Gout, Back Pain,& my AppendiX

David Foster, L.Ac.
13 min readJun 17, 2021


Do not take the following as medical advice. This is a theoretical relation of one individual’s experience, and you should consult a physician with all health questions.

As a practitioner of holistic medicine — an acupuncturist — some people assumed over the winter that I might be against Maxine — I wouldn’t allow the doctors to inject any foreign substances into the temple that is my body, and/or I would be fine so long as I consumed enough green vegetables. While the latter isn’t far from my belief system, neither I nor most of my colleagues were against Maxine within the present global circumstance. Being far from an expert in the field, I deferred mostly to mentors and peers smarter than me, one of whom even reminded me that Traditional Chinese Medicine arguably invented Maxine, hundreds of years ago crushing up smallpox scabs into powder then blowing it up children’s noses to create immunity. On top of which, I’d begun seeing patients in my own clinic in Manhattan and had a pregnant wife at home that I had to keep safe. My dates with Maxine were at the beginning and end of February, and although I was nervous, having not had one since childhood, deep down I figured that most anti-maxxers were kooky quacks. I’d be fine.

After my first shot I experienced almost constant heart palpitations for about one week, which abated after a few acupuncture treatments, although I’ve experienced them occasionally since, while especially hungry or nervous, a symptom considered to be common but that I’d almost never had in the past. I had the normal soreness and fatigue after the shot, but contrary to the mindless masses’ eagerness to share these miniscule side effects as evidence of its ultimate safety, to me this was insignificant. The graver concern is around systemic effects that develop latently over time, set in motion by a mysterious mechanism that is not yet fully understood. I agree that science is indisputable, however western medicine does not have a monopoly on science, and shouldn’t it be only logical to question modern attempts to manipulate it?

Over the fall and winter of 2020, I suffered with terrible low back pain that responded only moderately to acupuncture treatments, which was odd and frustrating, but around January began to finally improve thanks to my cousin, Jonathan’s online movement regulation program, aptly titled: “Beat Back Pain.” My case was confounding even for he and his partner, but in what I now refer to as “the ivy league of physical therapy” they finally discovered exercises that combined strengthening my quadriceps and stretching my hamstrings got me back in the right direction. By the end of January I turned to my wife and half-joked: “I did it, babe. I ‘beat back pain.’” I read that to facilitate a healthier response to Maxine it was a good idea to engage in some form of cardio exercise within twenty-four hours prior to your shot. I was grateful to be able to get back on our Peloton, followed my ride with prescribed rehab exercises, and in contrast to months prior felt no lumbo-sacral pain afterwards. I was cured.

My second shot came as advertised: Within a few hours I hit a wall that floored me for a day with headaches and low back pain, though no chills or fever, no stomach symptoms, and thank God, this time no palpitations. I was unconcerned about the back, well aware that my body was simply creating antibodies, battling a contrived flu, and this was common, temporary, and easily resolvable. Right on cue, after twenty-four hours I was symptom free, going about my life, anticipating full immunity. A few days later I moved a mattress and box spring from one bedroom in our apartment to another and a few days after that my back completely fell off a cliff. It wasn’t like it had been in January — it was worse — and while my wife cited the mattress as probable cause, I was skeptical. I’m a fit, forty-three year old man. I slid a mattress along the floor for ten yards and felt no discomfort whatsoever during or after the process, which is in contrast to how my lumbar spine felt immediately following Maxine. Still I figured it must be temporary and I had the precise tools by which to address it. I did my exercises daily, worked on my quads and hamstrings, even incorporated a few other movements I knew to be helpful, but my back got perpetually worse. For the first time in my life I experienced sciatica pain and even had trouble walking down the street some days. I returned to acupuncture, but treatments helped only briefly, another reminder that the initial twenty-four-hour outcome of some medical modality is not enough to deem it effective, ineffective, harmless, or anything else. We are all aware of long incubation periods of diseases, also the duration which certain medications for chronic conditions require to “kick in,” but for some reason our moron-brains expect for the complete result of any hands-on modality to show itself immediately. No one could figure it out. Nothing seemed to help. I was relegated to heating pads and putting pillows behind me on the couch like my pregnant wife seated next to me. I felt like one of my poorest patients, those who never eat right or exercise, addicted to a long list of medications, and can’t understand why their body is in a perpetual state of inflammation. Ah, yes… inflammation.

