Where Have YOU Been?

It has been a while since Cindy and I went out to Carmel Valley to work on the Arnold Cabin.  I gave you a peek at the emotional perspective in my previous post on the subject, The Arnold Cabin Project Part 3: The Real Story, but there's always more to say, isn't there?  For the more nuts-and-bolts perspective, I will kick off a little series of "how did" posts (as opposed to "how to").  And, as luck would have it, I've been invited to attend a family function out at Hastings this weekend.  I'll use the occasion to take some update photos of how things look after the Winter.

But first, a word on where I've been: We got back from the cabin project in August of last year.  I've written before about my neuropathy (numbness and nerve pain in my arms and hands), and through the paleo/primal diet and some great work by our chiropractor/functional medicine guy, Dr. Mango, I thought I had put that stuff behind me.  Unfortunately, I was wrong.  By the end of our week working on the cabin, the numbness and pain in my right arm and hand were back.  Working on my computer made the aching worse, and since I have to do so much computer work for my job, I kept it to a minimum at home.  That helped.

Then, in October of last year, I was raking through the drainage rocks on the green roof to wash the silt out of them (so we can collect the rain water from the roof without having to worry so much about filtration).  I was using a little hand fork to move the rocks around... for days.  You know how you can get absorbed in work and not notice what's happening to your body?  Well, I screwed up my elbow and became unable to use my right arm for any real work for months.  I switched to using my left hand to work the mouse on my computer at home and work, which helped a little.  But through January, I still couldn't grasp with my right hand without a sharp pain in my elbow.  Honestly, it was depressing.

Again, Dr. Mango came to the rescue with some intense muscle work.  I've also been working daily to improve my posture (with stretches and mindfulness), keep my inflammation down (by eating primal/paleo and avoiding sugar - within reason), and strengthen my back (with exercises and converting to a standing desk at home).  In March, my elbow finally started to improve.  It's not fully healed yet - I can tell the difference when I work the track pad on my laptop with my right hand for a few hours vs. my left.  But, I'm learning how to keep my shoulders and arms healthy and can add some more typing and computer time back into my life - just in time for Spring green roof updates!

Speaking of the green roof, here's Cindy mixing and adding some store-bought cow poo to our potting soil on the roof last weekend.

Paleo update

If you're wondering how our whole "paleo diet" thing is going, I'll tell ya.  It's still going.  I absolutely love it.  I can see in the mirror that I've traded some fat for some muscle.  And my clothes are fitting better.  I wouldn't mind dropping a bit more weight, but I'm not in any rush, and I don't care about it enough to make a big push (such as experimenting with intermittent fasting).  I'm staying the course.  The biggest difference for me is that my thought and hunger patterns have changed.  I rarely find myself mentally eating stuff I shouldn't have, like bread or desserts.  And I'm not negotiating with myself for permission to eat stuff I had told myself I wasn't going to have anymore.  It feels like a strange sort of freedom, and I'm learning what it's like for people who can stop eating when they're full - even if there's more food on their plate.  I am learning what it feels like to be clear of addiction thinking and to listen to my body.

Furthermore, I had a visit with my chiropractor this morning - Dr. Christopher Mango of Mango Chiropractic.  I've been seeing Dr. Mango for a while.  He is the last in a long line of doctors, physical therapists, etc. to whom I had been visiting to treat nerve pain and numbness I had in my hand and arm (history here).   I started out seeing him once a week, and there were times when I would have been happy to see him more than that.  But since getting my sugar levels under control, I can feel the difference in my arms and shoulders as my inflammation reduces.  I'm now down to visits every three months, and my joints feel progressively more oily and flexible.  I've also noticed that my recovery time from hard work is unexpectedly faster.  If you're in New York and have some stuff to work out with your health, I highly recommend visiting Dr. Mango.

Speaking of hard work, I mentioned in my 40 Paleo Days and Nights post that I don't like "working out."  I thought I'd say a couple of further words on the subject.  In my opinion, our lives are full of too much luxury.  We have machines that do almost everything for us, and that's good.  But much of the time, it's TOO good; we're getting flabby.  So then people go to the gym and lift heavy things or climb staircases that aren't there... I say we should do more real work instead.  Take walks.  Do stuff around your house.  Better yet, do favors for people!  When my neighbor's giant fallen tree branch needed to be cut up for our little backyard fire pit this weekend, I spent an hour or two breaking and sawing it into pieces by hand.  It was great!  It was also hard, but what's wrong with hard?  When you're doing hard things, you can always take breaks.  And, then, if you're like me, you can practice the art of determination, because the Sirens always come singing their Song of Lazy, trying to convince you to quit before you're done.  If you persevere, you can make a pretty little wood pile like this:

Besides using mostly hand tools around the house, I cycle commute in dry weather.  Both avenues present ample opportunities to practice patience, focus, and perseverance while allowing me to avoid the gym.  That's Buddhism on the go!

Anyway, it was a lot of sawing this weekend.  Before I started getting my sugar levels and such in order, it would have taken me days to recover.  But I woke up the morning after my sawing project pain free.  Proper diet... exercise in a way that makes the world better... this shit is starting to come together.

Cindy's also still eating mostly paleo, although she bought a box of matzoh for Passover, and she occasionally buys a sandwich or sushi for lunch.  Cindy has never had troubles with food addiction, so she is free of some of the "slippery slope" problems I have, and she can adopt a more "80% - 20%" approach.  She is also keen to lose a little weight, so she's putting a bit of effort into it and restricting her calories.  Cindy is down about 8 pounds from where she started, and she seems to be having a lot of fun.   In addition to challenges, Keiter really likes counting and keeping track of things.

