How I optimized my health

Note: This is a continuation of previous blog posts on histamine intolerance (part 1, part 2, part 3) and another one post histamine intolerance.

Short health history

• 2000–2002: Asthma-like symptoms during running, which eventually made me quit competitive orienteering.
• 2004–2009: Insomnia, mostly in winter or after alcohol (1 beer was enough).
• 2010–2012: Moved to Sweden and soon experienced migraines with aura, for which I took many different pills and all of them only made it worse. Worst insomnia and stomach problems. Spent about 3 months on sick leave. Got diagnosed with histamine intolerance.
• 2013–2014: Antihistamine medication relieved a lot of symptoms, but I had to stop taking it regularly because of side-effects. Spent another few months on sick leave. (blog post, another blog post)
• 2015–2016: Stopped seeing doctors and started experimenting on myself. No longer histamine intolerant. (blog post)
• 2017–now: Steady progress, every year I could eat more food, exercise more, sleep better, etc. I’d rate my health at 95% now.

(Non-)Measurable improvements

I prefer improvements that are measurable. Some changes might not look like improvements, for example gaining weight is considered bad, but I consider it great, as the gain has been mostly muscles. Similarly for heart rate while running, the higher the rate, the faster I can run.

Metric	2012	2016	2020
Weight (kg)	67	73	82
Heart rate (BPM, orienteering race)	150	165	175
Falling asleep	2:00	24:00	22:30
Sleep length	5h	6h	6.5h+
Exercise per week	0.5×	1–2×	3–5×
Podcast listening speed	1.3×	1.4×	1.6×

I’ve also experienced improvements which are hard to quantify, for example better mental focus or not being tired in the afternoon. Even though these are hard to measure, they are very closely tied to sleep quality. If my sleep is great, I can also focus. In any case, here’s a list of other improvements.

• I can now eat milks proteins and more fiber.
• I can drink alcohol.
• Better mental focus, no crash after lunch.
• No painful migraines.

Not everything is perfect, though. Instead of taking too long to fall asleep I now sometimes wake up too early. See my Last.fm 2019 music stats, they start to pick up before 5 AM. My goal is to wake up at 5:30 AM.

Last.fm listening statistics for 2019

What worked

Since the last post in 2016, I’ve changed the following.

• Moved back to Central Europe from Sweden, so I get much more sunshine.
• I take fewer cold showers, because the shower water is not cold enough in Central Europe. I also practice less intermittent fasting, as I want to weigh more.
• I’ve switched my exercise focus from cardio (orienteering, biking, ultimate frisbee) to strength training. I’ve also stopped stretching—the only noticeable change from this is more free time.
• I’m now sleeping on a Japanese futon, the hardest bed on the market. It improved my sleep times and sleep quality.
• Most importantly, I’ve made my diet more consistent thanks to a slow cooker and a big freezer. Diet makes for at least 80% of the whole improvement, so it deserves its own section.

Diet details

Through experimenting with supplements, I discovered that I need to focus on the following essential nutrients.

• Vitamins: A, B*, D, K
• Minerals: Potassium, magnesium, salt, iodine, selenium, iron
• Amino acids: glycine
• Other: nitric oxide

Getting enough (and not too much) of these from food makes for a diet very close to Perfect Health Diet. Below is a sample of my diet from the COVID-19 “lockdown”, when it was the most consistent.

• Breakfast: 5 free-range eggs with pickled or fermented vegetables. Occasionally no breakfast.
• Lunch: vegetarian meal from the restaurant downstairs.
• Afternoon snack: dark chocolate, almonds, fruits, yogurt, protein bars.
• Dinner: grass-fed beef organs or bone broth. With vegetables or potatoes on the side.

I know, I know, this diet has a lot of vegetables which are environmentally costly. They contain very few calories, require a lot of water, land and nutrients. They also require refrigeration to remain fresh. However, picking a diet which balances personal health with ethical considerations is not an easy task. I think I need to first read famous moral philosophers such as Immanuel Kant, Jeremy Bentham or Peter Singer before I can form an opinion that I can share publicly.

Ethical considerations aside, I think the Perfect Health Diet (PHD) is one of the easiest ways to get essential nutrients in optimal quantities. Some people might be able to make substitutions, but this diet should work for everyone. For example, PHD contains vitamin A mostly in the form of retinol and its esters. Another source are carotenoids, but they need to be converted first and some people have reduced conversion ability, such as myself. It’s a genetic mutation, so there’s not much you can do about it.

