(continued from part 1)
Diagnosis and prescription
The family doctor stared at me sternly, then issued his diagnosis and prescription. He explained that my guts were mostly like in a bad state of ulceration, and my diet was the most probable cause. The ulcers were about to start bleeding into my abdomen, which would be a very bad thing, and which was why hospitalization was one treatment option.
The other option (the doctor continued, with mordant glee) was to radically change my diet. No more caffeine in any form: coffee, black tea, caffeinated soda, chocolate. No alcohol. No hot spices. No acids – i.e., no tomatoes, no oranges. No gradual tapering off; cold turkey was the only way, commencing at once. Everything which injured, aggravated, or maimed my guts had to cease immediately.
(The food part was an extra dose of melancholy. I’d have to stop my refreshing morning glass of orange juice. No more would I proudly dare Indian restaurants to make me lamb curries “hotter than Indian hot”. Out with my battery of hot sauces, the Tabasco flotilla. Gone were hot wings, Buffalo flavor anything, spicy pizzas – heck, pizza at all. Gone too would be any Italian, tomato-based sauces.)
(And no alcohol? I hadn’t been a regular drinker since my college days, but still adored Guinness, and appreciated fine whiskey. My Russian DNA gave me a genetic predisposition in favor of vodka, as well. All gone.)
In a show of mercy, the clinician prescribed a heavy-duty painkiller, Percocet. He anticipated so much pain that a narcotic was called for.
I left the appointment feeling numb. We drove home through the Champlain Valley of western Vermont, my wife, Ceredwyn, at the wheel, as I was in a form of shock. We talked things over in detail. I was going to be in a bad way for a while, maybe a week. I would tell my employer that I was going to be under the weather for a few days. I would plan on not doing much work at home, including housework, child-minding, and homestead tasks.
Ceredwyn disliked the prescription, finding it too harsh, and wanted me to get a second opinion. I agreed, and decided to follow the doc’s advice, while hunting down a specialist.
The days that followed were, as you might suppose, terrible. It was like having a bad flu: random shots of muscle and joint pain, a bitter mood, a sense that the world had darkened around me. The fatigue was oceanic, sweeping across my body in tides, whelming me into near-sleep at any time of day. Christmas was a vague blur.
The headaches were fierce, savage, migraine attacks. If you haven’t experienced this, it sometimes feels like someone has stabbed you in the skull with an ice pick, then left it there, lodged in the bone, throbbing and oscillating, grinding from side to side. At other moments my entire head felt caught in a huge vise, which someone else was winding down, each turn crushing my skull a little further. Lights would flash, occasionally, as if the sun had broken through clouds, or interior floodlights suddenly switched on, followed by the descent of murk.
I tried to relax by reading and watching movies, but my body kept betraying my mind, sapping concentration. My foul mood spoiled stories and aesthetic effect.
I poured water into my body ruthlessly, always having a bottle or mug to hand. As Ward notes, dehydration* is a vicious thing, and I needed to hydrate extensively.
Sleep claimed me, deeply.
I never took the Percocet. I wanted to tough it out.
My family avoided me. The dog and cats, worried, comforted me.
On the second day of detox a new coffeemaker arrived, a present my wife had ordered before the diagnosis. I used it to make her coffee. The first two or three times it was awful, the heady scent of ground beans causing me to literally salivate. My hands shook as I carried her the steaming mug.
Medical tests followed, as we located a specialist. He ordered blood tests, a physical exam, and an endoscopy. As I headed into what turned out to be the first of several endoscopies, my brain quickly fogging closed with drugs, the doctor assured me that he probably wouldn’t find much. He was (and is) a jolly man, genuinely disarming and funny. But when I came to, he looked spooked, and described the results soberly.
Three (3) ulcers were at work in my stomach. Acid reflux was in full bloom, riotously shooting acid up my gullet. My esophagus had, well, mutated in a bad way, heading towards a condition called “Barret’s Esophagus“. The doc also used the phrase “potentially precancerous”, twice. H. Pylori was not a factor, which is unusual these days. He prescribed a stack of medication, continuing the bland, decaffeinated diet, and more tests.
I went home with my wife. I continued working (back at full+ time), took the meds, avoided caffeine and all of those tasty, spicy, acidic foods. I started a food diary to check for additional offenders in my shrunken diet. Things seemed grim, eroded.
And then… I got used to it.
The new normal
Positive reinforcement was the crucial step. After a week my stomach pains lessened. By the new year my daily morning nausea ceased. As Mimi comments, the absence of pain is awfully sweet. My body associated no-caffeine with the sensation of no-guts-on-fire, and liked it very much. Conditioning can be a wonderful thing.
