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?”

“Yeah.”

“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!

6 comments:

  1. Awesome post. The potatoes aren't bothering you, do you eat it everyday? What about rice?

    Looking forward to reading more of your posts in the near future. This is something that everyone with Crohn's needs to read, perhaps you should write a book.

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  2. I don't eat potatoes every day. At present, my main source of carbs is overripe bananas and homemade yogurt. I do eat rice occasionally as well, and it doesn't seem to bother me either.

    I made a cheesecake a week ago, but it was loaded with sugar and eating it twice sent me to do penance in the bathroom. But to be honest, I don't know what I expected. It didn't have gluten or starch, but it was loaded with sugar and enough fat to overload even my theoretically well fat-adapted intestines.

    I'm not sure if this is ironic or not, but right now Crohn's is far from my main health worry. I think I might have pinched a nerve in my back, and that's throwing me for a loop right now. I was hoping to do some work in the weight room this fall and gain some weight, but now that looks like it's in doubt. Without exercise as a motivator, I tend to eat a lot less, and less adventurously, so I doubt I'll have much interesting Crohn's news to report for a while. But if anything interesting happens I'll be sure to post :)

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  3. Thanks for posting this! I've been off meds for almost a year except for the occasional antibiotic. I used to take 22 pills a day! Thank God for low carb SCD diet.

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  4. wow glad you are all right!!! i have been doing low carb SCD but have still been flaring a lot. been on the diet for over a year now. i'm on prednisone and imuran again. ahh diet just doesn't seem to give me any ulcerative colitis relief. keep up with what you are doing and NEVER deviate. seems like you know what will happen from your scary experience.

    when you do consume fruits/veggies, how much do you eat in one day?? i have limited myself to 1/4 an avocado, 5 pieces of banana, and a handful of zucchini daily for a while now. also dabble with fermented pickles and sauerkraut.

    -jo

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  5. Trying going all meat jo. It really works, or at least less than 50 grams of carbs a day. Avoid the fermented stuff. Look into zero carb movement / ketogenic diet.

    Fiber can really hurt you if you have inflammation. So go all meat...

    I only eat grass fed beef, chicken, fish, pork, wild salmon, eggs, liver, other organ meats. Not even coconut oil as that acts as a laxative when I eat it.

    Read the books
    - Life without bread by Lutz
    - Fiber menace

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