Whenever patients come into my office with an orthopedic chief complaint of low back or shoulder pain and I ask them about their diet they look at me like I’ve got three heads, and why am I wasting their/our time with such irrelevance? What does pasta have to do with my rotator cuff? But from any holistic medical perspective, inflammation is inflammation, whether in the form of fatty liver disease, canker sores in the mouth, or a flabby psoas muscle that might put excess pressure on the spine and lead to low back pain. Chinese Medicine refers to it as different expressions of “dampness,” or pathogenic fluid accumulation logically within a complex vessel made mostly of fluids. Some dampness is “hot” in nature, others is “cold,” usually depending on the genetic constitution and hormonal tendencies of the individual. Mine is mostly hot, as is my parents’ and brother. That’s why I suffer from gout disease.

I had my first gout attack when I was twenty-five — unusually young, but not unheard of when one’s father and older brother both had it. I got attacks in my toe annually, and it got to the point that I could practically set my calendar. It was almost always between the end of summer and beginning of fall, the time of year by which all of the humidity of summer had time to settle and accumulate in my body. As there is an autoimmune component to gout disease, most attacks also followed a common cold. My body’s immune system exhausted, defenses were down, anti-inflammatory markers re-directed towards the acute, which allowed the chronic to embolden. In 2018, at the behest of one of my mentors, Dr. Frank Butler, I completely gave up refined sugar — subbing daily spoonfuls of nut butters and 90% dark chocolate in its stead — and never had a gout attack again… until three weeks after my second date with Maxine. It came on as it always had, painfully in my left toe, unexpectedly in the middle of the night, and on the heels of an immune response, although this time it wasn’t the right time of year. It was March.

Coincidence? Maybe. Possibly. Doubtfully.

During the interim I had a few new patients come into my office with Bell’s Palsy, onset immediately after Maxine. My friend’s father, an old man, went into anaphylactic shock and had to be rushed to the hospital. I went to a sports medicine doctor and a physical therapist who both relayed to me multiple cases of patients’ long-term chief complaints returning after the shot, similar to my back pain. Why aren’t we hearing these reports? That’s a rhetorical question. Does this mean I think Maxine is evil? No. Only you Simple Simon, binary-thinking motherfuckers without the capacity for critical thought require things be labeled as bad or good. My point is the public is entitled to more of a conversation than cartoons and black doctors in bad commercials just telling us it’s “safe.” I realize the majority has experienced no side effects, and we hope there is nothing brewing for them beneath the surface, as was apparently the case for myself.

105 days after Maxine — still fifteen days short of the lifespan of a red blood cell (which happens to be the same interim of time that ancient qi gong masters prescribe an exercise be done to alter one’s physiology) — I woke up at 4:00 in the morning with an acute appendicitis. One of my best friends, who got his vaccine a few weeks before I did, also had an appendicitis one month prior, as did two of my wife’s (who’s a doctor) patients on the heels of their Maxine. For those still living in the 1980’s under the illusion that the appendix — an organ in the body — serves no purpose at all, even western medicine has come around to understand that it acts as a reservoir for healthy gut bacteria that includes an integral portion of the immune system. That’s right: The immune system. Coincidence? Maybe. Possibly. Doubtfully.