One survival technique I discovered was continued hydration. I tried to have water near me at all times. This didn’t boost my energy at all, but kept me healthy, and simply feels good. I gradually trained my body to expect water, not coffee or Mountain Dew.
Another useful trick was more physical activity. I’ve lifted weights since high school, but haven’t been doing so frequently of late. I added workout routines throughout 2012. Now I have a kettlebell workout every morning, which means up to 30 minutes of painful (but productive) exercise. I added a treadmill to my home office standing desk, and run 45 minutes to 2 hours each day while doing all work that doesn’t involve much typing. During snowy weather I strap on showshoes and stomp across drifts for up to an hour. When I’m traveling, which is frequent, I do pushups and situps as soon as possible, after waking up. Then it’s time for a workout center, if there is one.
Tactic #3: sleeping a little bit more. During my caffeine years I routinely slept 4-6 hours per night, and did the occasional all-nighter. I flew frequently (up to six trips per month), and took sleep-destroying redeyes whenever possible. Now I force – no, allow myself to sleep 6-7 hours, 8 on weekends. The body demands it. In return, the quality of sleep is better.
Mid-afternoon sleepiness sometimes hits me. It used to, back when I was massively dosing myself with caffeine. I don’t nap, since naps don’t work for me (they leave me feeling dazed and more tired), so I used to medicate this with caffeine. Now the sleepies are weaker things, and I just bull through them, yawning and forcing myself to remain attentive.
Tactic the fourth: weight loss. That jolly specialist and his staff recommended I lose weight, so I did. I cut every meal’s portion in half, which is a bit harsh, but I was in no mood for delicacy. No food passed my lips after 7 pm. I started using the treadmill, mentioned earlier. After a month I dropped 20, then 35 pounds. There’s nothing like hearing a trusted medical professional use the phrase “potentially precancerous” to motivate lifestyle changes.
So how do I feel now, one year after I shut down the caffeine pump? How do I get things done?
I hesitate to describe my situation in glowing, post-conversion terms. A friend mockingly accused me of going straight-edge (no caffeine, no alcohol, no drugs, but lots of punk rock!), and I am leery of sounding evangelical. Exercise culture has always appalled me. But I do feel… well, well. My abdomen is no longer a hellish engine of pain. My breath is no longer coffee-flavored. I don’t experience the plunging abysses of fatigue I used to. I wouldn’t describe myself as relaxed or less active; instead, as cheesy as it is to write, I’m more aware of my body’s reserves of energy. I pay more attention to the body, rather than hurling caffeine by the gallon into it.
I get as much work done as I used to. That includes writing – my first book, The New Digital Storytelling, came out last year. I keep churning out articles, essays, reviews, and chapters (see the “Writing” tab up top), and just returned to blogging right here. For NITLE I consult, work with colleagues, give speeches, publish a monthly futures analysis, teach classes, and run a Web-based game. This includes a lot of travel, between two and six trips each month.
At home I help my family homestead, our project to live sustainably and getting off the grid. So a lack of caffeine doesn’t prevent me from cutting down trees, hauling wood, building stone walls, planting and harvesting crops, and dealing with animals.
That family includes two teenagers. I think I keep up with them, although my son still destroys me in Halo 4 multiplayer.
My diet is simpler, smaller than it used to be. Most of what I drink is water, either cold or very hot, the latter largely for warmth, as Vermont winters can be long and cold. My eating habits are restrained. Gone are large portions, hot sauces, and morning orange juice. Instead I eat a nearly paleo diet: fruits, nuts, veggies, eggs, meat, plus rice and granola. Some of that we raise ourselves – that’s part of the homesteading deal.
I miss chocolate, and console myself with white chocolate. I remember the morning ritual of creating coffee to banish sleep, but don’t recall it often. I still miss the delight in a huge meal.
I love making food for other people, and happily feed them what I cannot eat or drink; their pleasure, and the rich delight of cooking, is what I enjoy. Every morning I make coffee and bring it to Ceredwyn in bed, my hands no longer shaking. My children are a source of inspiration, as each has successfully coped with their own harsh dietary issues (celiac for one, milk intolerance for the other).
I cannot tell how energetic I appear to others in meetings, or when I keynote a conference. I think it’s the same level of energy. And if it lessens, how can I separate decaffeination from the erosion of age? I turn 46 in a month, and feel… calmer, more in control.
One more survival technique is the use of social media. Friends, colleagues, and total strangers gave me advice, courage, and comfort over Twitter, Facebook, and Google+. I appreciated them very much. I turned to blogging to share this story in the same spirit, and am thankful to every person who commented here, or posted on Twitter, HackerNews, G+, and Facebook.
*I may tell the story of how I once dehydrated, for those medically curious.