There are a lot of opinions about the Paleo Diet out there - both positive and negative.  As I've said before, we got our start with MarksDailyApple.com and Mark Sisson's book, The Primal Blueprint.  But if you're interested in learning more about what we're doing specifically, feel free to ask us questions in the comments below.

P.S. My sincere thanks go to Bernadette, who found and recommended Dr. Mango to me a couple of years ago.  Thanks, sister.

What I told my mother about c. diff (clostridium difficile)

This is a public service announcement!

About a year and a half ago, my mother was in the hospital for some surgery and what was supposed to be a maximum stay of 7 days.  While there, she developed a terrible intestinal infection called clostridium difficile, otherwise known as "c. difficile", or "c. diff" (if you can't be bothered with syllables), which kept her in the hospital for 24 terrible days.  I was with her for the first 20.

By "terrible", I mean to say that she was in constant, tremendous pain, nauseous, could hardly move or walk, couldn't eat, was hypersensitive to changes in room temperature, was rapidly losing weight, desperate, and was told that if her infection got any worse, they would have to remove her colon.

Terrible.

When my mother was diagnosed, the hospital brought in the infectious disease doctor, who explained that sometimes a course of antibiotics (which is standard for surgery patients) will knock out all the good bacteria in your gut, and allow the bad c. diff bacteria to take over.  He prescribed the standard treatment: more antibiotics.  I asked him whether my mother should take probiotics, and he told us they would neither help nor hurt.  She could take them after she got home from the hospital if she wanted to, but he didn't offer to give her any while there.

I was pretty skeptical about his "neither help nor hurt" comment, but we like to assume the medical community (especially the lead infectious disease doctor of a large hospital) is smarter than we are, or at least well researched in their field.  I accepted what he said, but when I wasn't assisting my mother with one thing or another, I quietly went about trying to research that doctor, probiotics, and c. difficile on the iPad I had with me.  I didn't learn much more than the fact that I can't do real research on an iPad; it's too clumsy, and I couldn't focus enough to figure out how to read medical papers  (high school biology class was oh! so long ago...).

After days on the antibiotics (by then given intravenously along with Mom's food-stuff), my mother wasn't much better, and may have been slightly worse.  The doctors decided to put an intermittent suction tube through her nose and into her stomach to try to draw some of the infection out that way.  She was hooked up to that suction for nearly a week.  She was also given an intravenous immunoglobulin treatment... whatever the heck that was.  I have a hazy recollection of it seeming helpful.

This is what she looked like.  You can see the IV's on the left and the hose running to the vacuum canister on the wall to the right.

By the time they finally took out my mother's suction tube, the intravenous feeding had given her back some small amount of strength, and although she was still in considerable pain, the heavy antibiotics had slowly started to get the upper hand.   Comfortable that my mother was on the mend, and called back to New York by other obligations, Cindy and I flew home on Day 20.

But I couldn't stop thinking about how that doctor had poo-poo'ed probiotics (see what I did there?).  As soon as I got home, I spent every spare minute I had researching more about C. diff.  I wanted to know about drug therapies, I wanted to know about probiotic and homeopathic therapies, and I wanted to know how the bacteria interact with our moods.

I started by researching probiotics.  I read articles, research papers, and testimonials, and two days after returning home, I had the following text exchange with my mother:

Me: Mom, I have been doing some research, and I want you to request Dr. Elmortada start you on a probiotic named "saccheromyces boulardii" immediately, please. Lory 11:06 AM

Kathleen Henning: I gave it to staff and they will see if its ok for me 11:24 AM

Me: Thank you. I have read several academic reports and personal testimonials that indicate it makes all the difference. I love you. 11:25 AM

Kathleen Henning: Thanks 11:28 AM

Me: Just spoke to your nurse, Nancy. She said you walked a full lap around the floor and they started you on that probiotic. I'm so glad. 4:26 PM

Now, I'm not saying that in within 4 hours of requesting that probiotic my mother was able to walk again.  She had slowly been getting stronger and was out of danger of losing her colon.  But I don't think it's a coincidence that on the day she started taking probiotics, she was able to walk much farther than she had walked since coming out of surgery 22 days earlier.

The next day, my mother was released from the hospital and taken to her dear friend Annie's home to recover.

C. difficile infections have reached epidemic proportions in this country. 

To add insult to injury, they have a high instance of recurrence.  I have read that 20% of C. difficile patients go through a second bout with the infection.  And 40-60% of those who have had a second bout will have more - some even get it every few months for years.

I also read that in Japan and many European countries, probiotics are prescribed anytime someone is prescribed antibiotics.  And there is a growing wave of research that proves how important maintaining a balanced micro-biome (bacterial ecosystem) in our guts is.  

In other words, the infectious disease doctor at Mom's hospital was flat wrong about probiotics.

Here's a link to an article from Science Based Medicine (.com) that supports my claim of his wrongness!  It's called "I've been prescribed an antibiotic.  Should I take a probiotic?"

In a minor synchronistic miracle, I started writing this post yesterday morning.  And as I was biking to work afterwards, a podcast came up on my playlist that is all about bacteria, probiotics, your gut's micro-biome (which is like a little ecosystem in your intestines), the potential future of healthcare, childbirth by c-section, C. diff, and how all of it fits together. It even touches on the lower diversity of intestinal flora in modern Americans vs hunter-gatherers (hunter-gatherers in the Amazon, for example, have 50% higher rate of bacterial diversity in their guts than we do).  That part in particular has me wondering if our processed food and pesticides are partially responsible for that lack of bacterial diversity!  Anyway, I haven't told you everything, and you should listen to this podcast for yourself.

I give you the excellent "Science and the City" podcast episode from The New York Academy of Sciences:

Hats Off to Bacteria!

