This is a feature series writeup disclosing who I am, my background, industry bread & butter ~ as well as challenges I carry years past, present and on-going so long as this concept initiative remains standing.

I am not writing this out of mere pity-seeking. Rather as obliged transparency.

In this first part, my health condition. Specifically only for this section ~ Anyklosing Spondylitis.

WIP / work in progress piece and subject to revision overtime for readability and/or revising of details.   

Live-it-forward, AW.

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One Paragraph Summary.

Throughout 2012-2014 ~ I succumbed all sorts of unexplained, difficult to trace pains. Chiefly lower back mobility(s), on top ofindigestion, persistent encumbrances, anxiety, stomach butterflies, and gut distensions. But the worst of it all ~ in 2014 I had my very first “real” injury on my lower back, following compound exercise prompting several consults in-between GPs, Chiropractor, and pain/inflammation specialist. At the end, amidst expensive MRI scans and rounds of drugs prescriptions (that which luckily I had the chance to refuse) - came upon realisation that I had a “minor” disc degeneration (on the L4/5/S1 to be precise). I then quickly entrust institutional faith(s). Going through one blood test after another, one chiropractor after another, and one “specialist” after another. Having spent the nearest thousandth of dollar, my neurologist called me in soon after I had my MRI that I potentially have Ankylosing Spondylitis evidently through recent blood test returning with HLA-B27 positive genetic expression. My knowledge surrounding this and nutrition back then were obviously lacking, as these were all news. But slowly and cumulatively I paced myself to learn what I could, as I simultaneously learn likewise the long and arduous recovery process  each time my L4/5/S1 disc flared again. Fast forward seven years+ later (and onwards) - I feel blessed to this day to ably mitigate but not fully cure this auto immune condition. Plenty of months and/or even years at times that I even “forgot” I had any pains. Adopting a life full of scientific scrutiny, mainly surrounding nutritional protocols namely Cyclical keto / low carbohydrate with weekday intermittent fasting and revising my own exercise routines conscious towards exhaustive productivity not intensity ~ all led me at least happily to where I am today that I can happily pass each day to sleep well, than I were to be bed-ridden days on end.

Overview of AS

AS or short for Ankylosing Spondylitis, as one may be aware is an increasingly recognised autoimmune condition gaining traction amidst general literatures. Though sadly not yet to the reach of public or mainstream awareness as it is often dismissed as yet just “another arthritis” or “arthritis like” cloud of symptoms.

The simplest one can describe AS is by dissecting its very title. “Fusing” “with” the “spine”.

Putting this simply ~ it is where discs along the lower lumbar spine can no longer (or at least gradually) withstand against regular pressures of hyperextensions and contractions. And this parallels with risks of disc herniations.

The “fluid” inside the disc gradually becomes leaky. In the medical term this fluid is called "Annulus Fluid".  During fast-twitch / compound resistance training movement, compelling risk for "Annulus Tear" which the contents of the fluid escapes, potentially pinching or pressing a nearby nerve.

When and if this occurs, I con only relate or describe to as whole body electric shock. Such is sign (at least from my understanding) that  it becomes stabilised then becomes “fused” overtime with a surrounding disc.

Let your imagination run from here onwards. If one herniated disc, that is contents / fluids “gels” with another disc overtime, then, you can see that whatever paints in your head, may not be all  that pretty.

This is why there is a profamed analogy of AS akin to that of a “bamboo spine”. That ~ is quite literally (and visually) the outcome ~ where the spine can longer flexion and is as stiff as its appearance resembles a bamboo.

Thankfully, I consider lucky if I were to have only less than three (3) flares per any given year. That sound may not seem much. But cumulatively ~ I do not know if there are also other very slow or asymptomatic tearing subtly in the background.

Mainly affecting men more than women, anyone with a suspected genetic expression of HLA-B27 is and would hopefully be alerted by their physician of this. While this genetic marker is only a half-diagnosis, as only few percentage of those with HLA-B27 do get clinically diagnosed, this is not a health condition I'd downplay, at least in the long term view.

Signs  / symptoms

As one expects - anything auto-immune related is unlikely an isolated "symptom" or "sign".  I am or have been experiencing for quite a long time throughout, the following list of surrogate or accompanying inflammatory risk factors that has been well documented to be part of AS.

