Trying Not to be Captured by the Medical Industrial Complex

One reason why it taken me so long to write this essay was that I was waiting on my current medical system to send me a CD (remember those digital media devices?) of some magnetic resonance images of my brain. I had a doctor’s appointment on March 12 to discuss some of these that were taken in mid-December of last year and so I wanted a copy of my images for my own use (or curiosity) and requested them after the completion of my office visit. The reception lady said that I probably couldn’t see anything without their software but I was naïve enough to think that meant the actual little “movies” we had gone through during the doctor’s appointment and that they must have just some plain old JPEGS or PNGs that I could use. Sadly, I was wrong but it took three plus weeks to get the CD mailed to me and then after I couldn’t find anything useful on it, I gave it to my retired physician brother to see if he could find any useful individual images. Well, it took him some time to dig out an old CD reader and after he checked out the disc, he confirmed that there wasn’t anything that I could use as a still image. I was bummed out but went onto the Internet and in less than 15 minutes I found a generic (more or less) image of what I was looking for and that’s what I’ve included. The overall slowness of the medical system I’ve been involved with is part of the following story and probably isn’t that unique of the current Medical Industrial Complex (MdIC) in the U.S. but that is my assumption and not based on any other empirical evidence. You may (or may not) be wondering why I’ve been talking about magnetic resonance images but we’ll get to that soon enough.

An internet acquired magnetic resonance angiography (MRA) image of the human brain.

I have been a relatively healthy man, now transitioning into past-middle age (at what age does “middle age” end?). By age 61 ½, I had only been hospitalized one time, in 2014 (I think) to have my gallbladder removed after a third attack, and had only one broken bone, my right big (great) toe after a kicking a 8^th grade football blocking device. I also have only been occasionally ill (besides “colds”), I think I can count the number of times that I’ve had true influenza on both of my hands in 50+ years of remembrance so I haven’t “worried” about getting the seasonal flu shot. I have probably carried around an extra 25 to 30 pounds on me most of my adult life for my frame but the extra weight never really slowed me down or impacted my daily life. I don’t have as much physical work stamina at age 60 as I did at say age 30 but generally that is to be expected, you don’t see too many 60+ year old professional athletes, even golf gives older guys a opt out option with a “senior” tour. Thus, I thought I was pretty health at around age 60.

I was 57 when Covid exile started, and yes, my organization kept most of us working from home for two years and two months. I was seeing my health care provider (most of the times a specific physician) in my bedroom town clinic of one of the large “not-for-profit” health care systems (notice I didn’t say “non-profit”, there is a very big difference between the two categories) about once a year. This was my annual “wellness” checkup that was usually towards the end of the year. Our health insurance company gives a $50 “wellness bonus” for having an annual check up so I obliged. I liked my local doctor, probably typical of the “family practice” genre of medicine but he and the clinic were certainly part of their system and I doubt he or they in the clinic would or have “bucked” anything that the “suits” who run their system and the whole Medical Industrial Complex (from now on I’ll use the acronym MdIC) tell them to do. I’m sure he was a generally competent physician but I doubt he would ever research anything fairly novel or certainly not contrarian to the mainstream narrative of MdIC medicine. Anyway, after several years of elevated blood pressure readings (in hindsight, its rather remarkable how few data points health care providers will make decisions on) he decided to put me on a blood pressure med that had been around a good while and when I was a pharmacy technician for about a dozen years in the same system (but before it had really blown up into a much larger organization) I had never heard the pharmacists say either too much yea or nay about the med. So, I said, “Sure, what can it hurt”. I believe that was in 2021 and I don’t even remember him starting me on the lowest dose this particular med comes in but when we checked later my records confirm it.

I went to a couple more wellness visits and my blood pressure readings at the clinic (they never had me record them on a daily basis at home at any point) were staying elevated so my physician cranked my dose up to the next highest amount. I think this was in late 2023. Thus, with maybe four to five sets of blood pressure readings over five years, I went from getting onto a blood pressure med to the middle dose of this particular one. 2023 would be my last “normal” health year.