The decision whether to have an appendectomy was the hardest I’ve ever had to make in my life. Obviously this sounds preposterous to almost anyone not formally educated in Traditional Chinese Medicine, but I have mentors whose intellect and clinical experience I hold in the highest regard, who observed countless cases of appendicitis successfully treated with herbal medicine in Chinese hospitals, albeit under the cautious care of a hospital environment. I knew the empirical formula — we’d learned it in school — but I’d never personally used or prescribed it, never saw its efficacy firsthand. None of my teachers could be classified as “woo-woo” kooks, quacks, or “faith healers,” not even by MD’s. These are scientific thinkers, responsible clinicians, all of whom smart enough to not formally advise me to leave the hospital. One of them was kind enough to write me a script to fill as soon as possible if I chose to, along with detailed instructions for how to treat myself over the next few days, with close monitoring; and God was I tempted. From a Chinese medical perspective, one does not ever fully recover from opening the body. While surgery can be brilliant and invaluable, it is nevertheless traumatic and inorganic — our abdomen is not an external orifice — which brings with it side effects that can potentially last a lifetime, depending on self-care (there is herbal medicine for recovery from such trauma). Professionally I can tell you that I’ve seen countless patients whose symptoms all began after some surgical procedure. This does not mean I think that surgery is inherently bad either — just that it should be reserved for when absolutely necessary. There was no way to know if mine was absolutely necessary. My wife and I stayed in the hospital for twenty-four hours, deliberating, crying, praying for a sign and not sleeping at all, until finally conceding to the safe side, the routine procedure, inadvertently reassuring the MD’s on staff that I was not completely out of my mind.

I sit here today a new person, safe but changed forever, a bit worried, only wishing I was so blissfully ignorant to not be so aware. “I had my appendix out,” many people have told me this week, “and look at me: I’m fine.” But none of them are fine by my standards. NONE OF THEM boast the kind of physiology I aspire to, nor do they live free of medications. This doesn’t mean their ails are a direct result of their appendectomies, nor that I cannot live a healthy life in my own right, by my own way. But it would be naïve to think now with my first hole and accompanying void in functionality, that I don’t have a steeper challenge ahead of me.

It would take a textbook to summate all of the principles of Chinese Medicine (see The Web That Has No Weaver or Enlighten-Weight), but one of them is that the body exists in three “jiaos” (jows), or horizontal sections. The upper jiao consists of the heart, the lungs, and corresponding skeleton, and is thought of as the respiratory microbiome; the middle jiao is the busiest, with the stomach, spleen, pancreas, liver, and gallbladder, or the gastrointestinal microbiome; and the lower jiao contains, you guessed it — those lower parts of the body: The adrenal glands and kidneys, the lower back that rests behind them, the intestines and urinary bladder, the urogential microbiome. People genetically predisposed to inflammation in this region have a tendency to “damp heat” symptoms such as low back pain, gout, kidney stones, foot fungus, jock rash, yeast infections, etc. It’s true, this describes my pattern perfectly, and curious that it flared up so dramatically within three months of Maxine.

Even the wisest doctors explain all the time: Some people have reaction X to Y, but some don’t… we can’t explain why. There is a lot holistic medicine cannot do, but with all due respect to doctors we can explain why. Every medicinal, whether a pharmaceutical, herb, a food, or a shot, has a particular nature, certain qualities that make it more agreeable to certain physiologies than others. For example, ginger has a very warming quality, which many people with hypotension, anemia, and/or hypothyroidism — those who fit a “cold pattern” in Chinese Medicine might benefit greatly from. However, for the alcoholic with a red face, red eyes, always sweating and suffering from hypertension (an apparent “heat pattern), ginger might be all wrong, and would likely make his symptoms worse. This doesn’t mean ginger is either good or bad — just that it is medicinal, which makes it intrinsically mutable depending on the vessel receiving it. The same rule applies to pathogens, which is why people with certain (“cold and damp”) constitutions died from coronavirus, while others barely realized they were sick. My growing suspicion is that those of us with the most difficult fallout from the shot may have fallen into the latter category if given the shot, no pun intended.

