchecked for another 3 months, which could have some very serious side-effects.

Some of the diseases on the 'more likely' list given the OPs symptoms are progressive and the various stages range from 'mildly unpleasant' to 'fatal'. You probably are not going to treat any of them using fresh fruit and yoga, and to advise someone that says he has 'extreme heat sensitivity' to spend time in Costa Rica makes me think this is advice you did not tailor to the OP so I'm modding you down.

I dislike doing that without giving a reason, I hope you can find yourself in my reasoning why.

A few points in response:

- He's already been to doctors, and if he's asking HN he has probably tried all reasonably probable medical treatments and spoken to at least a few doctors about his concerns/symptom.

- The nutrition regimen I suggested is quite similar to one that is used by some doctors to treat a variety of diseases. Don't underestimate the health impact of the lifestyle stuff I suggested.

- The projects/surprises angle is my version of mild psychotherapy, and if combined with some vigorous physical exercise and good nutrition will put his emotional system in tip top shape. At best, this will help his body heal itself, at worst having the conditions he describes would be very depressing and it would help with that. Planning nice things for others is a surefire way to cheer one's self up.

Generally when you go to a doctor and are otherwise young and healthy and you present with bizarre symptoms they take it VERY seriously. So unless there has been some very poor medical decision making going on he's probably failed all the diagnostic tests for the most severe possible culprits known to his doctors.

And, if I had three months to live I could think of worse ways to spend it then with a few good books enjoying surf and sun, and rewarding my physical body with the sort of pampering few of us ever take the time to undertake. Also, it's generally not all that hot right near the ocean.

Finally, I thing it's important to realize that medical science is just not very good and most medical treatments are scarcely better than placebos. Also, medicine is often very narrowly focused and very rarely advocates nutrition or exercise because typically the 70 year old with a heart problem isn't considered able to make significant lifestyle changes.

You are assuming much based on little information and the risks to the OP if he would follow your advice to the letter are grave, I really don't understand why you are so steadfast in this.

He's already tested positive for at least one disease that is both chronic, severe, progressive and downright (+) dangerous, he's had one anti-biotic treatment for it which did not have the desired result but that does not mean that that option is off the table, merely that he may have a resistant strain of it.

More clinical tests are needed, some of them urgently so.

I'm not a doctor but I know bad advice when I see it and I really wonder whether you are considering the consequences of your actions here.

Please, there is a time and a place to advise people to change their lifestyle, if any of the top contenders of what the OP ails is 'it' then by following your advice you could cause some pretty serious damage. A change of scene will make anybody feel better, for a while. But given his heat sensitivity Costa Rica is about as bad as it gets (I spent three months in Panama last year, the climate is pretty comparable on the coast), that's the last place the OP would be comfortable, unless he parked himself on a local mountain top.

Besides that, he should be finding out what ails him and sooner is better.

Ruling out which diseases are not 'it' is just as important as finding out what it is at this stage and none of that is going to happen lying on the beach. That's just playing ostrich and is eventually going to make the problems worse, not better.

"Follow these instructions to the letter" indeed.

edit:

+ expletive deleted, apologies to those of a sensitive nature that saw it before.

I actually gave this guy different advice a few years ago on Slashdot. At the time, I told him to go to the most prestigious academic medical center in his area and not to trust the average primary care doctors.

So I assume he's done that already. How else do you explain 18 years of going to doctor after doctor without any improvement.

Suppose he'd instead said that he'd been to astrologer after astrologer and found no improvement, in spite of the recent realization of the placement of Mars. You'd probably not tell him to keep trying to find an astrological explanation... so why are you so confident that there is a medical explanation right around the corner?

The body has incredible ability to heal itself. By following my advice (after 18 years of following yours) he may actually stumble upon some information that helps lead toward a solution. For example:

- Maybe he gets no exercise at present because he uses what energy he has for work.

- Maybe he has a rare food sensitivity. If so, eating the diet I suggested may make it much better or much worse. In either case he gains information.

- Going to a relaxing place (CR has the happiest population in the world) will help alleviate all the existential stress he's taken on after 18 years of dealing with this illness.

My suggestions are based on big picture lifestyle approaches that actually do work. Medicine does not even remotely consider suggesting such a therapy because most people could never actually follow it. I predict that if you could do a study where people followed the therapy I proposed you'd find it was more effective than many of the most lauded pharmaceuticals and surgical techniques in use today for a variety of ailments.

There is also the chance that this guy has some exceptionally rare condition that is not even known/understood by medical science. If so my advice would be to just enjoy life as much as possible rather than become a human lab rat.

> I actually gave this guy different advice a few years ago on Slashdot.