And here's Mom on the mend. This was on the occasion of her first walk around her property - approximately 3 weeks after being released from the hospital.  She has been free of Clostridium difficile ever since.

If you've made it this far, you'll want to read the actual research I gave my mother on C. diff.  Just keep in mind that I am not a doctor, and you are responsible for your own damn self.

First, a bit about the diagnosis:

Clostridium difficile (c. diff) - a bacteria in the colon that is harmless when kept in check by the normal balance of flora in a healthy colon.  When that balance is thrown off (often by the use of general antibiotics - frequently with Clindamysin specifically), the C. diff spores can "hatch" and produce two types of toxins (cleverly called "Toxin A" and "Toxin B"), which cause inflammation and diarrhea.  There are different strains of C. diff, and I never found out which strain my mother had.  Some are more drug-resistant than others.

Pseudomembranous colitus - a condition caused by C. diff toxins A and B (they currently think B is worse than A, but they are both harmful).  It is characterized by a pseudomembrane in the colon along with inflammation in the colon and diarrhea.

Standard or FDA-Approved Treatments:

Metronidazole/Flagyl - this is typically the first antibiotic prescribed to treat C. diff.  We noticed Mom improve for the first few hours after the first couple of doses of this, and then it seemed that the C. diff would surge back and regain the upper hand.  This was administered by IV.

Vancomycin/Vancocin - this is another antibiotic and is prescribed for patients with moderate to severe cases of C. diff.  Mom took this orally, in an orange syringe she squeezed into her mouth (the orange syringe was not important; she could also have drunk the medicine from a cup or a clear syringe).  If she had ever developed an obstruction (like an abscess, for example), they might have given her the vancomycin rectally.  Luckily, both of her CT scans showed no obstructions, so we knew the Vancomycin was getting where it needed to go.

Cholestyramine (aka Questran, Questran Light, Cholybar) - This doesn't seem to be well known, so it is worth asking about.  It acts as a toxin binder against Toxin A and Toxin B, helping to relieve symptoms of C. diff.  When using Cholestyramine, one needs to be careful to use enough to bind the toxins in the colon but not so much that colon function is slowed (constipation).  Recommended dose is 4 grams twice daily (2 hours before or after other meals to ensure as much as possible makes it past the stomach juices and into the intestines/colon).

Pharmaceuticals Still In Trials at the Time of My Research:

Fidaxomicin/Dificid - as effective as vancomycin in stopping symptoms, but supposedly has a higher rate of cure (no recurrence).  It is still in trials and not yet available.

Rifaximin/Xifaxan - This is an antibiotic generally used to treat traveler's diarrhea.  It is generally not absorbed by the body, which allows it to get to the intestines and colon, which is where the C. diff bacteria reside.  Rifaximin is almost completely excreted in the feces in its original form, and it seems to have minimal impacts on the beneficial intestinal flora.  It has been shown in small human studies and some hamster studies to be as effective as Vancomycin in treating C. diff, but it has a better rate of preventing recurrence of C. diff. Because it is minimally absorbed by the body, it is thought to have minimal side effects.  It is still undergoing tests and is not yet used as the primary treatment for C. diff (although it is used for other things as initially stated), although I see a study out of Finland from October of 2012 that concludes Rifaximin is safe and "can be considered as an optional treatment for recurrent C. difficile infection."

Meredex's CDA-1 and CDA-2 (aka MDX-066/MDX-1388) - these are antibodies and have also shown great promise in mitigating the effects of Toxin A and Toxin B, and they also reduced the rate of c. diff recurrence.  It appears these antibodies do the same thing as Cholestyramine, but better.  They are also still in trials and are not yet available.

Probiotics and Homeopathic Treatments:

Saccharomyces boulardii - this is a probiotic strain of yeast (not bacteria, so it is not susceptible to antibiotics) originally found in the skin of lychee nuts and the mangosteen fruit (both of which are delicious, if you ask me).  I ordered Jarrow Formulas' Saccharomyces boulardii + MOS for my mother.  There are some risks of developing Fungemia in Intensive Care Unit, immunosuppressed, and tube-fed patients, but those risks are apparently negligable in other people suffering from C. diff.  I have been taking a probiotic that includes S. boulardii for more than a year.

Lactobacillus paracasei, Lactobacillus plantarum, Lactobacillus acidophilus - These are probiotic strains of bacteria, and they are shown to be effective in fighting C. diff according to some studies.  In fact, since I've been researching all of this, I discovered that the probiotic Cindy and I take has all of these as well as the s. boulardii that I mentioned above.  Ours is by a company called Standard Process.  The specific pill is called ProSynbiotic.  I recommended my mother get something with more active cultures separate from the dose of s. boulardii + MOS until she had put this infection behind her.  After that, it seemed reasonable to me that she pare back to a single pill like ProSynbiotic for gut maintenance.

Mannan OligoSaccharide (MOS) - this is derived from the cell walls of the yeast, Saccharomyces cerevisia.  An oligosaccharide  is a carbohydrate made of simple sugars, and they tend to be indigestible - they belong to a broad category of fiber.  This means that they pass through the digestive system into the intestines and colon where they support the growth of beneficial bacteria and help prevent pathogenic bacteria from attaching to intestinal walls by essentially acting as a decoy.  MOS is most often currently used as an alternative to antibiotics in farm animals and pets.  It also appears to support the immune system, treat diarrhea, and allow the body to absorb more nutrients because of that reduction in pathogens.

Oregano - This is said by many to be a powerful, natural antibiotic, and I have seen patient testimonials referencing taking oregano pills or oil of oregano as part of their C. diff self-treatment regime.  There are also articles about farmers giving their livestock oregano as an alternative to antibiotics.  I have not yet seen any scientific papers on the subject, but it's worth keeping in mind in case more alternatives are needed.

