Poker readers resuscitate health column

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As I write this, the stagnant humidity of late summer in Florida has sapped my energy and parboiled my brain. Column ideas are slow-coming in this heat so I beg your indulgence as I fall back upon that time-tested device used by lazy journalists everywhere, the “Reader Feedback” column.

I actually have some pretty interesting comments and questions from readers that may serve to enlighten and entertain until the weather breaks and inspiration strikes me again.

• During the last Ante Up cruise, a reader I’ll call “Bill” thanked me for a suggestion in one of my columns that greatly improved his ability to enjoy playing poker and even helped the quality of his game. Bill, it turns out, suffers from severe, debilitating back pain. Many with his condition resign themselves to a life of inactivity, but not Bill. He’s active, works hard, supports his family and relaxes by playing poker. I’ve sat across the table from him and can swear by my ruptured L3 disc that he knows what he’s doing.

The problem for Bill was he frequently needed strong pain medication just to sit comfortably at a poker table for more than an hour. The meds control his pain but they also make him groggy so it’s tough for him to concentrate on the complicated decisions that arise during play. He was almost ready, he told me, to give up poker.

Then he read a series of columns I wrote last year on performance-enhancing drugs commonly used by poker players. After a consultation with his physician, they decided to try Provigil, one of the drugs I described. He said the improvement he experienced in his alertness and ability to concentrate was remarkable and now he enjoys poker more than ever. Of course, I can’t offer anyone specific medical advice through a magazine column, but if you want more information on Provigil, your physician is your best resource.

• An ER nurse who is a regular $5-$10 limit player at the local casino read my recent column on having defibrillators available in poker rooms. A few months ago, he was peering at pocket jacks when a player across the table from him keeled over and hit the floor. The nurse started CPR and called for help. Within just a few minutes, a casino “medical team” arrived with the Holy Grail of resuscitation equipment, an automatic external defibrillator. Just a few seconds (and 360 joules) later, the player was awake and protesting any attempts to transport him from the table and to the nearest ER. Kudos to the nurse, the casino and the guy whose job it was to know the location of the AED.

Positive results all the way around, except possibly for the nurse whose jacks were folded by the dealer. Actually, considering my luck with jacks, having them folded probably IS a positive result after all.

Does your poker room have an AED? If you’re at risk for “The Big One,” it’s perfectly reasonable to ask your favorite room to devote a little of your rake toward buying one. At about $1,700, it’s cheaper than a lawsuit.

• Another reader, a diabetic, asked me if I had any explanation why his blood sugar spiked when he played live poker. Of course, without doing some testing, it’s hard to do more than speculate, but I have a theory. Fear or excitement can trigger the classic “fight or flight” mechanism, which causes the body to release epinephrine. Epi has a whole list of side effects, including racing heart rate, shakiness, constricted pupils and release of glucose from where it’s stored in the liver, and hence, the blood sugar spikes.

If playing live poker gets you happy, excited, anxious or fearful, it’s quite natural for your body to want more sugar available for instant energy. Whether you need a little extra hit of insulin during those times is a decision best left to your doctor.

• Finally, a reader commented on my play of a tournament hand. Holding kings, my epinephrine surge made me a little shaky when another player shoved after an ace hit the board. I agonized for some time before reluctantly mucking my beautiful kings. The reader remarked there should be no hesitation on my part. Easy fold, he said. No hesitation. No shakiness. Throw them away.

My answer to his advice: There’s a clear reason why the Ante Up publishers have not asked me to write a column on poker strategy. They know my poker game well enough and have kindly and gently steered me toward writing a medical column instead, a subject that I may actually know something about.

If you have questions or comments about health issues (please, no poker strategy questions), I’d love to hear from you. Feel free to write, e-mail, log into the Ante Up forum or grab me in the local cardrooms. And if like me you’re sweltering in the late summer heat, hydrate, relax and play some cards.

— An avid poker player, Frank Toscano, M.D. is a board-certified emergency physician with more than 28 years of front-line experience. He’s medical
director for Red Bamboo Medi Spa in Clearwater, Fla. Email your poker-health
questions to ftoscano@redbamboomedispa.com