Medical Retirement
For more than a year, I’ve been trying to apply for medical disability through the federal government. If you’re new here, I used to be an air traffic controller in the Washington DC area, until a neuroautoimmune reaction to the Pfizer covid vaccine crippled me with devastating neurological symptoms and widespread brain dysfunction. These impairments often left me unable to hold conversions or safely traverse the stairs, let alone sequence airplanes. For a couple years after, I tried to make it work in an office job, working with new hire training, airline routing, and facility safety issues. That was, unfortunately, not much better.
As the adverse test results stacked up and the debilitating symptoms persisted, I eventually felt it was time to pursue a medical disability retirement. It was quite the process, to put it lightly. Beginning in November of 2024, I gathered clinical notes, physician testimony, supervisor statements, and more to make the case that working with my condition was impairing both my health and my ability to satisfactorily perform my job. It took until March to finally submit a final application – thanks in part to glacial paper passing in the FAA, and in part due to the difficulty in obtaining concrete physician support.
To be entirely honest, the quasi-interlude to follow is only partially to illustrate that difficulty, and partially because I’m bitter and angry. The ways in which I was mistreated by a number of physicians remains staggering to me. I already touched on the neurology practice that was the first to voice support for my application, but reneged when my IQ testing showed “only” single digit percentile performances in acute cognitive skills. And special thanks to the neurologist who told me my test results were meaningless because they were “only consistent with serious conditions like Alzheimer’s and Parkinson’s.” Two other doctors accused me, directly and to my face, of faking everything - not only my severe symptoms and pronounced cognitive decline, but apparently also the PET scan demonstrating widespread brain dysfunction and the range of adverse autoimmune symptoms suggestive of neuropsychiatric lupus. It was an uphill battle, even with simple things like scheduling and paperwork, to eventually get multiple medical professionals on board.
In any event...the application finally submitted in March was initially denied in July - failure to demonstrate that my health was sufficiently impacting my job performance, they said. What had been a ray of hope was, all of a sudden, a massive shot in the gut. I actually feel like I handled this stretch of disappointment fairly well, but was obviously dejected about the prospect of continuing to hurt myself at work every day when it could have already been over. I fell back into my usual routine of suffering and survival (and taking as much time away from work as I could) pretty easily, stacking a week or two of good health and good running before falling apart for days or weeks after. Repeat, ad nauseum.
The application was resubmitted a few week later and this time, finally, was approved at the beginning of November (in the middle of a government shutdown, no less!). This was, obviously, a moment of great relief and joy. I had viewed this retirement as a clear light at the end of the tunnel, the moment that would change my life for the better. I had locked in so hard for so long, just trying to make it to the other side, and this was the moment that was going to mark a real change. Unfortunately, I still had to make it through quite a bit more work, the reopening of the government, and the HR logistics necessary to finally get me out the door. Ultimately, November 19th was the last day in the office, but I was still missing entire days of work sick in bed as late as the 17th. The excitement and optimism had worn a bit by then, but maybe now things could finally be alright.
Retirement Hasn't Meant Relief
Well...Here we are, three weeks since my last day of work, and I’m in a pretty bad place. The last couple weeks of the government shutdown were extremely brutal (ironically, I was hoping I’d have less work without a government...), leaving me broken and sick despite only managing to work about half of my hours during that time. Since then I’ve recovered a bit, but haven't actually been able to turn a corner. I’m....OK.
But what OK means is that trying to clean the basement destroyed my neck, leaving my neck and head numb and “asleep” for days. It means I haven’t had legitimate feeling in my hands or feet for over a week. It means every morning is a crapshoot as to whether my legs will actually move properly or if I’ll need to hold myself up against the wall in order to get to the bathroom. It means I struggle massively with processing information and making decisions, or really even understanding how to make a decision. It means I’ve tried and failed to run several times, simply because I can’t force my legs to move properly or control where they land, while my heart rates tickles threshold levels at 11 minute pace (to be clear, I’ve run a number of times as well with less issue).
I’m writing this on a Thursday, having been unable to complete my run yesterday and unable to attempt it today. I couldn’t get through the dog walk this morning, actually. Yesterday afternoon I did maybe an hour of work around the house (ok, 20 minutes of work spread across an hour), babying myself through laundry and dishes. But I could only do a couple minutes at a time, because my spinal cord couldn’t handle looking down. A couple minutes left my spine shooting with pain, my arms and legs fully numb, my brain dizzy and nauseated. Rest for a few minutes on the ground, then repeat.