Banana flakes or chips - These are noted as an alternative to Cholestyramine, although I can't find research on whether banana flakes help bind and reduce the virulence of Toxin A and Toxin B the way Cholestyramine does.  (NOTE: Mom ate banana chips and found them very helpful.)

Stool Transplant/Fecal Transplant - People are having some success in curing C. diff with this technique.  It's basically poop from a healthy person, cleaned up, and transplanted into the sick person, so the beneficial flora from the healthy person can colonize the sick person's colon.  It is not a commonly performed technique, but it is good to know about.  Dr. Brandt at Montefiore Medical Center in NYC and Physicians at St. Mary's/Duluth Clinical Heath System in Minnesota are both mentioned in an article to have very high success rates.  It's also discussed in the podcast mentioned earlier.

Final Notes:

If you have a C. diff infection, do not use drugs which slow the colon, such as narcotics and antidiarrheals.  It is thought that they prevent the body from passing the C. diff toxins as quickly as possible, and may extend toxin-associated damage within the colon.

Especially if you are trying to fight infection, probiotics should be taken two hours before or after other meals to ensure they get to the gut without being subjected to higher levels of stomach acid that are present when the stomach is digesting food.

Feelings of desperation, fear, hopelessness, and wishing for death are common among sufferers of C. diff.  Although I could find no specific studies related to C. diff, there are general studies that show bacterial infections can influence people's mental status and behavior.  If you have a C. diff infection and are having uncharacteristically negative emotions, please know it's not you, and you CAN get better.

UPDATE - An Incomplete List of Links:

On the sound advice of a good friend, I went back into my search history and culled some of the articles I read when doing my marathon C. diff research for my mom.  There are so many more articles these days, so I'm sure you can find much more that is worthy of your time if this issue is important to you.

General Web Sites:

http://www.webmd.com/digestive-disorders/news/20080530/c-diff-epidemic-what-you-must-know

http://www.mayoclinic.org/diseases-conditions/c-difficile/basics/definition/con-20029664

http://www.cdc.gov/hai/organisms/cdiff/cdiff_faqs_hcp.html

http://www.earthclinic.com/CURES/c-diff.html

http://www.uptodate.com/contents/clostridium-difficile-in-adults-treatment (this article states that studies on the use of probiotics are inconclusive)

http://en.wikipedia.org/wiki/Clostridium_difficile (let’s not forget Wikipedia!)

C. diff in the News:

http://centerforhealthreporting.org/article/scientists-make-strides-new-cdiff-infection-findings

http://www.gastroendonews.com/ViewArticle.aspx?d=In%2Bthe%2BNews&d_id=187&i=July%2B2009&i_id=541&a_id=13458&ses=ogst (shocking that this article, which is about the anticipated improvements in C. diff diagnosis and treatment, doesn’t mention probiotics)

C. diff and Probiotics:

http://www.mayoclinic.org/diseases-conditions/c-difficile/basics/definition/con-20029664

http://revistes.iec.cat/revistes224/index.php/IM/article/view/4c457c5bbdbb9.002

http://www.livestrong.com/article/322714-which-probiotics-are-good-to-take-with-a-c-diff-infection/

http://www.probiotics-lovethatbug.com/c-diff-infection.html

http://www.meschinohealth.com/blog/infections/2012/08/30/probiotic-supplements-shown-approach-prevent-c-difficile-infection-hospitalized-patients/

http://www.probiotics-help.com/c-diff.html

http://nexabiotic.com/search-reviews-for-diff/ (an add for this specific probiotic to treat C. diff)

Testimonials:

http://www.peggyfoundation.org/ (a C. diff education and advocacy group with some amazing stories)

http://www.peggyfoundation.org/c-diff-stories/129-amy-burke-dc (This woman’s story interested me the most)

http://steampunkpaleo.wordpress.com/my-c-diff-story/ (in fact, this is a whole blog about a person’s experience with and after C. diff)

http://www.kingmaker.net/CDIFF.HTML (seems fishy, since they’re selling something, but it’s interesting anyway)

Research Papers:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC108158/ (This one focuses on Toxin A and B)

http://cid.oxfordjournals.org/content/40/2/265.short (This one too)

http://www.gabionline.net/Biosimilars/News/Medarex-With-CDA1-CDB1-MAbs-better-metronidazole-or-vancomycin-treatment-against-C-difficile-toxins (this is one of the trial drugs)

http://www.gutpathogens.com/content/3/1/2 (a general study of probiotics in medicine)

http://www.ncbi.nlm.nih.gov/pubmed/23095030 (this is one of the ones about Rifaximin)

http://www.hindawi.com/journals/grp/2011/106978/ (and this is another)

And, lastly, I just found this: http://globalbiodefense.com/2012/07/20/drinking-tea-to-combat-ricin-anthrax-and-c-diff/ (an article explaining that good old cups of tea might help prevent C. diff)

40 Paleo Days and Nights

Yesterday marks Cindy's and my 40th day eating according to the Paleo Diet.  

Cindy's long-time friend, Beth, gave us this book after we'd joined her and another good friend, Jill, for dinner and breakfast.  Beth (and Jill, for that matter) is slender and apparently in good health, and she enthusiastically attributed both her health and weight to having cut grains out of her diet.  She'd read several books on the idea, and she gave us the one she thought was the best.  It's Mark Sisson's The Primal Blueprint.  You can see it there in this picture from our visit!

Beth, Jill, and Cindy

I tend to be pretty skeptical, and I'm not naturally quick to jump on the band wagon for things.  But, Cindy read the book, and she was keen to try its diet plan.  Everyone knows that if you're going to change the way you eat, it's miserable if your family doesn't change with you.  Besides, my weight slowly fluctuates by 10 or 15 pounds, and I can almost always stand to trim down a bit.  So I read the book next, and here we are.