I wasn’t able to fix everything through the diet, though. For example, I need to supplement a lot of potassium. I went through 2.5 kg of potassium citrate in about a year, which makes for more than 2 grams of supplemented potassium per day. Some people say that modern food production reduces potassium content in our food. It could be also caused by poor absorption. It’s particularly annoying, as supplementing potassium is very tricky and cumbersome.

Histamine and methylation

I want to share one particular finding regarding histamine, perhaps it’s going to be useful to someone.

People diagnosed with histamine intolerance in Slovakia are given a brochure that emphasizes diamine oxidase (DAO) as the degradative enzyme of histamine in the body. However, other sources also mention histamine-N-methyltransferase (HNMT).

Once formed, histamine is either stored or rapidly inactivated by its primary degradative enzymes, histamine-N-methyltransferase or diamine oxidase.—Wikipedia

Consequently, flawed HNMT activity leads to chronic forms of histamine intolerance.—Wikipedia

In general, increased sensitivity against biogenic amines is due to a weakened enzymatic amine degradation caused by genetic or acquired impairment of MAO, DAO, histamine-N-methyltransferase (HNMT) function.—Histamine intolerance and dietary management: A complete review, 2016 paper by Martin, Brachero and Vilar.

Histamine is N^τ-methylated by HNMT, as the name histamine-N-methyltransferase suggests. In 2015, after reading about methylation, I have slowly made methylation-related changes to my diet with great results. Some time in 2016 or 2017 I’ve learned about the connection between methylation and histamine and made my diet even more strict, which led to even better results.

In the spirit of health bloggers, I’ll now conclude that my symptoms were fixed by methylation and HNMT. Post hoc ergo propter hoc. Haha, just kidding, I can do better!

My diet is now rich in B vitamins, magnesium, collagen, and many other nutrients. These have plenty of other effects, so it’s hard for me to judge causality. In any case, people having histamine-related problems could try it out and see if it helps. All of this made me curious why histamine intolerance patients aren’t told about HNMT but only about DAO. For example, HNMT is active in the central nervous system, where DAO is not present, so focusing purely on DAO might not improve all symptoms.

Interestingly, the histamine intolerance brochure given to patients was written by the producer of the DAO supplement, who wants people to buy their product and has an incentive to hide information about HNMT. I’d still give them the benefit of the doubt using Hanlon’s razor: “Never attribute to malice that which is adequately explained by stupidity”. In this case it could be my own stupidity, since I’m not an expert.

If you’ve made it this far and are interested in methylation-related dietary changes, check out Chris Masterjohn’s methylation guide and his presentation on Methylation, MTHFR, and Histamine.

Doubts about modern medicine

Over the years, my opinion of medicine became gradually worse. In 2011, I thought that I have a condition that’s hard to diagnose and treat. In 2014, I was questioning the Swedish public and private system. In 2016, I shared Robin Hanson’s proposal to cut medicine in half, but added that I’m not buying it yet. Well, now I’m totally buying it. We spend too much on medicine.

If you want to challenge your believes, I recommend reading Robin Hanson’s article or his book The Elephant in the Brain (together with Kevin Simler). I also recommend the article When Evidence Says No, But Doctors Say Yes by David Epstein.

The early phase of COVID-19 is a great illustration of these ideas. People assumed that enough ventilators would save us all. However, early data showed that survival rate on ventilators was somewhere between 3 to 35%. Ventilators and their operation are very expensive, requiring intensive care from nurses and doctors, but they only save few people. Ventilators are used at a very late stage of the sickness when they cannot do much. Preventive measures such as social distancing and face masks are cheaper and more effective. However, they require participation from everyone.

Most money in medicine is spent on people over 60, when it’s too late for miracles. There are cheaper preventive measures such as exercise, good nutrition, better sleep, not smoking, etc., but these require participation from everyone.

I think it’s important to spread Robin Hanson’s message, but not because it would make us spend less money on medicine. The spending will continue, but perhaps people would start taking better care of their bodies if they knew that medicine can not do much.

Recommendations

There are many people in the better half of medicine and I have to thank them for a big part of my progress. I can recommend the following people for health advice. Some of their content is not free, but I highly recommend spending some money on valuable information.