I should have mentioned earlier that I get ocular migraines. These basically affect my vision for anywhere from 5 to longer than 20 minutes, mostly by having “holes” in my view that morph into a “kaleidoscope” of zigzags or flashing diamonds– I think it would neat to see them if they could be visually captured and then replayed– but these events rarely cause me any pain. And I’m grateful for that because some people have truly debilitating migraines. I don’t like driving through them, although I have, and once, when I was doing a semester as a substitute college instructor, I lectured through one (that was fun 😉) but they are something I can handle. They started in early adulthood and were infrequent but have become more common as I’ve gotten older. When I was still a pharmacy tech and taking meds up to the various hospital units, I ended up talking to a neurologist who had been a Boy Scout with me and he said these ocular migraines really weren’t an eye thing but the brain and optic nerve not getting along and generally trying to “fix” them could cause more problems than it was worth, although this was in the 1990s. Anyway, there has probably been something a bit mis-wired in my brain or perhaps more susceptible to getting mis-wired than in most people. Or maybe it’s totally unrelated to the events that occurred in 2024.

My first seizure came one late Saturday morning in April, 2024 as I was returning from dropping off an eBay sale package at bedroom town’s post office. It was unobserved. My old car, at least then, drips oil after getting parked so I tend to park it on the street in front of our house. I don’t remember me parking and certainly not the seizure itself but I do remember coming into the house, in a groggy state, and going to my recliner to take a nap. I don’t know how long I was in the car during the event but it must have been a good one, my baseball cap ended up in the back seat and it appears that I bit my tongue at least once. My wife and I decided I should see my family practice physician the coming week and after hearing my story, he ordered getting a CAT Scan done on me. The first available opening was actually at the health system’s “children’s hospital” which is on the overall campus but didn’t exist when I was a pharmacy tech there during the 1990s. That test was fairly quick and painless but showed no smoking gun so at the next doctor’s visit a week or so later, he marked my April event down as “temporary global amnesia” (something he said that they were seeing more often) and we continued on with what we had been doing health maintenance wise and the rest of the spring and almost all of the summer went along as normal.

A self-photo of my bruised tongue after my April 2024 event. Sorry for the nose hairs and the coffee/tea-stained teeth (blushing as I write this).

My routine ended Sunday morning, September 15 when my wife woke me up and said, “Get up, we’re going to the ER!” She had just witnessed the last ten minutes or so of my second seizure and being an RN (retired) knew more about medical presentation than I ever did so I got out of bed, got dressed, and we headed into the city, along with my oldest son who just happened to have that Sunday morning off. I didn’t really feel bad, except for being groggy again and I basically didn’t feel like I had woken up any different besides her telling me to get up. We got registered at the ER desk (boy, things had changed, such as way more security, since I used to check for outdated meds in the ER when I was a pharm tech) and I got placed into an ER bay.

They got an IV started and added a bag of “Keppra” (levetiracetam, an anti-seizure med) and monitored me for a while. My wife called my brother to tell him what was going on and he asked if he could talk to the ER doctor when they came to visit with us. The ER doc showed up for the visit– I think he was there briefly ordering the IV and Keppra starts, and we asked him if he could also talk to my brother about the next plans in treatment. He agreed to do a conference call between us, him, and my brother and told us he was going to schedule an MRI to see if there was a brain tumor involved. My brother agreed that was a great first step but also wanted, given I would already be in the MRI tube, to do a MRA as well. The A in that acronym is for “angiography” and is a more specialized MRI that looks at the brain’s vascularization. My brother’s concern was that my seizure could have been caused by a mini stroke and not just neurologic misfiring and other issues. The ER doctor said that they were really busy and didn’t think that a MRA was needed at this point. He had (or would) consult with the neurologist who was on call about adding that test. The ER doc’s view was confirmed by the on-call neurologist (who never came in) and I was off to get just the MRI.