I was sort of confused at first, because Mark (Cindy calls him by his first name, and she's got me doing it too - as if we're all friends!) doesn't just talk about diet.  He talks about 10 "Primal Blueprint Laws" that are supposed to at least point you in the direction of a healthier, happier  life than you might already have.  

Those laws are:

1. Eat Lots of Plants and Animals

2. Avoid Poisonous Things

3. Move Frequently at a Slow Pace

4. Lift Heavy Things

5. Sprint Once in a While

6. Get Adequate Sleep

7. Play

8. Get Adequate Sunlight

9. Avoid Stupid Mistakes

10. Use Your Brain

Mark goes into detail with at least one chapter per law.  I think the majority of them will be fairly obvious to most people.  But there are a couple of things that require further explanation for the purposes of this post.  #1 is obvious.  But #2 is slightly more nuanced.  It's obvious we should avoid things like poisonous snakes or, frankly, toxic people.  However, Mark makes the case that grains, processed foods, sugar, and legumes are also poisonous.  More on that in a minute.

Numbers 3, 4, and 5 all deal with exercise.  Personally, I can't stand working out for the sake of working out.  I'm happy to work.  I'm happy to ride my bike or run to get from one place to the other.  But Cindy, on the other hand, LOVES to work out.  She runs circles around Prospect Park, she happily takes 90 minute Bikram Yoga classes  several times each week, and she lifts weights for hours in the gym.

Mark's assertion is that we get ourselves trapped in insulin surge/crash cycles and weight gain with our high-carb, processed food-based diets.  So we either slow down and get far less exercise than we need (me), or we work out so much that we get more carb cravings, only to eat more high-carb food (Cindy).

The "primal" or "paleo" approach to this problem is to eliminate (or greatly reduce) foods that would not have been available to our Paleolithic, pre-agriculture ancestors.  The thinking is that our bodies have not evolved to handle the type and quantity of carbohydrates and chemicals we consume in the typical Western (a.k.a. American) diet.  So we will do much better by eating foods that are closer to what our ancestors ate.

The Primal Blueprint recommends turning the US FDA food pyramid on it's head (that thing is a joke, anyway), cutting way back on carbohydrates (but NOT eliminating them!), and adding more healthy fats into your diet.

Mark Sisson's Primal Blueprint Food Pyramid

Essentially, what Cindy and I have been doing is trying to keep our carbohydrate counts to between 50 and 100 grams per day, protein between 70 and 85 grams per day, and fill in any additional calories we need (whenever we're hungry) with fats like avocados, nuts, full-fat yogurt, etc.

For me, I've made no change to the amount of protein I eat from when I was on the Zone Diet years ago, but in the past year or so, I have cut back on soy significantly.  I mostly get my protein from eggs, yogurt, fish, and foul.  I've even discovered some delicious ostrich and pheasant at the farmer's market.  The only 4-legged animal I eat is the venison my mother gives us every year (Cindy adores pointing out,  "She shoots it with a bow and arrow!").  Cindy also eats pork, bison, and beef occasionally.

We'd previously been in the habit of eating very little processed food, and we've nearly eliminated it all now.  The only thing I can think of that I would consider processed is some frozen yogurt popsicles that Cindy likes.  I suppose you could make an argument that the dark chocolate we eat is also processed.  But that's not going to stop us from eating it, so you might as well shut your pie hole.

We're 40 days in, and you might be wondering how do we feel!?  Well, we feel great.  I notice that my neuropathy symptoms are basically non-existent.  I'm not getting energy slumps in the afternoon, and I'm not stressing about when the next time I'm going to eat will be, because the type of hungry I get doesn't make me crazy or hangry or desperate.  In fact, it feels like the kind of hungry I got when I was a kid, when I could ignore it or not, depending on how interesting things were at the moment.  This, for me, is a revelation.

That said, I do have a couple of things to which I haven't fully cottoned.  First, no legumes?!  The reason why Mark advises against them is because our Paleo ancestors wouldn't have been able to collect as many in the wild to make up a significant part of their diet, and because they are higher on the glycemic index.  I don't know how much I buy that.  I've never been a big bean-eater (they had the texture of tiny bags of chalk to me as a child), but they look so cute and harmless...  Besides, who can really say what our Paleolithic ancestors ate or didn't eat?  I'm sure they ate a lot of things; they lived in a lot of places in a lot of seasons, after all.

Second, bread.  Now bread is a slippery slope for me, because I love bread.  If I allow myself to eat as much bread as I want to, I find myself right back in the throws of my sugar addiction, and that's never a good thing.  After all, given my health history, if I don't play my cards right, there will be one piece of bread in my future that is the one piece of bread that finally turns me into a diabetic.  I would like to play my cards right.

But, Michael Pollan, food guru for us enviro-hippie liberals (and hopefully everyone else, too), made news by taking issue with Paleo. And, while I quibble with a couple of things he's quoted as saying in this article (the Paleo diet doesn't mean you have to eat your food raw, nor is it the Atkins Diet), I think his other points are valid and applicable to the conversation Cindy and I have about how we want to eat - particularly what he says about microbes.  

Although the fact that a person could live on bread alone does prove that there is nutritional value in grains, Cindy and I haven't stopped reading and investigating after The Primal Blueprint.  We're now on to a new book called Grain Brain, by Dr. David Perlmutter.

We're taking turns reading a few sections at a time to each other, and I love it.  We're about half-way though, and he has a lot to say about adding fat to your diet that jives well with Paleo.  I know confirmation bias is probably at work here, but I think there is a lot of value in knowing about the research described in this book.