• Chris Masterjohn might be the most knowledgeable person on micronutrients. I recommend his Cheat Sheet or Vitamins and Minerals 101 course/book.

• Barbell Medicine is run by two doctors who are great lifters. They have great content regarding exercise, though mostly strength training. I’ve successfully used their free and non-free training programs. Also, I highly recommend watching their lecture series on low back pain (part 1 and part 2).

• Slate Star Codex: Scott Alexander is a psychiatrist who blogs about a lot of topics, medicine being one of them.

• Stephan Guyenet is a neurobiologist blogging mostly about obesity but also other topics. Also see his old blog.

Conclusion

I wish there was one simple trick but I failed to find it. I’ve counted about 15 micronutrients that I need to be cautious about and 5 daily/weekly habits. And all of these need to be correctly dosed, which is a lot of work.

Hopefully this is my last post regarding health. It took a few years—almost 2 decades—but now I can live life to its fullest.

How to be happy and build socialism (for real this time)

Recently a couple of friends started a mail discussion on where to live. Some people like to choose places with interesting work opportunities but I think that approach maximizes the wrong thing. I think that happiness should be the ultimate factor. When it comes to happiness the more important question is how to live instead of where to live.

So how should you live? I think science, namely psychology, can now offer an excellent answer. In the last couple of decades psychology evolved from a "quackery" into a solid science. The Happiness Hypothesis book by Jonathan Haidt does an excellent job of presenting the latest research on happiness. I particularly like Haidt's thorough scrutiny of known facts. For example, it is known that married people are happier. But are they happier because they are married or are they married, because they are happy and thus more attractive to others?

Here is my short summary of the book.

• Perhaps the most important factor is how well socially connected you are—your family, friends or local community are very important. When it comes to a local community, I have been a member of various sport clubs or volunteering groups and many of my happiest memories come from these communities. And don't let me started on all the memories with friends.
• Some people mistakenly equal comfort and pleasure with happiness, but it doesn't work that way. If you derive happiness from drinking wine, after a while it wears off and you would need to upgrade to a more expensive wine or find something else instead (see hedonic treadmill). Stoics and Buddhists were right: go ahead and take a cold bath!
• Nietzsche was right when he said "That which does not kill us makes us stronger". In the last 4 years I have struggled with health problems, but I think I'm happier as a result. I really appreciate ordinary things like a good friend or a day without pain. Also, lack of adversity is one of the reasons why overprotected kids end up being less happy adults.
• Money only buys you happiness until a certain level of income and then they don't matter anymore. If you want to use money to increase happiness, use them on other people or buy experiences instead. There is also new evidence that saving might be the best option.
• Altruism is a great source of happiness. Giving a gift is more beneficial to the person giving the gift rather than the one receiving it.
• Work is not as important as most people think, but it has a measurable effect particularly if you have some autonomy in your work. Also, many people experience flow when they are immersed in a challenging exercise. I remember countless nights when I barely drank or ate until a particular math or programming problem was done.
• Genes and early environment are an important factor in happiness but they are the thing of the past, so there is little you can do.
• The place where you live is not as important as people think. You'll be as happy in sunny California as in cold and dark Tromsø. Although there are some environmental factors that stress you out and make you less happy, like commuting or high noise levels. Stress in general is a bad thing and not just for happiness.
• Some sense of morality and meaning of life are important too. Traditionally these have been provided by religions but atheists also need them to be happy.

If I were to sum up the book in one sentence, it would be "Relationships matter the most and career, money and comfort are overrated." Your grandma would probably tell you the same thing, but it's good when scientific findings agree with reality for once.

Live like my parents

My parents have lived their life as preached by Happiness Hypothesis even though they haven't read it. They have very strong social ties, spend money mostly on travelling and don't work a lot.

For example, my father is a doctor but he is better known as the head of an orienteering club. He doesn't have an impressive professional career but he has a spectacular career as a volunteer. Did you know that Pezinok once hosted the World School Orienteering Championships? Alright, you have probably never heard of the small town Pezinok, but still...

When it comes to money, they spend most of it on experiences. My brother and I didn't have a lot of fancy things while growing up, but by the time I was 10 years old I have been to half of Europe. They still travel a lot with their small community of 20–30 people, doing things like biking for a week in the Alps. Most people my age wouldn't dare to go on the bike tours these almost retired people manage to do.

