Chronic Triathlete: Green Hat, Baseball, World

I went to see Dr. Carolyn Britton at Columbia University Hospital in Manhattan yesterday. Dr. Britton is one of (if not the) top female Neurologists in the country and an entirely pleasant and enjoyable person to spend time with. My LLMD, Dr. R, referred me to her after our last meeting with the idea of settling my worries about other neurological issues — MS, ALS, etc. It was well worth the time (and cash out of my pocket).

Riding the Duc all the way up to 168th street from Brooklyn at 9:00am was a bit of a chore, but I had been in Atlanta for the previous 5 days celebrating Thanksgiving with the family. I welcomed a little adrenaline fix to shake off the remnants of my triptophan hangover. However, about halfway up the Westside Highway I started to question the sense of turning up at the neurologist on a motorcycle while complaining of a foggy brain that that refuses to concentrate. There's no disguising my mode of transport. I can't lock my helmet up to leave it with the bike and my "armored" and reflective Rev'it riding jacket uniquely stands out as a little more than just a winter coat.

When I got there I put the jacket over the helmet and sort of carried it behind me. Upon entering the Doctor's office, I sat opposite her with the desk between us and placed everything on the floor out of site. Luckily she didn't seem to notice. After a quick and random laugh about the economy, she pulled out some note paper and we got down to business. I gave her the medium-length rendition of my story and explained to her why, specifically, I was there to see her.

Since day one I've been about 90% confident in my Lyme diagnosis. I'm very sure that it's what's causing my problems, however, after having many doctors confidently tell me that I had everything from Chronic Fatigue Syndrome to clinical depression to... well, nothing... I take everything they say with a grain of salt. I think that if I had responded more significantly to treatment I would be more sold on it, but after 8 months of moderate improvement on oral antibiotics — improvement that, to me, could just be my body slowly taking care of itself — I started to worry that maybe it's Lyme and/or something else entirely that's causing my problems. And since 90% of my symptoms are neurological in nature, none of candidates on the list of possibilities are very appealing.

After really pressing Dr. R to address my concerns he referred me to Dr. Britton. She's not only a very good neurologist, but she's a neurologist that's also done a lot of work with Lyme patients and athletes (she treated Mike Tyson. Does he have a brain?). Columbia University has a strong, active Lyme research group run by Dr. Brian Fallon and she's participated in some of their studies. I think it's fair to say that she's more than Lyme-friendly, she's Lyme-literate; though she doesn't treat Lyme patients in the specific ways that LLMDs do.

She asked me a whole host of questions about my symptoms and then did a basic neurological examination — hammering on me to test my reflexes, sticking me in various places with the business end of a safety-pin and getting me to push, pull, squeeze, rotate and tap my extremities. All things I had done previously with a different neurologist many months ago before my Lyme diagnosis.

In the middle of all this, she asked me to repeat the following words, "green hat, baseball, world" which I excitedly did. I say excitedly because I had just watched the movie, "Super High Me." It's sort of a spoof on "Super Size Me" except the main character (a stand up comedian known for his voracious pot smoking habit) decided, instead of eating McDonalds for 30 days, to smoke weed all day, every day for 30 days. As part of the "experiment" he goes cold turkey for the 30 days leading up to his binge to "clear his system". During this time he works with a doctor to test and benchmark his physical and mental capacities. During the testing the doctor does a little mini psych test on him. He asks the comedian to repeat 3 words — cucumber, boat, wire — after which he distracts him with other simple questions only to later circle back and ask him to repeat the 3 words again. The comedian is stumped and can't remember them. Click here and skip ahead to 7:40 to see the clip.

So, here I am, getting the same test as some half-assed, stoner comedian and I'm determined to not to fuck it up. Green hat, baseball, world. Green hat, baseball, world. Green hat, baseball, world. Over and over I repeat the words in my head while Dr. Britton distracts me with math questions and touch my finger to my nose tasks. Green hat, baseball, world. I'm obsessed with remembering and sure enough, at the end of the examination, as she's waking out of the room and telling me to put my shoes on she turns to ask, "what were those 3 words again?"

"Green hat, baseball, world." I replied.

And that wasn't the only excitement. After the examination she told me that I'm neurologically fine and that she concurs with Dr. R and feels that pursuing my current treatment for Lyme is the correct course of action. She took some blood to rerun my Lyme titers and she wants me to get a SPECT scan. I'm interested to see how the Lyme test comes out. She said that it's important to run it again after being in treatment to see if/how the bands change. The SPECT will be interesting too. As I understand it, the experience of a SPECT is similar to an MRI in that they inject you with some radioactive isotope and scan your head to see where the blood goes... or more importantly doesn't. Apparently there's a blood flow deficientcy pattern that's representative of Lyme patients. Another indicator that strengthens the diagnosis and can be used as a benchmark for recovery.

Additionally, she said she wants me to try and do some sort of exercise every day. She said that much of my recent depression can be attributed to the change in brain chemistry I've experienced in dropping from a 100-125 mile a week endorphin habit down to 15 or 20. I agree. I always feel better, no matter how shitty I felt before, after a run or a ride.

Unfortunately, she had one piece of bad news. She strongly recommended that I go on IV antibiotics. She said that I could try IM shots, but that for neuro symptoms IV is really the best route for ensuring that enough meds get into the central nervous system. I talked about this with Dr. R at my last meeting with him. I've been really resistant to it, but I don't know if there's another option. The orals don't seem to be cutting it and if IMs aren't going to take me all the way, what's the point.

I see Dr. R on the 16th. We're sure to discuss it fully then. I'll post more about it later.