Two, and maybe three, good things came out of my ER visit. The biggest one was that I didn’t have a brain tumor and a more minor one was that I was not overly claustrophobic of being in the MRI tube, although I prefer to keep my eyes closed because is there really a point of looking at white plastic less than six inches in front of your eyes for 15 or so minutes? The third possible good thing is that the ER staff loaded me up on Keppra which may or may not have stopped any future seizures. The ER bill arrived a few weeks later and the “fake” one (the one they base things on but is never real unless you are a poor sucker self-pay patient) was nearly $10,000. Our insurance discounted almost 90% of it and that left less than $350 that we had to pay out of our checking account. I think the tradeoff for finding out that I didn’t have a brain tumor for $350 is probably a pretty good deal. However, that only ruled out one puzzle piece of what had caused my recent (and probably the April) health events.

The next week was a roller coaster of transition. The law in my state is that someone who has had a seizure can’t drive for six months (needs to be seizure free for that length of time), although the ER staff didn’t give me any official paperwork stating that (just verbally) nor did they inform law enforcement of my seizure (which I’m thank for knowing how the Administrative state can get into people’s “business”). Thus, I needed rides to my work place and I was very lucky that two of my colleagues, who had been carpooling, agreed to pick me up at a mostly closed seasonal business parking lot that wasn’t out of their way to the work place and only about five minutes from my wife’s and my house. That Wednesday, I ended up ay my local clinic because the ER staff had given me cellulitis from at least one of their various IV sticks on Sunday and so the nurse practitioner that I saw put me on a course of Augmentin, a combo antibiotic that I’m sure that I’ve had before but is well known for messing up one’s normal gut processes, and sure enough it, along with possibly getting adjusted to taking generic Keppra (500 mg twice a day) pills, my guts were messed up for the next month or so. Finally, that Thursday I may have had another “event” during a normal “walk around the outer corridor” (about 400 meters in total) of my work center that I used do twice day, but when I got about two-thirds of the way through my walk this particular time, I thought I was going to face plant to the carpet and it seemed more pronounced on my left side. I turned around and got back to my office (less than half the distance that I had just walked) ok, took my scheduled pill (which was due), and felt alright the rest of the day. However, this Thursday episode concerned my brother a good amount and was more evidence (perhaps) that some sort of other aspects besides a “regular” epilepsy seizure situation was in play.

The feeling of “face planting” while walking long corridors inside buildings did seem to happen more after September 15, both at work, which had long boring gray painted hallways with almost no other visual stimulus in recent times, and in big box store types of environments. Part of it could be a side effect of Keppra but also my brain may be trying to compensate for my weakening left eye as I walk. I’ve worn corrective lens since I was ten and my left eye has always been weaker than my right eye but even with some new glasses in early 2025 based on a 2024 vision prescription, I think my left eye has gotten weaker and will need a new stronger lens this year. I don’t have that same feeling walking outside with broader horizons and walking a quarter to a half mile later in the fall or over the winter didn’t seem to present the same issue. We’ll see what the eye doc says in early May about how much my left eye has changed in a year’s time.

I actually got to see a neurologist in early November, nearly two full months after my ER visit. She appeared to be a very competent physician but her sub-specialty was more in movement disorders, such as Parkinson’s, and not in seizures. She ran me through a couple of office tests which included various finger coordination movements where I didn’t do as well using my left hand versus my right and watching me walk in the hallway, after which she asked my wife, “Did you know he was a shuffler?”, with my left leg seemingly more announced.

This doctor agreed to have a MRA test done and also wanted to do an ambulatory EEG (Electroencephalogram) that would measure my brain activity over a three-day time period. I had also mentioned my ocular migraines in giving my medical history and she perked up by saying she could prescribe a med that may help those go away. It was another blood pressure med and because my brother’s working theory was that my current blood pressure med may have been involved in my seizures because of a change in “median blood pressure” where it might have gotten too low not to clot in the extremely small arteries and veins in the brain (the brain has no capillaries), I wasn’t overly trilled in adding another prescription to my daily routine. Later on, I found out that one of “nice” side effects of this particular new (but old) drug is that it often causes ED. If the choice was possibly getting rid of an occasional inconvenience migraine versus not being a fully operating adult male, it wasn’t much of a choice to make. The new ‘script got filled and was never used. The nice movement specialist neurologist set me up to see a seizure specialist neurologist in March, five months away.

