Wednesday, August 28, 2013

August 2013 Update

My last colonoscopy was in 2011. The gastro thought things looked good enough to put off my next one for two years. Well, here we are in August 2013. Colonoscopy time.

First, a bit of a recap. For the past two years, my diet has gradually shifted from fairly strict meat and lactose-free milk with minimal vegetables to a more broad gluten-free, low-fiber heuristic. Nothing particular drove this change other than natural drift and complacency born of the fact that I was completely asymptomatic. Each change is small, each new re-addition tiny, but over time they add up, and soon you’re eating mashed potatoes on the side of your steak instead of another steak.

By July 2013, I was getting pretty lax. And again, it was hard not to be. I’d love to believe I have monk-like eternal dedication and discipline, but the reality is that I’m as human as they come. Give a human enough time in a situation, and they’ll adopt it as their new normal; my new normal was that I could eat a fairly broad array of things without obvious serious consequence.

So it was with that mindset that I went to Wales for ten days to visit my parents. While there, I think every meal was meat and potatoes. No complaints, either, as most meals were quite good to my taste. We hiked and bicycled and saw various historical buildings, and through it all I felt just fine. This was probably the most sustained starch assault I’d experienced since starting the diet, with no obvious consequences. I flew home a bit bemused.

I’d been experimenting with SCD yogurt for a month or two, just to see what the hubbub was all about. I’d created my own yogurt maker, which was fun and deserves its own blog post, and had made a bunch of successful batches. However, about a week after I got home from Wales, I made a batch that didn’t seem to turn out quite right. Instead of being smooth it was chunky and never really seemed to “set” into a creamy texture.

Being a stubborn ass, I ate a bunch of it anyway. Simultaneous to this, my wife made some chili. We have a running joke about chili: no matter how many times she cuts the ingredients, it always seems to come out so radioactive as to be inedible. This one was no exception, but again, a hungry stubborn ass eats what’s there, and I sweated my way through a decent sized bowl.

Needless to say, I spent my Thursday in communion with various toilets. If you’re reading this blog, you know what happened.

The next day we were driving to the beach to visit with my wife’s family. All through the drive, I felt an odd twinge in my lower right abdomen, almost like some little animal was taking quick bites inside my intestine. A bit disquieting but nothing to worry about; lower right side pain has been with me since my diagnosis and it doesn’t usually register consciously.

That night, I woke up nauseous and stumbled into the bathroom for an hour long session of “will I puke or poop”. Poop won (its victory lap was quite an affair), but the right side pain had stepped up its frequency. Now I was worried. I’d come across accounts of obstructions and strictures, and my experience roughly jived with what I’d read. There’s nothing quite like lying in bed, shaking slightly from insane diarrhea, legs and butt numb and full of pins and needles from too long on the toilet, wondering if you just dodge a bowel perforation.

Anyway, you know that lack of focus and clarity? It comes back with a vengeance after a night like that. Monk-mode, engaged.

From then until my colonoscopy yesterday, my only grudging detours from the Path of Meat were some hashbrowns on a hiking trip to Washington. During that time, my bowel quickly normalized, and the right side stabs started to subside. But they didn’t go away entirely, so I found myself actually looking forward to the colonoscopy. If there was a problem, they’d find it and that would be that.

The anesthesiologist said, “Good night!” as he gave me the sleepy juice. Believe it or not, that was a new one. Usually they just fire that stuff in and you’re out. See you on the other side, doc.

I woke up and did the usual massive groggy fart routine for about fifteen minutes. The nurse asked if I was on a special diet. I said I was. She said something like, keep up the good work. I gave her a thumbs up and she smiled and walked away. I’m guessing I wasn’t 100% all there yet.

Then the doctor walked over to hand me my results and have a quick chat. My gastro is very mild mannered and calm, so there’s not body language or facial expression much to read. But I imagined he seemed bemused or quizzical.

“So you’re still doing that Life without Bread thing?” he asked.

“Yep. Mostly meat diet, kind of low-residue.” I replied.

“Oh, low-residue as well? Steam all your vegetables?”


“Huh. Well, seems like it’s working. Everything looks fine.”

He shrugged and leaned on the gurney.

“Let’s say another colonoscopy in three years, office visit next year just to get some blood work. Sound good?”

“Sounds good.”

“Ok pfw, see you later.”

My WTF meter was off the charts. Keep in mind here I was expecting to be told that I had some sort of flare going on, although the pains had gone down to once a day by the time I went in. Instead, I had a completely clean bill of intestinal health. The report is boring as hell, just various bits of my colon and statements like, “Normal”.