I can't tell one anonymous poster from another.

> At the time, I told him to go to the most prestigious academic medical center in his area and not to trust the average primary care doctors.

What changed your mind ?

> So I assume he's done that already.

How can you be sure ? How do you know for sure it is the same person ?

> How else do you explain 18 years of going to doctor after doctor without any improvement.

Mis-diagnosis. Possibly unresponsive to treatment.

Mistakes can and do happen.

> Suppose he'd instead said that he'd been to astrologer after astrologer and found no improvement, in spite of the recent realization of the placement of Mars. You'd probably not tell him to keep trying to find an astrological explanation... so why are you so confident that there is a medical explanation right around the corner?

Because each and every of his symptoms ties in with at least two fairly common and very serious conditions that are in spite of being so common routinely mis-diagnosed and/or mistreated.

> The body has incredible ability to heal itself.

Right, let's use the power of our minds to heal. Some guy not personally known to you comes with a veritable laundry list of symptoms and instead of sticking to tried and true medicine you want him to practice yoga.

> By following my advice (after 18 years of following yours) he may actually stumble upon some information that helps lead toward a solution.

Or he may waste 3 more months on a trajectory that seems to be deteriorating to the point that he's asking total strangers for help. Not that we're going to be able to give him concrete advice, only a very qualified doctor could do that. But instead you advise him to get away from it all.

> - Maybe he gets no exercise at present because he uses what energy he has for work.

> - Maybe he has a rare food sensitivity. If so, eating the diet I suggested may make it much better or much worse. In either case he gains information.

It may be, or it may not be. But changing so many variables at once is never going to give him information, you do that by keeping a diary and slow variation over time so you can isolate a cause.

> - Going to a relaxing place (CR has the happiest population in the world) will help alleviate all the existential stress he's taken on after 18 years of dealing with this illness.

That's great, and I'm sure the Tourist Board of Costa Rica approves of your message. But that's not medical advice.

> My suggestions are based on big picture lifestyle approaches that actually do work. Medicine does not even remotely consider suggesting such a therapy because most people could never actually follow it. I predict that if you could do a study where people followed the therapy I proposed you'd find it was more effective than many of the most lauded pharmaceuticals and surgical techniques in use today for a variety of ailments.

Poppycock. Surgery and medication when needed are effective ways of dealing with a large variety of ailments, and good lifestyle can help you avoid those for a long time.

Lots of people die on an annual basis because of following the well meant advice of quacks that have little knowledge and too much self confidence.

Red flag right there "Medicine does not even remotely consider suggesting such a therapy because most people could never actually follow it", if a change in life style was all that is needed to treat Chron's, Lyme's and a whole pile of other serious diseases you can bet that plenty of people would be following it.

I'm not saying that there are no individuals that would not benefit from changing their lifestyle, but we can't all live in Costa Rica and even some of those that could follow it might end up seriously dead if their conditions are not treated by an application of medical knowledge.

> There is also the chance that this guy has some exceptionally rare condition that is not even known/understood by medical science. If so my advice would be to just enjoy life as much as possible rather than become a human lab rat.

Then say that, and qualify it.

Medicine works if you get athlete's foot or asthma or if you need blood thinners or antibiotics... and occasionally there is a Lorenzo's oil sort of story.

So you're telling this guy to pray to the medical gods that someone will come up with a miracle cure which he can magically ingest in pill form and then go back to a normal life.

This view dramatically oversimplifies the human body. One achieves health by eating a nutritious diet, exercising vigorously, by breathing clean air and drinking clean water and by having a calm and focused mental state. Only then can the body's complex systems function properly.

You fall into the Cartesian trap of mind/body dualism. It's all the same material. If you're not exercising vigorously, eating a superb diet, relishing and enjoying life, and enriching relationships with people you care about you are simply not going to be as well/healthy as you could be.

I imagine the medical technology of the future will actually be machines that twist the patient into yoga poses. Eventually we'll even see machines designed to trigger the adrenaline response of surfing a big wave or fucking a hot person, etc. All in the name of healing.

Don't knock it unless you've lived it. Try it for just 30 days. Eat tropical fruit and rice and beans, exercise a lot, swim in the ocean every day, read for pleasure, plan some surprises.... and then take a moment and observe how you feel.

Since we cannot instantly experience the impact of lifestyle, our brains average our experience and we don't realize how horrible life actually is in our unfit, unhealthy bodies... we have a hunch, though, which is why we define ourselves only on the basis of what is above the neck.