It stands to reason that Maxine’s nature would be damp and hot. It is stimulating an immune response, which is inextricably linked to feverishness; meanwhile the nature of coronavirus, from a Chinese medical perspective, is damp, which is why mortality rates were so much higher in obese people. Possibly it was a bad sign for me that I didn’t experience a fever the day after my shot. In our lexicon we might say its heat bypassed the superficial layer of the body intended to fight foreign pathogens (the “tai yang” or innate immune system), and lodged deeper into the adaptive immune system, the organ layers of where I am most vulnerable, my urogenital microbiome, quietly perpetuating a ticking time bomb. Giovanni Macciocia is a famous acupuncturist who theorizes that all expressions of Maxine create heat (inflammation) at the body’s deepest level, thus reminding the masses that it is not those first forty-eight hours after the shot that anyone with half a brain worries about, but the forty-eight years after that.

I’m not a psychopath. I don’t believe there is a chip implanted in me, nor that Fauci and Bill Gates created CoVid-19 in a lab, or that the Super Bowl is always fixed. Such far-fetched theories are as dim-witted as those they detest — those who take every medical report on the nightly news as gospel and follow conventional medicine as an orthodox religion. Instead, it just confirmed what I already knew to be true: Maxine is inherently inflammatory. It is doing what western medicine does — robbing Peter to pay Paul — which in this case would be difficult to argue is not the best option for the global good. Although, it would be equally difficult to argue there haven’t been casualties in the process.

Personally, I’ll probably never go out with Maxine again, however even this decision should not qualify me as “anti-max.” My baby to come will receive many shots, as I can’t make a good argument that the risks outweigh the benefits. My baby will probably not receive the flu shot, because I never got the flu shot, nor did I ever get the flu; not to mention the fact that it is only approximately 50% effective anyway! I’ve had a physically traumatic few months and come to the reasonable conclusion that this shot was basically the high dose ginger and I the red-faced sweathog who would’ve done better without it. Many other people may be the cold-faced, obese, hypothyroid patient, for whom it is more beneficial to pay Paul. If only we lived in a perfect world, where there was some way to have known the qualitative nature of the shot, then for all of the doctors to line us up and diagnose our holistic patterns, determine who the shot is most suitable for, and what medicinals the rest of us can take to counter its effects. Unfortunately, such a procedure is impractical at best.

These things are complicated. On one hand I can recognize that the shot may be saving the world, and if everyone chose to not get it things could get universally quite dark quite quickly. On the other hand, I equally understand people not wanting to get it, especially those with a holistic proclivity to “damp heat in the lower jiao.” But we cannot be so mindlessly hypocritical as to shout: “Don’t tell a woman what to do with her body!” (when it’s not even really her body that’s the issue there), then at the same time insist that everyone inject into their body what the masses recommend. I don’t agree with the platitude that it is my responsibility to protect everyone else by compromising my own well-being. My masking and social-distancing has been of the highest order, the Liberal New Yorker, Jewish-husband-to-a-Jewish-doctor-level masking and distancing. I can accept this as a responsibility we all carried, as such practices carry with them no side effects (sure, there is the distancing-induced depression, but a) that is more temporary than losing your reservoir of immunological gut bacteria, and b) social distancing exists along a huge subjective spectrum wherein we’ve still all been able to see and interact with loved ones). But there is a line for us all, where the science of Darwinism takes precedence over medical advancements. It is not the line where we stop following science, but where we determine science to be closer to nature than to technology. I sincerely wish the best for everyone. I wouldn’t harm a fly. But it is not my responsibility to protect the weak — especially the self-induced weak, the ignorant and lazy — at the expense of my own long-term health. I’ve done enough. Please pray for my future immunological gut function.



David Foster, L.Ac.

Acupuncturist and Chinese medicine in NYC, special focuses in neurological, psychiatric, orthopedic, and autoimmune conditions. Hip Hop Head, '88-'98