An update: I'm fine

The last time I wrote a full post was 2016. Typing that sentence was disorienting - has it really been that long? Of course it has. I'm just getting old enough to start noticing the passage of time like old people do, by commenting on it incessantly instead of getting to the point.

tldr: I'm still fine. I had another kid, I ratcheted up to way more work stress, and I still don't eat gluten. But otherwise I'm pretty lax about what I eat, and have been for years. So far as I can tell, I'm basically normal except for a lingering hyper-attention to my poop. I guess that'll never go away.

The longer version is more of a ramble. Settle in, if you dare.

I got a colonoscopy this summer. When I was doing the pre-op visit, the gastro suggested that maybe he could get the Crohn's diagnosis off my chart, if the colonoscopy was normal. I was floored by the suggestion. I pointed out that I had years and years of biopsies confirming the diagnosis, polyps removed, tons of symptoms. He flipped through my chart, shrugged, and said, "Yeah, but there's no evidence of it from the colonoscopy in 2016. If there's none this time, you wouldn't be diagnosed if you were a new patient, and probably don't need to worry about it much." While this is, more or less, how I have been living my life, it was still very strange to hear it from a doctor. And sure enough, my colonoscopy results came back over the phone as a voicemail saying, "you're fine, you don't need to come in for a follow up."

So... I'm fine. Big reveal.   

What do I eat? Well, I use meat now almost medicinally. If I go too long eating too much crap (starch, carbs, sugar, whatever) and start having digestive issues, I'll do an all meat week or two and get back on track. Then I'll slide back towards crappy diet eventually. To be clear, my diet is likely still "cleaner" than the vast majority of Americans, still lower-carb and more meaty, but I don't want to give the impression that I'm still doing the same thing I did fifteen years ago. I'm not. Nor do I anticipate needing to, unless I have another real flare up. 

How's my health? Interesting! I went in for a physical earlier this year and got a routine blood work up. My iron levels (basically all of them every which way) were off the charts high. I got a test for hereditary hemochromatosis and confirmed that I am indeed a lucky winner. Two out of the three genes! Yay. My brother also has it, but it doesn't look like anyone else in the extended family won that particular lottery. Interestingly, despite eating a very red meat heavy diet, my brother's iron is not high, so he doesn't have to do anything. I'm going in for regular blood draws until my iron levels get to normal, then I'll be giving blood every few months to keep them there. I have no obvious symptoms of high iron, but they can take decades to appear, so I'm happy to treat it early.

Sidenote: If you're of northern European descent, you have something like a 1/200 chance of having hereditary hemochromatosis, and when you're in your thirties you should probably get your iron checked if you're not already doing so. 

What else? I can run without crapping myself, to the point where I can get out and work up to six or seven miles in the mornings. Running performance, digestive and otherwise, has steadily improved as I've gotten older and further away from active Crohn's, which is welcome if unexplained. I appear to have baseline middle-age energy levels. My cholesterol was 180 something after that physical I mentioned, which was a bit low for me and probably a bio-marker of eating less meat more than anything useful. I got an electric car and will be getting solar panels? Does that count? 

Oh! Sometimes I take a gander around the wild west of the crazy diet internet, just so see how it's doing these days, and I can't help but laugh. Still the same old, same old. Everyone is convinced that they're right, that everyone else is wrong, and fighting it out underneath a thin layer of profiteers looking for their scummy nibbles. It always tickles me when my blog and/or my experience is mentioned, one way or another, in those arguments. Fifteen years and it seems that we're no closer to having any real idea what the hell is going on with Crohn's disease, so the internet will rage on. My advice is to not get too sucked into any of that swirl. "Just eat meat" really is that simple and I still can't believe people can make money consulting about it. Second career maybe? 