One of the main things that hits home for me is the idea that the low-fat/high-carb American diet is not only contributing to (causing?) the huge rates of diabetes, heart disease, hypertension, and cancer in this country, but it is also contributing to or causing strokes (one of which a dear friend recently suffered) and Alzheimer's Disease (which killed my beloved grandmother).  As we read our book together, I can't help thinking of all the people we may have lost due to misguided dietary choices.

Winifred Henning (1918-2005) and Lory Henning (1971-)

We're only half-way through the book, and according to this review, some of what I suspect are going to be Dr. Perlmutter's dietary restrictions in the second half of the book (including largely eliminating fruit from our diet) aren't appropriate for us.  I'll update you when we get to the end and discover how it turns out.

I'm also reading (not out loud) a really fascinating book by Jared Diamond called, The World Until Yesterday.  It's a comparison of tribal, hunter-gatherer and early agricultural societies with modern state societies from all sorts of perspectives (such as war, religion, language, conflict resolution, etc).  The next chapter is going to be about diet and nutrition, and I can't wait to see what this guy has to say about tribal societies' diets!

In the meanwhile, I sure hope Cindy and I are on the right path with our diet and education; I want to live to be 100 years old, so we've got to last for another 58 years at least.   

Oh, and one last thing.  If you're interested in learning more about Mark Sisson's Primal Blueprint, you don't have to buy the book.  You can find everything you need to know on his excellent website.

What I Learned on The Clean Program

Although I don't anticipate it being the main focus of this blog (or our lives), I wrote about my health history and my addiction to sugar  in previous posts because I wanted to provide some context for what we've been doing lately.  But I have one last bit of back story to give you before you're all caught up.

For years, I've had a problem with my hands and forearms going numb - usually early in the morning while I sleep.  There's the normal thing that happens to everyone: when you sit on your foot for too long, it falls asleep and you have to shake it out and go through that pins-and-needles feeling to get it to come back.  And then there's this thing that happens to me: I'm sleeping in bed in no particular position - often flat on my back, but it could also be on my side, and my hand goes numb.  When it's really bad, I can also get nerve pain (which feels like pressure, burning, and freezing simultaneously), and the only way to make the pain stop and the numbness to go away is to sit or stand up and let my arm dangle by my side.  This leads to a fair amount of sleep deprivation, which leads to crazy.  The problem gets worse when I'm working on projects that require a lot of upper body work (like woodworking, one of my favorite things to do in the world), and the problem subsides during periods when I'm doing less upper body work.

So I've gone to doctors.  I think there's been 5 or 6 of them, and a couple of physical therapists, and 3 chiropractors.  I got x-ray'ed and zapped with things to make my nerves fire and given stretches and exercises.  I learned a lot, including that I have a herniated disc in my neck, and that there's one particular way a chiropractor can crack my neck that makes my hands feel like they light up with electricity.  I found out my condition is called neuropathy.  But nothing made the problem go away completely or long-term.

Then, in late December, 2012, my mother got sick, and I spent 3 weeks taking care of her in the hospital in Grand Rapids, where there is very little healthy food to be found (it's a high-carb sort of world out there).  By the time I got home, I was feeling pretty crummy, and my friend Bernadette recommended I try The Clean Program, the instructions to which Dr. Oz had put up for free on his web site.  I think it has been taken down now, so if you're interested to find out more, this link points to the FAQ on The Clean Program's community forum.  If you dig around, you can find everything you need to know to try it without buying anything.  There's probably nothing wrong with them, but those kits and things people sell always smell like quackery to me.  

Cindy is a dream, so she was all for trying the month-long cleanse together.  If you don't know, The Clean Program (as we did it) is basically just a short-term restricted diet on which you cannot have things like sugar, anything in the nightshade family (such as tomatoes and peppers), peanuts, strawberries, bread, dairy, and the big one for Cindy: caffeine.  She complained about it her lack of coffee the whole time, which I mostly thought was hilarious.  (Perhaps my disinterest in caffeine comes from my Mormon genes; I've never really cared much about it, personally.) 

During the second half of the cleanse, I noticed that I was not having any nerve pain symptoms anymore.  They have gone away for periods before in the past, so I didn't think much of it.  But when it came time to reintroduce the foods we had eliminated, I remained completely fine until the night I had dessert with dinner for the first time in a month.  Early the next morning, the numbness was back!

Well, that was pretty much a revelation, peppered with a dash of torture.  And reading up on neuropathy a little bit shows me that there's a known link between numbness and diabetes.  To me, that spells validation!  I don't have diabetes, but I very easily could (It's very prevalent on my Mormon side).  And I DO have a sugar addiction, with a long history of putting way too much of it in my body.  So now I get to choose between feeling pain and eating sugar. 

By the way, when I say "sugar", I'm talking about bread-type-stuff in addition to sweets.  Hm.  Perhaps I should have mentioned that sooner...

It has been a year since we did The Clean Program.  Addiction thinking is slithering and persistent, like a snake.  I sometimes find myself negotiating with my addiction and pushing the envelope.  My sugar tolerance has gotten better since I've drastically decreased the amount of it that I'm eating.  Now-a-days, the numbness will come after a couple of days with bites of candy and dessert after meals (such as during our Valentine's weekend trip to Virginia a couple of weeks ago).  I often don't stick to terribly rigid rules and eliminate sugar completely.  But then, sometimes I do.  Last night, I had a dark chocolate peanut butter cup after dinner.  It was too sweet and made me feel a little jittery.  So maybe I will just avoid the stuff entirely.  I don't know... I just want to stay healthy and pain free without having to fuss.

