Tuesday, October 30, 2012

When you lose your trump card; or, Welcome to Middle Age

Disclaimer:  I know my last blog was medical and personal in nature, and I promise I'm really not fixated on these types of things.  I can only write about what is happening to me now.  Besides, I think this actually is revlevant to yoga practice vis-a-vis mens' issues.  So....

My trump card, as of late, has been pristine health.  You know, that radiant, yogic well-being we all boast about one way or another.  It's not that I go around saying "ask me about my health."  But when asked about being a vegetarian, for example, one of my lines is that I'm never sick.  When I bump into people from college or high school that I haven't seen in years and I'm complimented for looking fit, I credit, as casually and nonchalantly as possible, my yoga practice and my mostly abstemious lifestlye.  I have lost that trump card.  It turns out I have prostatitis.  My entry into middle age (I will be forty in February) has become most unceremonious.

Prostatitis is not as bad as having the Ebola virus or ALS, but it isn't fun.  When symptoms are at their worst.... I had described the symptoms in an earlier draft but I decided that it might be off-putting.  If you're desperate to know hit me up on facebook and I'll tell you.   Let it suffice to say, in short, that it sucks.  Apparently the condition is somewhat baffling.  Sometimes it's a clear-cut bacterial infection treatable by antibiotics.  Sometimes it's chronic, unexplainable, and tricky to treat.  My interweb research into the condition yielded this abstract, which could have heavy ramifications for my practice of Ashtanga Vinyasa Yoga as taught by Vidwan Shri Krishna Pattabhi Jois:

Anyone with prostatitis should be aware of the disagreement among professionals about the cause of prostatitis....
The reason that understanding this lack of agreement about the cause of prostatitis is important, especially for sufferers of the problem, is that the definition of a problem determines what you do about it. If you have chest pain caused by indigestion, you don't elect to have open heart surgery to correct the pain. Indigestion tells you what to do about your chest pain..
Similarly, if prostatitis is caused by chronic tension in the pelvic muscles where there is no evidence of infection, you might take pause before you elect to have your prostate removed or take another course of antibiotics or have your prostate gland painfully squeezed and massaged.
There is a genuine controversy about what prostatitis is among urologists and professionals treating this problem. There are three basic views outlined below:
  • Prostatitis is a condition caused by chronic squeezing of the pelvic muscles that, after a while, causes a self perpetuating and chronic irritation of the contents of the pelvic floor, including irritation of the nerves and other delicate structures involved in urination, ejaculation and defecation.
  • Prostatitis is caused by a bacteria or unknown microorganism in the prostate gland.
  • Prostatitis is an autoimmune problem.
The majority of urologists tend to propound the second and third theories. Because of this, their treatments tend to focus on the use of antibiotics or pain medications. Sometimes urologists will tell their patients that there may be a microbe responsible for the problem that still has not been identified..
Below I want to discuss the first that prostatitis as a condition of chronic tension in the pelvic floor. In this view, everyone deals with the stresses of life by focusing their tensions in different parts of the body. For instance some people tense in their necks and heads and get headaches. Some tense in their gastrointestinal tracts and get irritable bowel syndrome or constipation. Some clench their jaws and get a condition called TMJ syndrome. Some subset of these people develop pain and dysfunction in their heads, gastrointestinal tracts, jaws etc. as a result of this chronic focus of tension.
Similarly, prostatitis as a tension disorder sees abacterial prostatitis/prostatodynia essentially as a 'headache in the pelvis" or "TMJ of the pelvis". In this view it is a condition usually manifesting itself after years of tensing the pelvic muscles. It usually tends to occurs in men who hold their tension and aggression inside. They squeeze themselves rather than lashing out at others. Often they have work in which they sit for long periods of time and the only way they have found to express their frustration is to tense their pelvic muscles. This tension has become a habit with them. Often they do not know they tense themselves in the pelvic floor.


Oy vey.  Could it be that Mula Bandha, one of the fundemental building blocks of my practice, is to blame?  To invert Juliet's dillema, has my one hate sprung from my only love?  What to do?  Now I'm not a knee-jerk "western medicine is always wrong" type of guy by any stretch.  But I think this could be as good a case as any to get some Ayurvedic or TCM (traditional chinese medicine) work done.  Especially since the Ciprofloxacin I'm on isn't really doing it this (second) time around.  I will say, though, that for the first course the antibiotics worked as they were supposed to and I was symptom-free for about three weeks.  The other thing to bolster the tension issue claim is that I'm asymptomatic when I wake up in the morning and when I'm practicing, during which times I'm either chilled out or warm and open, respectively. 

I have to re-evaluate.  As one of all-time favorite quotations goes: "everybody has a plan until they get punched in the face."  It sure is easy to sit around and say "we are not our bodies" when our bodies are in good working order.  I'm hoping this can be an opportunity to see if I really mean it when I say that.  And if I don't mean it when I say it, to mean it in earnest from now on.  But I hope even more that this condition will respond to some form of treatment.