Economic systems

Do you know what is absolutely essential in capitalism? Reputation and trust. When you buy a meal in a restaurant, you trust the employees that they will not serve you spoiled food that makes you sick. If they did that, you wouldn't come back and you would tell all your friends to stay away from the restaurant. The reputation of the restaurant would get damaged, people would trust them less and the restaurant would get fewer customers. They might lower their prices as a result.

If this happened repeatedly, you would mistrust restaurants altogether and stop eating out. This would then lead to an inefficient outcome: you could be doing your normal job instead, get a higher salary for that and then use it to buy an excellent meal. Instead you forgo your salary and cook a mediocre meal at home, while the restaurant decreases its revenue. When people don't trust companies, everyone is worse off—the regular people as well as the companies. By the way, high level of trust (and capitalism) is one of the secrets behind the Scandinavian success.

Sometimes capitalism doesn't lead to good outcomes. People near a major tourist attraction just come and go, so the owner of a restaurant might not care about reputation and serve bad food (word of advice: don't shop near tourist attractions). In a closely knit community you can't afford cheating like that, because people would gossip about you and maybe even exclude you from the community. Evolutionary psychologists theorize that our obsession with gossip makes a community well-functioning. Gossip is a great tool, you quickly get to know who's a cheater and who's honest.

When you are doing transactions in a community, you rarely pay the market price, if you pay at all. When you help a friend move, you might get a lunch as a reward. Even a friendly outing to a bar is a transaction: you trade your time and company in exchange for theirs.

Being a member of a community gives you access to goods that capitalism is bad at providing. Only a friend's hug feels like a friend's hug. Only your grandma can cook a pork knee exactly like your grandma. Only your friend can plan a vacation tailored for your small gang taking into account everyone's preferences. No company can ever do those things, although the Japanese would disagree.

The economic system I just described is very similar to socialism. Socialism and capitalism have both its place in a society and both have advantages and disadvantages. Once you start applying them where they don't belong, you'll get into trouble. If you charge your partner each time you have sex, your relationship won't last long. If you make a whole country use socialism, it will also end in a disaster, because it takes enormous brain power and gossip to track reputation in a huge community. The people who founded the Soviet Union overestimated the capacity of our brains by a factor of about one million.

A small community has a cultural advantage in addition to an economical one. You can ignore your country's culture, since you spend most of your time in your own subculture. You can also ignore politics to a large extent. When a politician messes up unemploymeent benefits, you stay calm, because you have 10 people who would help you if needed.

Work is less important

Apart from work not being the main factor in happiness, I see many other problems with prioritizing work over everything else. For example, if you move to a different place solely for work, you severely cut your social ties. Most people think they will find new friends in the new place, but that rarely works out. Most expats end up befriending other expats and only integrate with the locals very slowly. If you really want to prioritize work, choose a place with more expats.

I also realized that where and what I work with doesn't matter that much. I like to do many things and most of them can be done almost anywhere.

• I really enjoy writing and people seem to enjoy reading my articles. My most successful post I wrote for Spotify has been viewed 49 000 times until now.
• I also like to organize vacations for my friends and they trust me that I pick good places. In the summer I can barely focus on regular work and I often procrastinate by planning vacations.
• From the jobs I have actually been paid to do, I have enjoyed teaching the most. That is another option that can be done almost anywhere.

All jobs mentioned above—writer, travel guide and teacher—usually don't offer high salary, but that is not an issue if you don't care about money, as I explain below.

Early retirement

My life turned around by 900 degrees (that's 360 + 360 + 180 for the mathematically inclined) when I started reading about saving, investing and early retirement. Did you know that you can retire in 17 years if you manage to save half your salary every month?

What happens when I save enough to retire? I won't start laying around doing nothing! I might just do something else than before, like starting a travel agency specializing in bathing in ice-cold lakes all over the world. Perhaps I could write books or teach courses about bathing in those ice-cold lakes. These ideas might not be very profitable but that doesn't matter, since my investments would provide enough income anyway. Interestingly, I achieve flow more often when working on hobby projects than in regular jobs, so doing this should also increase my happiness. And I would also like to work less than 40 hours a week to have times for activities and people that make me more happy.