"Red flag right there "Medicine does not even remotely consider suggesting such a therapy because most people could never actually follow it", if a change in life style was all that is needed to treat Chron's, Lyme's and a whole pile of other serious diseases you can bet that plenty of people would be following it."

Wrong. Most people are inherently lazy and lifestyle changes are difficult, all-consuming commitments that a lot of people aren't willing to undertake. Coincidentally, I listened to an intriguing story on NPR (sorry, couldn't find a link) last weekend in which the MD was proposing that depression is a lifestyle disease along the same lines as most cancers, heart disease, and most of the other top killers in the western world. Those things just don't exist in [places like] rural, coastal Costa Rica (or any other aboriginal environ). This isn't to say I wholeheartedly support Grandalf's proposal, but I don't agree that total reliance on the medical establishment is a great idea, either.

My family is fortunate to have a PCP that will call us and say "Here's my latest research [from reading journals, talking to peers & specialists, etc] -- would you like to come in and talk about it?" Even though we often have to wait an hour or more to see her, having this kind of a personal, caring relationship is priceless.

You are correct. Most people don't realize this about how medicine works.

Eating a healthy diet and getting vigorous exercise will cure type 2 diabetes, heart disease, and help with many others. Medicine ignores the early (mostly harmless) incarnations of these and then advocates drug and surgical therapies when it's too late to remedy them via lifestyle.

My answer shows that I have confidence in medical science to do what it can do (which the guy has tried for 18 years) but not to work magic.

I think I'm feeling somewhat in need of this cure, too...

Actually - how does one go to the rural coast of Costa Rica? Do you have any information about that sort of thing?

Just go to Tamarindo first and spend a few days there until you find a slightly more isolated place to go. Tamarindo is touristy but very small and so one does not need to go far to find untouched beaches and very inexpensive lodging.

For about $20 a day all inclusive (shared dorm + 3 square meals) you can volunteer in their national parks for pretty much as long as you want. I did this two summers ago and it was fantastic. At night you pretty much have the whole place to yourself. Highlight was sitting on a bench watching the moonlit Pacific ocean and having an ocelot walk right by me.

You just go. There are very few places in the world you can't just show up and get by with no language skills, knowledge of the area with a very little bit of money.

I was camping on the east coast of Oahu in a free campground one time and met these two brothers in their 70's. One of them had some medical condition, something related to being allergic to "everything". They had tried many things, traveling all over the world, and this location, with the wind coming off the ocean, sleeping in open air, no tent, with a canvas (not plastic) tarp as cover from rain, eating only fresh local foods, was the only thing that worked for him. Who knows, if I was in your shoes, I'd try anything.

We call it the Windward side, not the East Coast. In addition, there is a sewer line running down most of it. It overflows every time it rains too much.

Maybe on Maui, or Kauai, or the "Big Island", but not here.

lol...Placebo effect then maybe! :)

Have a recommendation for finding a place to stay? Is it best to just go down there and figure it out? I have heard the internet is very good down there, do you know? I have been thinking about this for a long time, thanks for the post.

Good advice ...

Lifestyle is THE #1 cause of illness. ESPECIALLY of the type listed here. Detox is the way forward, stop throwing drugs at the problem and trying to put a name on it!!

This advice is fantastic. I think people are too afraid to take drastic changes in their life and this sort of change will offer many peripheral benefits. I plan on writing some articles about this.

In short:

This 3 month change will break your daily routine. People are extremely habitual in their patterns. This individual could be extremely allergic to some mould found in the coffee shop they go daily - and have no way of ever knowing. Basically making this drastic change will force the individual to change their entire life, habits and thinking. Consider it a reboot of your entire system. Reminds me of:

   A novice was trying to fix a broken Lisp machine by turning the power off and on.
    Knight, seeing what the student was doing, spoke sternly: "You cannot fix a machine by just power-cycling it with no understanding of what is going wrong."
    Knight turned the machine off and on.
    The machine worked.

I would suggest a few small modifications to your points. Oils are extremely healthy. I would have copious amounts of vegetable oils in the diet suggested since it contains no other sources of fats. Coffee and tea can be a fantastic natural stimulant with next to zero side effects. They have been used forever. People traveled at high risk across the world to obtain them - they do have some value.

The nutrition advice I gave is still going to be 10% of calories from fat which is plenty. And, it will allow the person to quickly reach a fairly ideal weight, which may help with a variety of other issues.

It's VERY difficult to eat <= 10% of calories from fat, so chances are it would be closer to 20% without any deliberate effort to consume oils.

Also, I love coffee but I advised against it for 3 months because it's a fairly powerful drug and I find that when I quit it my sleep/wake balance is improved...

Fuck, that sounds idyllic.

What's stopping you?

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