And in case you're wondering how things turned out with my mom, here she is on the day after I brought her home from 3 weeks in the hospital and 2 weeks in recovery at a dear friend's house.  She's getting ready to do her favorite thing to hate: clear snow off her 200 yard driveway with the tractor.

Me and My Sugar (Addiction)

One of the main aspects of our Project Happy Life is Health and Well Being.  As I said in my post about my health history, I stepped back from the brink of becoming truly fat by having the shit scared out of me and finding myself trying the Zone Diet at the recommendation of a nutritionist.  But with everything diet-related, it's complicated.  And it's as much a mental game as it is a physical game.

I was a (doughy) teenager in the 1980's.  We thought back then that if something was "low fat", it was our key to keeping our weight down.  But we were gaining weight, so then we thought we just weren't doing the "low fat thing" well enough.  We thought we were weak when it came to eating the right foods, so we started trying to help ourselves by working out - aerobics, running, jazzercise...  People bought leotards and track suits.  We were determined, but we were misinformed.

Around 2002, while I was reading my copy of A Week in the Zone and trying to decide whether it was right for me, I thought a lot about commitment. . .

I once worked with a director, named Elaine Vaan Hogue, who gave a speech to the cast on the first day of rehearsals about commitment.  She acknowledged that as much as they wanted to be working actors, and as much as they wanted to be in that show (I think it might have been The Crucible), there is still a process of commitment we go through when we begin a project.  She said some of them might already find themselves fully committed.  Some of them might be experiencing full commitment at that moment - while she was talking, and for some of them, it might not happen until well into the run of the production.  She asked each cast member to choose a small, inexpensive item, and to present it to another member of the company on the day they finally felt they had committed.

That idea has stayed with me.  Before she said that, it had never occurred to me that a person could undertake something without being committed first.  Here was something new!  We can decide to do things with the full force of our abilities, but allow our commitment to come - in it's own good time.

The Zone Diet (my first actual diet regime beyond the smattering of diet-related thoughts that sifted out of 1980's TV commercials and talk shows) talks a lot about insulin and sugar.  It sounds obvious to me now, more than 10 years later, but at the time, my mind was blown!

Here's a typical day's worth of eating when I was a latch-key kid in middle school:
Breakfast - Fruit Loops, Sugar Smacks, or Apple Jacks with non-fat milk.
On the way to school - Hostess fruit pie or double pack of cinnamon rolls (my mother didn't know about this habit of mine)
Lunch - Peanut Butter and Jelly sandwich, small bag of chips, and a Twinkie or other Hostess dessert.
After School Snack - Another Twinkie (or other Hostess dessert), and/or spoon-fulls of peanut butter with chocolate chips mixed in, and/or hunks of pepperoni that I would cook until crispy in the oven, and/or flour tortillas with a stripe of peanut butter across them and rolled into burritos.
Dinner - Lowry's Seasonings Tacos, pizza (from Organ Stop Pizza - my favorite), or something from the barbecue.  I also loved hamburgers and french fries.  Mine was a single, working mother, so dinners had to be simple.

(Bear in mind that my mother was doing the best she could with what she had, and I turned out alright.  Also, I know I ate fruit and vegetables; I loved fruit especially.  I just can't remember eating them daily.)

Insulin and sugar!  I essentially spent my middle school years going from one sugar high to the next, and then I did the same in high school, but added a nice, sticky layer of guilt and weight gain on top.

So what Dr. Barry Sears was saying in The Zone Diet made sense to me: I needed to control my insulin levels by avoiding sugar and foods that turned into sugar once inside my body.  To do that, you spend a few days completely eliminating from your diet sweets, breads and pastas, etc. (which you can re-add later in moderation - or maybe I just made that part up).  And you eat a balance of 30 grams of carbohydrates, 20 grams of protein, and 10 grams of fat for three regular meals per day, and two small snacks.  Choose your food from a list of Zone "approved" protein, fat, and low-carb fruits and vegetables, and voila!  Magic weight loss.

This was unimaginable to me.  Okay, give up sugar, but GIVE UP BREAD?!

And yet, the reasoning made sense - to control your weight, you had to control your insulin levels.  I was without a better alternative...

I decided to try it.  For a week.  A week is finite.  A week let's you keep one foot out the door.

It took three days before I stopped thinking about bread and carbs all of the time.  But they weren't just casual thoughts like, "Oh, isn't bread nice?  I like bread."  No, my thoughts were more subversive.  They slithered into my mind like a snake.  "Oh!  Look!  Someone left this pita here... it would be a shame to see it go to waste."  Or, "You're an adult.  You're not beholden to anyone.  If you want to eat those M&M's, you can.  They're small.  It doesn't matter."  My thoughts tried to charm me away from my plans like a siren.

And then it occurred to me that I had a sugar addiction, and those thoughts - those insidious voices - were my addiction talking to me.  But my addiction was not me.  There could be a separation, a space between my addiction and my self.  My decisions could be my own.

It was in that moment I felt myself commit.

As I said in my previous post, one week turned into three weeks, which turned into three months, which turned into indefinitely.  I watched my body change, and I watched my addiction thinking come and go.  And come.  And go. . .  I began to feel less desperate about it.  I felt more accepting.

At my first wedding (in 2003), I was surrounded by food.  It was the Maine blueberry pie that un-did me.  That, and the fact that my then-wife had abandoned her own attempts with The Zone Diet.  I no longer had an in-house comrade and mirror.  She had a rebellious streak, and allowing herself to eat anything she wanted was like a big fuck-you to the diet industry, which she felt had raised her hopes and dashed them again her whole life.  I was angry about the abundance of pies and sugary food around me, and I secretly blamed her for her lack of support when I saw that my sugar addiction had come back.