I would have been better today had I not done that but the real problem isn’t folding laundry, it’s the inability to provide any meaningful continuous energy to my nervous system. That’s by far the greatest fundamental problem, that my brain and nervous system can’t produce or utilize energy through traditional means. I make constant efforts to mitigate those effects through deliberate ketosis, but that’s been made extremely difficult lately.
What I’ve found again and again (to be clear, this checks out fairly obviously physiologically as well) is that any great stress response tends to inhibit ketosis. Your body responds to stress by prompting your liver to create glucose, raising blood sugar and inhibiting ketone production. Part of why I’m in my current mess is because I had a cold that had exactly this effect, but the persistent issue is how massively difficult it is to actually recover. When I’m reasonably healthy, a high-fat/zero-carb diet will commonly lead to stable blood sugar in the 70-80s and blood ketones of 2.0 or higher (those values are “below average” and “quite high” respectfully). But when I’m in a bad place and can’t get out from behind it, the same diet will instead produce fasting blood sugars of 100-110 and ketones barely above zero. When this happens, I’m providing extremely limited energy to my nervous system for days at a time. In both cases, the situation is prone to self-propagation. Long-term elevated ketones prevent many or most symptoms and issues, maintaining a fairly healthy state. But low ketones and limited energy availability means things as simple as reading emails or sitting on the wrong chair can exacerbate ongoing issues, further driving the downward spiral.
Moving Forward
You might read that and wonder how I’m even writing this today, given I just told you how bad today was. If you’re wondering, my blood levels a couple hours after waking were glucose of 102 mg/dl and ketones of 0.3mmol/L. Those are not good numbers, and suggestive of a continuing long-term trap of poor energy availability and debilitating symptoms. So what am I doing? I’m cheating, in a sense. Taking drastic measures, more accurately. I wrote once before about the varying alternative manners by which you can provide energy to the nervous system, and how ketones are by far the healthiest and most stable long-term option. But as just described, its massively difficult to pull out of a spiral and raise ketones high enough without somehow first providing some sort of reprieve.
So I’m currently or soon to be utilizing every other method I outlined in that previous post. I’ve had many, many carbohydrates (fruit) today. Enough to raise blood sugar high enough and long enough to at least partially overcome my nervous system’s relative inability to properly use carbs for energy. I’ve had some alcohol. Not enough for true intoxication, but enough to provide another stream of energy over the course of a few hours. And I’ve had and will have supplemental ketones as well. This is not healthy, or a good long-term solution, but between the overconsumption of carbs, the alcohol, and the exogenous ketones, I have massive energy availability for at least the time being. Which right now means I can write. I can put together thoughts and sentences in a way I wouldn’t have been able to recently, and can do so without cratering my health. But its a temporary reprieve, that I need to take advantage of while I’m able.
The result of these efforts should be that my nervous system will recover all day today, and that tomorrow morning I’ll have a relatively easier time getting out the door for a run. Which is the last, best alternative option for energy delivery. Exercise is really the only way to acutely increase glucose metabolism in the brain and nervous system (without binging sugar) and thus has been a reliable tool in my battle for health. But much like the ketone spiral, I can’t take advantage of that pathway when I’m too unwell to get out the door (the days I can't get out the door never get logged, but my Strava is still littered with quasi-failures like these).
Tomorrow I’ll wake up with zero ketones, but should feel far less numb, less dizzy, in better control of my limbs. The trick then will be transitioning from today’s short-term energy availability back to something more lasting. But the transition to ketosis is, generally, when I’m at my worst and most susceptible.
As an aside – the “transition” to ketosis is where I existed for most of the first year I was dealing with this. In the long-term, that just means sensible but non-zero carbohydrate consumption that results in stable, healthy blood sugar that is too low for my nervous system to utilize but too high to allow ketone production. The same state occurs transiently in the days after high carbohydrate consumption while waiting for meaningful ketone production to return. I don’t typically spend much time in that state anymore, because I can manage it in the way I’ll describe in short order.
