Thursday, January 19, 2017

i just split three days up into little pieces and, in the end, ended up back where i was to begin with. i guess i needed to catch up on the sleep. i was up on the 17th about 17:00, and ended up awake on the 19th at about the same time after sleeping for most of the day (in fact most of the last 24 hours). so, i'm cycled back around and ready to pick up where i left off.

but i need to pick up the pace...

i need to eat, first. and then i need to have a productive night.
also, in the long run i'll need to keep an eye on my cholesterol. but, it's currently actually pretty outstanding.

i've been over this: my diet seems terrible, until you realize that i don't eat very much and i walk a lot.....

these numbers are real. and attainable. note: both of my parents have/had high cholesterol. my dad actually had several life-threatening cardiovascular episodes before brain cancer got him, and his father died of heart disease. if this were a purely genetic concern, i'd be in a lot of trouble. and yet look at these numbers....

chol: 3.69 mmol/L = 66.42 mg/dl. this is actually lower than the normal range (3.8-5.2). i also have low blood pressure....

tg: 0.88 mmol/L = 15.84 mg/dl. lower end of normal range (0.6-1.7).

hdl:  1.37 mmol/L = 24.66 mg/dl. this is pretty much in the middle of the normal range (1.00-1.80). higher hdl is preferable (apparently, above 1.6). but, i have to keep in mind that i'm low, overall. the way you measure a situation like this is to look at a ratio, and while it's not on the print-out, google confirms my logic. my ratio is 2.69; under 3.5 suggests i'm at low risk for heart disease.

ldl: 1.92 mmol/L = 34.56 mg/dl. this is also lower than normal (2.0-2.6), but again you have to keep in mind that the total is low. the important ratio here is ldl/hdl, which is 1.4. that again suggests very low risk - around half of the average risk, it turns out.

non-hdl chol: 2.32 mmol/L = 41.76 mg/dl. this measure is just a difference between total cholesterol and good cholesterol; it's the amount of cholesterol that is not good cholesterol. apparently, i want to keep the difference between non-hdl and ldl less than 30 mg/dl. well, i'm at 7.2.

i have to keep an eye on this because i should be at high risk. but, my lifestyle is very different than either of my parents, and the effects of that are showing pretty clearly.
ok. umm...

i was vaccinated.

the doctor is...he's got a lot of work to do....this is why i asked for the print-out...

the blood test results indicate i'm positive for anti-hbs. that means i'm immune. given that i also have immunity to hep A, i must have gotten twinrix at some point.

the test that the lab requested is to determine if i may have defeated it naturally and become a "chronic carrier". note that a "chronic carrier" is not the same thing as a "chronic infection". whether i misunderstood or he misspoke is less important than getting it right...but i think he read the information too briskly and misspoke, leading me to a false understanding...

when i said today that i should wait until march because there's a temporal component and i wouldn't learn anything from an immediate test, he nodded and said something about a graph and appeared to be struggling to remember something he hadn't thought about since college. google is so remarkably useful. he was no doubt thinking about this:



if i had picked up hep b in the blackout, i wouldn't have tested positive for anti-hbs a mere 11 weeks after infection, which is what happened. i must have already had immunity. what he told me had led me to believe that they had picked up lgM anti-HBc which, at 11 weeks, would indicate exposure. that is not the case. this was a miscommunication.

if i wasn't in shock, i would have asked for it in writing in the first place.

doctors are not magicians. it's always a good idea to ask questions, get things in writing and do independent research. i'm not upset because i consider this to be my responsibility, and not his.

but this is cleared up. whatever sickness i had this month, it wasn't hep b. i'm already immune to hep b. and i think it's clear that i'm immune to hep b because i was in fact vaccinated.

i still don't know what happened that night, though.
i woke up sopping wet because i was outside in a torrential downpour. my reconstruction of the last moments of the blackout suggests it's probably why i got in the guy's car. but it means that any relevant evidence got washed off.

there was nothing on my clothes. and, i was bruised, but there was no residue.

i should have inquired around about the existence of an anal rape kit rather than assumed one doesn't exist. i was in a daze and didn't want to deal with it.
"There is no chronic (long- term) infection with hepatitis A. People do not become carriers of the hepatitis A virus."

"Avoid having sex while you're infectious – hepatitis A is most infectious from around two weeks before the symptoms start until about a week after they first develop."

ok. so...if i got hep A in the blackout, the person i got it from would have had to have been exposed recently. and, further, it would have had to have been in an anal-oral transmission. even in the worst blackout scenario, i would have no doubt gagged. 

i wish he would have told me that or printed the results out, because the transmission possibilities around hep A really rules out the possibility of a consensual encounter. i was either raped or i was vaccinated. which is more likely?

on the one hand, i think it's pretty low probability to suggest i happen to have been raped by somebody who was in an active transmission stage of hepatitis A in detroit in 2016. this is a third world disease that has a short window for transmission. and, i guess that detroit is in bad shape. but, poverty does not introduce disease, right? the disease has to come from somewhere. this is so unlikely as to rule it out.

unfortunately, however, the low probability of the scenario doesn't rule out all of the other evidence leaning towards a sexual encounter and a disease transmission: waking up with a sore anus and bruises, and then getting sick not once but twice over a long period of lethargy that included a bout of possible jaundice.

of course, it's not impossible that i could have had sex that night and already been vaccinated.

there's nothing i can do except wait. but, i think that the possibility that i got hep A is really so remote that the presence of antibodies is re-opening the potentiality of a vaccination in my mind; i had all but ruled that out once i got sick. and, if i got a hep A vaccination, i would have almost certainly gotten it with a hep B vaccination.

i can't handle being unable to deduce this. that's what upsets me. but, it's just more demonstration of the superiority of empirical epistemology. like i needed one....