Recovery Continues

So August is here and what's happening with my body. By day, I'm feeling pretty good. I can walk more or less normally but my left ankle is still not quite right. After walking 4.7 km today, my left foot was visibly swollen but not painful. Some Arnica applied to the region reduced the swelling. My fingers still feel slightly stiff but I can play the guitar without difficulty and my grip strength has largely returned to normal.

By day things are generally OK but the nights are a little different. Awakening from sleep, I often find my fingers kind of frozen and I need to move them to regain normal mobility. Sometimes my shoulder or wrists can be painful. Overall, I'd say that I'm about 80% of my former self, that is to say my pre-fall self. Whether I'll ever recover the lost 20% remains to be seen. 

I am walking nearly everyday but I've sadly neglected my isometrics. My thymoma is noticeable mainly when I move about in bed at night but during the day it's hardly noticeable. Transiting Uranus will station within a couple of degrees of my natal Moon on September 1st and I'm hoping that this won't lead to any unexpected health problems. I won't go into the astrology here as that's better addressed in the appropriate blog (AstroWatch).

I have been making sure that some days I walk around 10 am when the Sun is rising but it still hasn't reached the meridian. The Sun in Jakarta is too powerful after that to do any sustained walking until about 3 pm. I'm hoping that this will boost my Vitamen D levels.

Recrudescence

A recrudescence is defined as the recurrence of an undesirable condition and that's certainly a word that applies to me at the moment. For a while there, I thought that my stiff fingers, weak wrists and dodgy left ankle were on the mend and that the discomfort caused by my thymoma was largely in abeyance. However, the last few days have seen a rise in finger stiffness and a noticeable uptick in thymoma-related discomfort. My ankle remains tender but then again I've been walking fairly regularly of a morning so that's to be unexpected. Overall, my mobility and ease of movement have declined and I tend to dodder about the house being particularly careful when negotiating any stairs.

While on a walk, I can generally stride about as I did in the old days but with the constant awareness that all is not right with my left ankle. Apart from the morning walks, I'm engaging in very little physical activity around the house. I found my old resistance band that was fashioned from pantyhose but have yet to make use of it. One can only speculate on the cause of this decline and what the dire consequences might be if I were I to suffer another fall. I've spent no time at all on introspection designed to discover what remedial action is necessary on my part to stem and perhaps reverse this decline.

I've adhered to my a significant reduction in my intake of fried foods, assisted by use of an air fryer. This is a healthy choice of course but I don't whether it's sufficient in itself to turn things around. I need to look deeper into the underlying causes, both physical and psychological. To this end, I decided to take another Etorvel (Etoricoxib) tablet. I still had four tablets left following my tooth extraction. It was 2:30am at the time of ingestion and this gave me about four hours before my morning walk to monitor the changes in my physical condition.

If there's a noticeable reduction in my finger stiffness, ankle soreness and general restricted mobility, then my problem is definitely of an inflammatory origin. The body is attacking itself. I've written about the effects of this drug in my recent post titled Tooth Extraction. As I said in that post, it's not a drug that you'd want to take in the long term given its side effects but this one off experiment should prove useful. So how is the experiment progressing?

• After about half an hour, the physical effects are quite noticeable. I feel quite flushed and I'm sure my blood pressure is elevated. My brain is not working all that well. I don't feel like concentrating on anything too taxing. I have an inclination to listen to some music which I'm doing. My fingers still feel stiff so not much change there.
  
  
• After about an hour, there is a noticeable reduction in finger stiffness and wrist weakness and overall a general feeling of well-being. I'm continuing to enjoy the music.
  
  
• After about an hour and a half, the flushed feeling has subsided and my mental faculties have returned. The general improvement in my fingers and wrists remain but has far from disappeared entirely. I'm definitely moving more freely and am feeling far less stiff as I walk about.
  
  
• About three and a half hours later, I went for my morning walk and felt particularly strong with my ankle giving me very little trouble. It would be good if I always felt like this but I have the drug to thank in part this time.

What conclusions are we draw then from this little experiment? It would seem that the drug is working as it's supposed to:

Etoricoxib works by selectively inhibiting an enzyme called cyclooxygenase-2 (COX-2). COX-2 plays a role in the production of prostaglandins, which contribute to pain, inflammation, and fever. By blocking COX-2, Etoricoxib helps reduce these symptoms.

The question is why is my body continuing to produce prostaglandins that cause pain and inflammation. As Google's Gemini explained:

Prostaglandins are major contributors to the inflammatory response. They trigger processes like: 

• Increased blood flow to the injured area
• Increased permeability of blood vessels, allowing white blood cells to migrate and fight infection
• Pain perception by sensitizing nerve endings

 This process is what led to my DOMS but the problem is that the process never stopped.

ADDENDUM:

A day later and I'm still feeling very good. I have very little stiffness, my ankle is not troubling me and even the discomfort from my thymoma is greatly reduced. It will be interesting to see how long this feeling of well-being will last. Doubtless, the production of prostaglandins is still being inhibited by the Etoricoxib.