But I have, unfortunately, still been there from time to time. I’ve been flirting with that place a fair bit lately. And that place, those circumstances, are when it’s made clear to me that things aren’t actually getting better. Quite honestly I think they’re getting a little worse. It is glaringly obvious that even without great cognitive stress, normal human function is difficult if not impossible to achieve - the constant numbness, dizziness, stabbing pain, impaired motor control, and so on and so on, the squeezing blackout feeling compressing my spine and brain, all of that – it feels more and more difficult to actually escape.
And has been made clear on multiple occasions, the addition of cognitive strain – the actual acute stressor placed on an unfueled brain – sends things to a place that simply doesn’t feel survivable. I am, at this “baseline” - the existence that a healthy person would take for granted – too sick to hold my life together. I scored in the single digit percentiles in acute intellectual skills when I was healthy. When I’m not I can’t even hold a conversation, in either direction. I am, in what really is just a “normal” human state, still too sick to fully understand the things people say to me, and too sick to remember words or piece together sentences when trying to go the other way. I am, still, too sick to get up and down the stairs without using all fours for balance, without stopping to take a break.
What the hell was I talking about? I think my rambling got off track a bit. I know my underlying health hasn’t improved and I suspect if anything it’s a little worse, but I can avoid those catastrophic situations for the most part these days (even if I’m bedridden nonetheless).
And the way I do it is how I’m going to do it tomorrow. Through constant utilization of some kind of energy source. I’ve utilized several today, in order to write this and in order to get myself out of bed tomorrow morning. More ketone supplements (on which I’ve spent some $800 this year...) will help make sure tomorrow’s run gets started. And then, I’ll run... and run some more. Hopefully all day, more or less.
Two things should hopefully happen tomorrow – the run itself, for what I hope will be 5, 6, 7+ hours, will provide another fantastic source of energy/brain metabolism to help get through tomorrow. And I swear to you, that if I’m actually well enough to run for 6 hours, my legs will hurt less after than they did after the six-miler I couldn’t complete the other day. Even the generic neuromuscular pain is worse than anything I’ve ever been able to inflict running or racing. I’ll also fuel that run entirely with ketones and fat. Despite eating a lot of carbs today, I hope to reach meaningful levels of ketosis in 24 hours by virtue of simply moving all day, depleting all stored glycogen, and driving insulin down around zero.
And then we’ll see what happens. If I get the run started, tomorrow will probably be ok. I’ll run for hours and, if that's true, will feel reasonably ok for the next day regardless of what I eat just on the strength of the run alone. But hopefully in concert with high-fat/zero carb fueling and diet, I’ll be back to a meaningful level of ketosis by the following morning. Or at least meaningful enough, while feeling healthy enough, that the next day’s run is enough to finally see big ketone numbers again.
I’m still waiting to be healthy for the first time since my retirement, and hope this “Hail Mary” of sorts is enough to ultimately get there (Update: Only kinda. I made it just a couple hours into that run, and it took a couple more days to finally start getting over the hump). I remain optimistic, for lack of a choice as much as anything else, that I can reach a long-term stable, healthy state in which I’m able to exercise daily and avoid the kinds of crushing circumstances that used to plague me at work.
But I also feel like it needs to happen soon. I know these massive binge/alcohol/supplement/long run episodes are not a healthy long-term solution and not something I should be trying to repeat if I can avoid it. Combine that with the sobering research into dementia and other neurodegenerative diseases, the ways in which the inflammatory cascades, neurotransmitter disruptions, and so forth result directly from acute energy deficits while simultaneously causing further long-term damage, and it becomes obviously apparent how important a stable energy source really is.
I don’t think I will ever be healthy enough to live like a “normal” person and also walk and talk at the same time. The expectation is that I will be significantly impaired for the rest of my life and will need to fight it, forever. So here’s hoping that if I actually posted this on the internet, that it means I finally broke out of miserable couple of months and reestablished a stable, healthy situation again. The hope then would be to string together several weeks or even months of consistent running, but that’s a lesser concern right now. Running has been extremely difficult lately. It is right now nothing more than a tool, a means to an end. Its the manner by which I’m trying to force myself back to health, which is why I promise a random 30+ mile run isn’t as crazy as it might seem. Its the manner by which I’m trying to move closer to the light at the end of the tunnel. Hopefully I can find out what happens when I get there.
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