I am collating a ranking of symptoms below, from highest to low severity :

• Definite pattern ~ on/of occurrence of pains and lower back mobility compromise particularly during early parts of the day. And does not resolve or regain resilience when exercise sets in.
• On/off random lower back immobility affecting all pull and push movement strengths.
• Propensity to oxalates sensivity = lower back pain probability coming next fasting windows.
• Psoriastic like skin condition ~ for quite significant number of years, on/off I have been witnessing itchiness under arm, leading to scaly skin as a result. These however have been somewhat or mitigated by experimenting inbetween various intakes of Vitamins A, Zinc and E.
• Persistent Red eyes / uveitis like symptoms ~
  • Rare but few occasions of light sensivity / photophobia.
  • Consequently ~ “floaters” which thankfully can be ignored in the background.

What I have been doing thus far 

• Standard ketogenic regiments (2014-2015),
• Cyclical keto (2016-2017),
• then intermittent fasting (late 2017~).

Self analytic / self-“meta” way of life, including self journalling, cyclical approach to macronutrient  at scrutinising various food groups; one small piece at a time. Intermittent fasting component featuring 18 to no more than 20 hours, including training windows semi-fasted (with basic / minimal ergogenics with occasional novelty~ creatine, ALCAR and EAAs / essential aminos.)

Suspecting foods that manifest likelihood to the above signs and/or symptoms:

• High oxalates foods.
• High PUFA Omega N6. Suspected, unfinalised / preliminary suspicion.

In terms of supplementations, at least in context of injury recovery from rare episodical L4/5/S1 nerve tension flare/s during lower mobility training = Creatine Monohydrate. Very Interestingly in just small finger pinch amounts = do restore some mobility almost immediately. For overall psychology(s) and surrogate mental health markers   - I have decided to revisit the usage of NOTROPICS. Notably - ALCAR and Gingkko appears to be helpful at maintaining cope and overall resilience inertia throughout the fasting and training windows.

Minor yet unconfirmed supportive roles ~ Vitamin D, K2, other fat soluble anti oxidants ~ particularly COQ10 still maintains periodical standard dosages. However supplements that demands periodical cycling between low and high would likely be Vitamin D. Please refer to the feature series Self-Meta on Vitamin D.

Things I am finding ambivalent / counterintuitive.

The following are supplements and/or workarounds that I find ambivalent in terms of their effects at managing the above conditions.

1/4 High Omega 3 PUFAs
First in the list of what I consider somewhat not effective. Seafoods, actual salmon I shall specify, at times made my overall psychology and back pain recovery(s); especially amidst minor L4/5/S1 episodical flare(s) somewhat worse or at least, indifferent. However these does not immediately suggest all high seafood source of PUFA N3s are permanently bad; I did not notice this pattern amongst other likewise seafoods ~ particularly mackerels (lower fat variety), and sardines. One thing for sure, salmon, at least by defenition ~ salmon which are sold often at premium markup - appear to induce the worst of symptoms. Yet paradoxically not so on other seafoods.

2/4 Regular high dosage of NSAIDS.

This may deserve yet another lengthy discussion but very similarly to cycling in and out of high PUFA N3 intakes ~ does not seem to expedite or improve recovery especially amidst or in the middle onset of ~ injury recovery on L4/5/S1 nerve flare episode tensions.

3/4 high dose Vitamin D

The is rather perplexing one and it is something that I would not readily nor I am to accept to go without for certain lengths of time. As I have written my Self-Meta on Vitamin D - there appears to be a subset of functional medicine practitioners who are against supplementing any Vitamin D as they believe this to be counter productive to the innate immune and thereby / consequently likewise - auto immunity homeostasis in a given system. My own experience at complete abstinence to Vitamin D did, somewhat gave me some temporary ability to resume movement. However at long list of expenses of numerous surrogate QOL markers also occur. Just from everything one can imagine from psychological wellbeing, composure, etc. In other words I am less than my own default capable or capable person in any circumstance were I to go without Vitamin D.

4/4 (High vs low) Vitamin A

This is still largely a preliminary suspicion. So far as I can recall as of recent years of cycling in various amount of dietary Vitamin A (be it retinoic acid from organ meats or beta carotene from carrots) ~ some symptoms seem improved (eg. pink sclera on the eyes / dry tired eyes in general) whilst others seem somewhat worse than usual (itchiness / psoriatic like feeling).

There are certainly more that I am yet to include, but for keeping this as readable as possible I'd wager this can only be saved as entire feature writing altogether, unless if I feel compelled or if I have indeed found something else as an update to the above.

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Closing (Part 1)

Ankylosing Spondylitis is hard to describe illness, that, anyone with HLA-B27 + gene may lead a totally manageable and symptom-free life on any given day, month or even year. And yet an injury can trigger or worsen all the above chain of symptoms to the point one indeed feel it as though it is an illness.

I am glad I am still fine, at least for a good decade since I was made aware of this condition (AS).

Next - is a continuation of my illnesses; but this time surrounding the "non-communicable" aspects.

Live-it-forward,

AW.