With time, I grew to see that I could decide when to go through my withdrawals again and get things back under control.  It wasn't up to anyone else to facilitate my choices or to help me stick to them.  I stopped being angry, and I began to accept that this was the nature of my addiction.  Each time I let myself rekindle it, I knew I could also leave it by the wayside again.  All I needed was to truly commit.  "Forever" didn't matter.  "Now" mattered.

Yesterday morning, I read a thing by Russel Brand about addiction.  Death by sugar addiction won't come as quickly as it might for drug addicts, but a lot of the thinking we experience is just the same.

For me, knowing that I have an addiction to sugar, and allowing space for my relationship with sugar and my diet to change and grow (or fall backwards a bit) over time, makes all the difference along the way.  I haven't got it all worked out yet, but I'm making progress, and in a future post, I want to share some thoughts about the paleo diet and The Primal Blueprint, by Mark Sisson.

Before I end for the day, I do want to say that one of the main things that makes all the difference for me is Cindy.  Cindy is one of those rare souls who loves working out.  She loves to move her body as much as I love to make things with my hands.  It is a source of her sanity, and it is inspiring for me to see.  And Cindy is game to try things (like The Clean Program cleanse we did last year), and having her to support and to be supported by is a gift and a joy.

Try and find yourself a Cindy.  You should.  But you can't have mine.

Melvin, Janie and Me: A Little Health History

This is Melvin today.

I first met Melvin and his sister Janie 17 years ago, when they were new, and I was 25 years old.  And we have a few things in common when it comes to our health.  Mainly, diet and alone time. Melvin and Janie spent their youth eating the best cat food I could buy for them: Iams dry whatever-flavor cat food.  I traveled a lot for my job, so I would leave them with giant bowls of water and cat food while I was away.  They seemed perfectly content with this system, and I couldn't afford or imagine anything better.  As time went on, Melvin and Janie got fat, but I couldn't really figure out why, since I was feeding them the best cat food in the grocery store.  Melvin is a big cat, and he carried his weight fairly well, but Janie is smaller, and she looked sort of like a basketball.

Janie in her Basketball phase.

Now, I was an only child of a single parent.  In my early childhood (pre-3rd Grade), we lived with my beloved grandmother and one of my cousins.  But before I started 3rd Grade, my grandmother and cousin moved to Salinas, California (to take care of my great-grandmother), and I stayed with my mother in Phoenix for the school year.  I went to Salinas every Summer when school was out, and my mom kept working in Phoenix.

So, like Melvin and Jane in their adolescence, I had a lot of alone time.  My mother left for work before I had to go to school, and she got home a few hours later than I did.  So after a few valiant-but-failed attempts on my mother's part to have someone watch me (as we both learned to cope with our new, smaller family), I convinced my mother that I was self-sufficient enough to get myself to school every morning, and let myself back into the house every afternoon.  And my mother stocked the freezer with PB&J sandwiches, chips, and twinkies, so I could assemble a little bagged lunch for myself every day, and I could have a snack when I got home.

But, just like Melvin and Jane, I got fat.  I'm lucky enough to be sort of lanky (for a girl), so I carried my weight fairly well, like Melvin, but if I was a bit shorter, I could easily have been in the basketball category, like Janie.  Anyway, this was me around 180 pounds in April of 2001.

I have this distinct memory during that era, when I was living in Greenpoint, Brooklyn, sitting on my toilet with the sun streaming in (which is the horribly perfect moment to assess what has become of one's thighs) and thinking, "I could just get really fat.  It would be easy."  I could forget all my guilt and shame that comes with my weight just accept it, let it get really bad, and be a fat person.

A few months earlier, I had gotten word that my father, a man I had never met in person and only spoken to on the phone a handful of times, had died.  And his large Mormon family started reaching out to me (another story for another day).  One of the things I learned from those aunts and uncles about my father's family was that of his parents' nine children, there were only 5 left (I think there are 4 or fewer now).  There was a huge problem with diabetes in the family, it was what ultimately killed my father, and it was likely a major factor behind the deaths of his siblings.

Well, if that isn't enough to scare the shit out of a girl, I don't know what is.  But, I was scared, fat, and frankly, sort of paralyzed - not knowing what to do.

Around that same time, I got set up with a primary care physician here in New York City, and on my first exam, she suggested I needed to "trim down".  And she recommended I visit a place called Haelth on Broadway and Houston.  We had a convergence of themes.  I decided to pick up what the universe was laying down.

Two interesting side notes about that: first, I worked one flight up from Haelth in the same building in Manhattan, so it wasn't hard for me to find.  And two, I discovered later that that's one of the places Morgan Spurlock went to get checked out in Supersize Me.

The kind nutritionist at Haelth suggested I try The Zone Diet.  Now, if you ignore the fact that I was still suffering from a fear of hair salons in the photo above, I'm on the more masculine spectrum, and I'd never done the Cosmo Magazine, lipstick-wearing "diet" thing before.  But fear of an early death is an excellent motivator.  So feeling confident about my ability to commit to a full (7 days, mind you - not 5) WEEK of giving it a try, I bought A Week in the Zone, and followed the instructions to the letter.

One week turned into 3 weeks, which turned into for-as-long-as-I-could-go-until-there-was-a-good-excuse-to-eat-an-abundance-of-pie (or whatever).  And I've been down as much as 50 pounds, but usually around 30 pounds from my high (pictured above) ever since.

It isn't as easy as a neat little story summed up with a two-sentence paragraph, though.  As I go along, I'm learning a whole lot about health, addiction (raise your hand if you have a sugar/glucose addiction problem like me), and our food system.  In coming posts, I'll have much more to say about all of that.

Oh, and lest you think that Janie is still looking like a basketball, after switching to an all-protein cat food (which is what cats are built to eat), both Melvin and Jane are looking good.

Janie today.