And three years until my next colonoscopy.

Wow. I might forget how bad the prep is in that time.

So what does all this say? As always, I’m at a loss to explain it. N=1 is a horrible epistemic position to occupy. I don’t even know what I want to know anymore. I’ll retreat to some bare facts:

In AUG 2009, I started eating a meat-only diet. I crapped my brains out for three months until stabilizing in OCT 2009.

In NOV 2009, I stopped taking my medication.

In AUG 2010, I had a polyp removed from my intestine during my yearly colonoscopy and started drinking milk.

In Jan 2011, I started eating small amounts of potato starch.

In AUG 2011, I had a clean enough colonoscopy to warrant a two year gap until my next one.

Between that time and AUG 2013, I ate potatoes, ice cream, fresh vegetables, drank gallons of Lactaid (all on top of a diet of mostly meat, of course) without obvious negative consequence. I avoided gluten strictly, and while I didn’t count calories or carbs, I suspect that aside from heavy milk times I was still lower-carb than the general population.

In AUG 2013, I had another clean colonoscopy, warranting a three year gap until my next one.

I’d like to believe this is more than incredible coincidence. I’d like to believe that diet CAN influence the disease. It’s all quite suspicious, but I can’t prove any of its connected. And so I’m right back to where I was a few years ago: feeling fine, and wondering why.

Better than feeling like shit and knowing why. Here’s to three years until my next colonoscopy. I hope they’re as boring as the previous two!

Sunday, March 17, 2013

Interim Update

Just wanted to post a brief update since it's been over a year since the last one and a few people have asked how I'm doing. I'm supposed to get a colonoscopy for the summer, which I might do just for science, or I might not. If I do, that would be a logical blog update event.

But I might not, simply because I feel fine. I am completely asymptomatic. Why pay a thousand bucks to have a guy shove a tube up your butt to be told something you already know? At least with Crohn's there's no real "silent symptoms" - you're either flaring and you know it or you're not.

Some points about my diet and health state in no particular order:

My diet continues to be "meat-centric", but by no means is it "meat-only". My plate is beginning to look a lot more normal at a meal, but it still is completely absent any gluten containing product. For example, I recently ate a 1.5lb rib steak, which had on the side some mashed potatoes and a small pile of steamed spinach. No bread.

I've tried and survived eating ice cream and high-sugar treats. The consequence of over-indulgence is of course diarrhea, but I don't think that's a Crohn's symptom necessarily. That's just bombarding my body with something it's not used to eating. No lasting flare has followed this behavior.

As I said, symptom free. Normal stools most of the time. The timing of this post catches me in an odd spot, which is noted below, but in an overall sense I've got a drug-free remission going and I'm happy.

Recently, I decided to see if I could start running again. Periodically, the memory of past attempts to get in running shape dulls, and I wonder if this time is different. In the past, I've been able to run for a week or two, usually long enough to convince myself that this time is different, before the inevitable run where I have to find a spot in the woods to vent my entire body cavity, followed by a shaky walk home and the shower of shame.

This time it took about two weeks. I decided to ramp up as slowly as possible. I ran .5 miles to start. That's right - a half mile. Despite an utter lack of endurance training for years, I was barely breathing hard at the end. I then added a tenth of a mile per day. I always ran fasted - I don't eat breakfast usually - in an attempt to avoid jostling too much.

This past Wednesday, I ran 1.1 miles, went home from work, and barely made it to the bathroom. Note: taking your belt off while you urgently waddle through your front door is probably confusing or disturbing to your neighbors. 

On Friday I ran 1.25 miles as kind of a middle-finger to the whole situation, and haven't had any serious consequences. Maybe the 1.1 mile event was an outlier. But my father, who trained for and ran a marathon, also had to make sure to run on an empty stomach while training, and he doesn't have Crohn's. Maybe I'm just blessed with a weak stomach.

I'll probably keep this up until the next "event", and then bail back to strict weight lifting. I might not be able to eat enough to become genuinely strong, but at least struggling through some squats doesn't make me crack the toilet with a rectal shaped charge.

So there you have it. Meat still hasn't clogged my intestines, and I'm still alive. I'd still recommend giving the diet a shot to anyone who felt up to it, but I'd probably dial back the duration of strict meat only to "as long as it takes to normalize your bowel movements plus one to two months". A year is a nice number (lots of fun to shock people with), but it's probably excessive. 

Does it actually work? Hell if I know! This would be a heck of a coincidence if it didn't, but stranger things have happened.