When we were leaving the neurology clinic and setting up the appointment for the EEG, we were again shocked that this medical system couldn’t get me in until the end of February at the earliest, almost right before I would meet with the seizure specialist. Perhaps it didn’t really matter how long the results were in as long as the next neurologist could read and think about them before they talked to us but the long wait was sort of a gauntlet thrown down in front of my wife and she is persistent in challenging schedules so she started to pester the department in charge of the getting the EEG test done and within 10 days had a new appointment for me in December. It ended up that both the EEG and the MRA tests would done that month.

The loss of my independent mobility was the biggest thing to get used during the fall and winter of 2024 and early 2025. It was the first time in almost 46 years that I couldn’t just jump into a vehicle and drive myself somewhere, except for my sophomore year of college when I didn’t own a car for most of the year. The carpooling with my two colleagues worked out well. We still had the ability to work from home some days and they went in three days a week so I adjusted my schedule to fit theirs, I had been going into the office most days for much of 2023 and 2024. My wife would drive me over to the seasonal business parking lot and await “the girls” (what my wife called them) and most of the time we were waiting only a few minutes for them until they got off of the nearby freeway. My wife or my oldest son would be waiting for me when we got off work and down the hill by around 5 pm. I think my co-workers only had to drop me off at my house one time in six months. A few times, when only one of them drove and maybe had an earlier appointment, I made arrangements for my son to come pick me up “out at the corner” so he didn’t have to hassle going through security to enter my work place, although a couple times just talking to the guards was a fairly easy thing to do to allow him to just drive in to pick me up. I actually liked walking out the corner, about a quarter mile (about 400+ meters) away from the front door. Our winter was basically open (almost no snow) so on a not an overly cold day, it was a good walk for me to head out there, although I wondered what the guard in the “shack” out at the entry point thought when I walked out past them and down another 100 meters or so to wait to get picked up.

For non-work trips, my wife, son, or brother helped me out. This included finishing up the gardening at several places, such as picking and helping Jalapeno sell the last of his tomatoes or the couple of times my son drove us over to “Robert’s” folks farm where I gathered up what Bloody Butcher corn had produced ears resulting from the dry days during the critical July pollination time. Robert’s dad had made the mistake of cutting down the rather pathetic looking corn stalks (certainly no 12 footers in 2024) so kicking through the downed stalks to find good viable red seed ears was an added challenge but First-Born son and I did alright in finding most of them in the end. I don’t know if I ever got used to be chauffeured around but it was mostly good bonding times and I can say with honesty that I only cheated once and did a short drive right before my mid-March neurologist appointment.

My “driver” son with one of the last boxes of Jalapeno’s tomatoes to sell; The same “chauffeur” helping me find viable Bloody Butcher corn ears in October, 2024.

December was the month of tests for me. The first was the MRA which was basically the same, from a patient’s view, as the plain MRI that I had in September. The EEG was a bit more time consuming and “interesting” in that it took 3 days to do, but there was also a good hour of prep time as they wired and wrapped my head up and hooked me up to a box that I could “push the button” on to record the timing of any neurologic event. None occurred but I did end up sleeping upright in my living room chair because I didn’t trust myself moving my head around if laying prone in our bed. At the end of the three days, I pulled the various leads off, rolled them up along with the box, and placed all of it into an envelope to hand into the hospital. This was all the testing that I was going to have until I met with the seizure neurologist in mid-March.

Meanwhile, I had my annual “wellness” appointment at bedroom town clinic the day after Christmas, this time with the nurse practitioner I had seen in September to check out my ER-induced cellulitis. I had started to do only half strength on my blood pressure med and laid out the hypothesis to her that perhaps my higher dose had caused mini strokes that had caused my seizures. She was highly skeptical of that theory and so I challenged her about my brother’s (a retired internal medicine physician) idea of “permissive hypertension” but she didn’t buy that idea either. My diastolic number at the clinic that day (and at home) had been in the mid-80s or so, and I tried to debate her that a 62-year-old man probably shouldn’t be expected to have the same “normal” diastolic as a 25-year-old but she continued to disagree with me. However, she was willing to let me continue on the half dose if I wished, in the end she couldn’t pop the pills into my mouth every day.