You might think that saving 50% is impossible, especially in this economy. This is nuts, because you have it 10 times easier than your great-great-grandmother. People in the US spend less than 13% of their income on food, while in 1950 it was 30% and I bet similar development has happened all over the world. A couple of centuries ago sometimes even 100% of your income wasn't enough during a famine. People are so poor that whenever I go to a shopping mall in any modern country, it's always full of people. With such enormous economic prosperity and wealth people still have trouble surviving from paycheck to paycheck and happiness is not increasing. Everything is amazing right now and nobody is happy.


Buying expensive things doesn't make you happy, so why would you waste money on them? If you imagine yourself retiring in 15 years and having more time to do things that make you truly happy, getting rid of your expensive habits becomes a piece of cake.

The rise of the robots and artificial intelligence is also a very good reason to save as much as possible, because we will all lose jobs sooner or later.

Conclusion

The message of all the knowledge about economics, stock market and the science of happiness is crystal clear to me. Use capitalism to get wealthy, retire early, embrace the power of socialism and increase your happiness in the process. Marxists used to say that socialism is the next step after capitalism and I guess they were right. I still think that Marxism is a dangerous ideology that killed at least 100 million people, but deep inside of it lies a bit of truth.

A good place to look for wisdom is where you least expect to find it: in the minds of your opponents. – Jonathan Haidt in Happiness Hypothesis

The importance of F-You money

In the previous year, I have given advice to many people about saving and investing, so I thought I would put some useful tips into one post. I don't consider myself an expert on the topic, so it's mostly links to other blogs and books. Enjoy!

Introduction to F-You money

Having F-You money brings your stress level down and makes you happier. Once you have enough of it, you can say F-You to your boss and do nothing for the next couple of months. Or say F-Everyone and retire when you are half the age of other retirees, but getting there takes longer. Just don't say F-You too often, most people don't like it.

It’s a big beautiful world out there. Money is a small part of it. But F-You money buys you the freedom, resources and time to explore it on your own terms. Retired or not. – Jim Collins

By having F-You money, you are becoming one of the bad rich guys: your savings help some companies create new jobs, expand or innovate. While doing that, you are refraining yourself from consumption and helping our poor planet.

How do you do it?

Forget your bank's mutual funds where you get a worse product for higher price. Real (wo)men buy cheap index fund ETFs on the stock exchange. Every couple of months I take some money and buy ETFs on Berlin or New York stock exchange, while ignoring the price. I also own some bond funds. I buy mostly Vanguard. I never sell and I don't keep an eye on the stock market. Trying to outsmart a random walk is very risky.

The most bulletproof strategy for saving each month is to take money from your salary on the pay day and move it to an account that is not connected to a debit or credit card. You might have been told that you have already made a good investment by buying your house, but that might have been a huge mistake.

When talking to my friends about saving some F-You money, their most common excuses are "I have a girlfriend" or "I can't downgrade my lifestyle". Well, you can talk to your spouse and you should know that luxury is just another weakness. You don't need the new iPad. While changing your mindset, you can go further and upgrade your philosophy and become happier in the process.

For all the Slovaks

One of the typical Slovak pastimes is complaining. Slovaks are so poor that when you go to any shopping mall, it's always full of people. And for them I have one message: as shocking as it sounds, the only way to get richer is to save. The politicians tell you the opposite – they tell you the economy needs more consumption. But what they mean is that they get richer from your consumption through taxes. What your (and my) country needs is capital. So instead of complaining, go ahead and do something about it; save 20% of your salary each month, that's a good start.

Further reading

• A Random Walk Down Wall Street: The Time-Tested Strategy for Successful Investing, by Burton G. Malkiel. The stock market behaves like a biased random walk, so outsmarting it is futile.
• Mr. Money Mustache, a blog with a lot of philosophical and frugal advice. Very entertaining.
• Jim Collins' stock series, although he talks about many more things than just stocks.
• Spend 'Til the End: Raising Your Living Standard in Today's Economy and When You Retire, by Laurence J. Kotlikoff and Scott Burns. A book claiming that most of the advice linked above is too simple and that you need to use a computer to optimize your retirement savings.

Living with histamine intolerance, part 2 – Cold showers and the road to stoicism and happiness

Some symptoms mentioned in this post come from other diagnosis than histamine intolerance. Read more in part 3.