A photo of me five days before Christmas, 2024 after removing the leads of my EEG test. The gray spots on my head were the left over “goo” that had kept the leads in place under a gauze wrap.

My discussion with the NP at the end of December prompted me to create my own dataset of my blood pressure readings given that the medical system had made decisions based on less than ten blood pressure readings in five years. Afterall, I used to play a scientist on TV (😉) and used various datasets all the time. I did this for about two months straight, missing only one day, and ended taking daily readings on the morning of my March 12 appointment with the seizure neurologist. I took my BP readings twice in a row, often after I just gotten up but sometimes later on in the mornings, and sometimes after having coffee (which I noted). I usually did half strength of the BP medicine I was on sometime after the readings, a few times the full strength, but for the last two plus weeks, the majority of the days I took no BP med. For the 62 days that I tracked my BP (missing one day), my mean was 137 for systolic and 82 for diastolic, with the highest systolic being 156 (3 times), the last being on February 14, and the lowest being 117 (two times), both coming during the last two plus weeks of data capture. My diastolic highest reading was 100, which surprisingly came on March 10, and the lowest were 67 (2 times), again coming the last two plus weeks of daily readings. I’ve taken my BP readings four more days since March 12, with the mean of those eight readings being 134/82 and on no blood pressure med. The extremes of my systolic was 144 and 126 and of my diastolic 87 and 79. I have also lost about 10 pounds since starting the BP reading test. I’ll roll the dice with the above readings, especially if I lose some more weight.

My appointment with the seizure neurologist wasn’t until March 12 but the preliminary notes from the tests were back in my patient’s digital chart by early in 2025. The MRA had revealed some “small vessel ischemia” in my front temporal lobe and the EEG had detected some abnormal brain waves in the same area. Obviously, something had occurred in that part of my head. The EEG was read by the neurologist I was going to see in six weeks.

I asked my brother to go with me to my seizure neurologist meeting and he came and got me on March 12. I was quite impressed with this physician and she spent a good 45 minutes doing some office tests on me and discussing the whole situation. One of the surprises that came up was when she said that seizures do tend to rise with people in their 60s compared to younger adult decades so I wasn’t out of the norm, although no definitive cause(s) could be determined for my two 2024 seizures. We agreed to keep me on my daily generic Keppra and she would see me back in a year or sooner if needed. She did clear me to drive so my liberation day of being behind the wheel again started later that week. She was the last of the five or so health care providers I had seen since my first seizure 11 months before and the one who best addressed the problem. Maybe that’s the way it was supposed to be or the way it often plays out nowadays. I did find it a bit curious that she asked me why I was taking an 81 mg aspirin once a day? My response was, “Can it hurt?” So it goes.

Overall, I think that the MdIC won’t make much money off of me at this point in my life. 2024 was an interesting year and I hope its not repeated anytime soon. However, it could have been much worse and I’m thankful that we have such medical systems in place, especially for acute things. I just wish that the “suits” (including the insurance companies) didn’t control so much of how its run. Remember back in 2008 and ’09 when “Obama Care” was been discussed and then the “Affordable Care Act” got passed and set into law, one of the main talking points was that health care was 20% of the entire U.S. economy and at that time, the U.S. was the largest economy in the world. That supposed 20% didn’t develop overnight, it had been building for a long time coming, so people shouldn’t be surprised that the “suits” control the overall MdIC, with a few token actual (or former) health care providers in prominent positions to give the various systems the appearance of being controlled by doctors. And maybe as the global population ages (in average age), starting first in the most affluent countries, its part of modern societies that health care will be costly and lucrative all at the same time, whether its run mostly by a government or in some hybrid system that the U.S. has developed. Almost all of us are just along for the ride in one way or the other. The best we can do is be captured the least by the whole process 😊.

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Next time: Go Time for Playing in the Dirt for 2025