My struggle with histamine intolerance continues but I feel great most of the time. There is not much information online and if there is, it's often contradictory and confusing. By sharing my experience I hope I'll help someone. As a bonus, you might learn about cold showers and ancient stoic philosophy.

Last year I wrote a very optimistic post after feeling great for 3 months. However, things got worse again soon after that. Thanks to Spotify's private insurance for employees, I was able to avoid long waiting times in the slightly dysfunctional Swedish public health care and talk to doctors more often.

It turned out that my diet was too restrictive with too much fiber and too little histamine, so I made some changes like eating more meat. I am now also taking medication, mostly histamine antagonists and also Daosin is essential if I want to travel or enjoy the occasional dinner in a restaurant. I am still trying to find the balance between different side effects. If my diet is too strict, I suffer from some side effects; if I take too much medication, it's other side effects.

Looking back, it was an awesome year since I wrote the previous post. The number of times I had excruciating pain in my stomach could be counted only on one hand (computer scientists: using unary encoding), which is a big iprovement. I did two research stays – two months in Switzerland and one month in California – I worried first about the unknown food but it went well in the end. I also had a lot of fun and I have been on many trips in 13 different countries. Travelling is easier than I thought, I just need to be prepared. And last but not least, after a very long time I had a date which I could fully enjoy without feeling any pain.

Cold showers and exercise

The best thing about Sweden is that in winter you can get ice-cold water in the shower. If I only get 4 hours of sleep for some reason, I take a cold shower, bike to work as fast as I can and I'm productive until late afternoon.

Cold showers are great and you are missing out if you are not taking them. One guy even said:

The world would be a better place if everyone took cold showers – Lukáš Poláček

Okay, okay, I'm quoting myself but this is my blog, so I can do whatever I want! I usually take a quick warm shower for 2 minutes, then turn the water to ice-cold, which in December is about 7 degrees Celsius, and continue for about 30 seconds. I also tried a 3-minute 15-degree shower, but I found it less effective for my purposes than the first variant with 30 ice-cold seconds.

The ice-cold water gets blood circulation going and your body starts to release endorphines. The feeling is very similar to the Runner's high you get after a run but without the tiredness caused by exercise. Cold shower has many more health benefits but I do it mostly for the ones I mentioned.

A couple of months ago I moved to central Stockholm, so everything is reachable within 15 minutes by bike. For the first time I don't have a public transport card and I love it, even though it's winter. Cycling in Swedish winter is more enjoyable than cycling in the rain and studded tires make it safer on ice than walking. Cycling is exercise, so it's also very good for waking up.

I recently read Fight Club and it became one of my favorite books. I can relate to some of the excellent quotes in it:

You aren't alive anywhere like you're alive at fight club. – Chuck Palahniuk: Fight Club

I wasn't alive anywhere like I was alive beyond the Arctic Circle while ski touring in the worst weather.

Kolo skinning up to Tarfala

The medication and strict diet can make me tired and lethargic. I discovered that the best cure for these side effects are cold showers and exercise. They both make me feel alive again.

A little bit of philosophy

My diagnosis has taught me a lot about life. This year I stumbled upon stoicism, which is a very interesting philosophy that I was slowly reinventing myself. According to Mr Money Mustache, the core of the philosphy is: "To have a good and meaningful life, you need to overcome your insatiability". Cold shower is an example of stoic activity but how can I further apply stoicism?

• Instead of complaining that I only have one choice in a restaurant, I'm grateful for having that one choice.
• Instead of complaining that I can only run twice a week, I'm grateful that I am able to run.
• Instead of complaining that I get a migraine once a month, I'm grateful that it's not every day.

Complaining does not help with things I cannot control. My metabolism will not change by complaining. On the other hand, expressing gratitude will help me to be happier. I still want to find the best combination of diet, exercise and medication, but if it stays this way for the rest of my life, I'll be fine with that. It is interesting that stoicism has existed for thousands of years and scientific research now confirmed that it was (mostly) correct.

I have spent my whole life scared, frightened of things that could happen, might happen, might not happen, 50-years I spent like that. Finding myself awake at three in the morning. But you know what? Ever since my diagnosis [lung cancer], I sleep just fine. – Walter White in Breaking Bad

Walter got cancer, which is worse than what I have, but I can relate to his words. The amount of pain I had in the last 3 years is more than I would wish to my worst enemy. There is more pain to be had but I'm not afraid and I know I'll be alright.