I suspect this post is a bit of a disappointment, if you've read this far. An anti-climax, at best, yet that's the honest summary of my Crohn's experience since 2016. I would bet if you're reading this on your phone while crapping your brains out, though, an anti-climax probably sounds pretty great, compared to where you are now. So I'll close this off with the same thing I've said to the people who email me or leave comments: it's worth a shot. Eat only meat and water for six months. Take a multi-vitamin if you're worried. Don't cheat, because nature cannot be fooled, and don't become a zealot, because there's more to life than what you eat. Just give it an honest try and see how you feel. I have no idea what the NNT of this diet is, but at this point I'm pretty sure it's both non-zero and non-infinity, so at least someone reading this who takes the dive will benefit.

And if that's all this weird blog ever does, it will be worth it.

Who knows when I'll write my next post, but if something big happens I'll let you know. Until then, it's back to regular boring life for me. Hopefully for you as well!

Three years? Time flies

It's been three years since my last colonoscopy, and three years since my last post. Reading that post feels like reading a note in a time capsule; so much has changed since then. My wife and I bought and fixed up a house, had a baby, both had work changes (she moved schools, I got promoted) and have had some wonderful and trying times. Stress out the wazoo.

But one thing hasn't changed: I'm still symptom free. More on that in a bit.

Diet-wise the only hard rule left is "no gluten", which in pragmatic terms translates into "no regular, large starch piles". However, I do eat potatoes with regularity, and have ventured into the dark lands of gluten free pizza a few times (with predictable results). Overall, my diet remains centered around meat, eggs and cheese, with fruit (mostly "gross" bananas), vegetables and starchy tubers rounding it out.

One negative health event was scoring high cholesterol for a physical two years ago. 290 total, I forget the exact splits. At the time, I was chugging milk and yogurt, so I stopped. A year later I was down to 204 and had an extremely positive Boston Heart panel. High HDL, the right LDL pattern, etc. The cardiologist was a little stunned by the turnaround and mentioned that it takes most people years to pull that off. Most people probably aren't drinking that much milk. I guess my phenotype doesn't respond well to a sustained dairy onslaught. Oh well. I've been making up the calories with a shake made from protein powder, super-ripe bananas and peanut butter, with no negative side effects.

On to the colonoscopy.

I switched gastros to one who had a facility a little closer to my new house. The prep they gave me was astonishingly inoffensive (suprep). I recall gagging and being almost unable to finish a similar prep (fleet phosphosoda or something like that), but this one was so mild it was no big deal. Only complaint about the procedure itself was that instead of giving me the relaxant a few minutes ahead of time, they just knocked me out - come on guys, I crapped my brains out for twelve hours, I think I deserve a little legal high time.

Woke up and the doctor told me everything looked fine. No polyps, no inflammation, no visual signs of disease. Come back in two weeks for follow up.

When I went to my follow up appointment, he said that I didn't look like I had Crohn's. He had me go through my history just to make sure that my diagnosis seemed sound, and I don't think there's any doubt that I do in fact have the disease. He said that it's so thoroughly in remission it's hard to tell. All of my biopsies were unremarkable except one which showed some signs of old inflammation, which wouldn't be enough to diagnose the disease if I was a brand new patient.

He grilled me about my diet for a bit and said that he's seen a few people like me, all with their own random diet stories. It's not possible to say if I actually induced remission with my year on meat, or just had a random remission start at the same time, but he said that given the individual nature of the disease and our lack of understanding of the microbiome, anything's possible. Maybe in ten or twenty years, we'll be able to sample your gut and say, "Eat like this and you'll be fine." The science just isn't there yet.

He said that given my results I probably shouldn't bother coming in for another colonoscopy unless I had symptoms, but he's obligated to recommend a follow up given that I have a history. Keep doing what I'm doing, and call him if anything changes, but otherwise my colon looks like any other 32 year old colon. Not bad.

So, maybe in another three years I'll go get scoped again. We'll see. For now, though, I'm fine.

Eight years ago I decided to eat nothing but meat for a year. Now I have a perfectly normal colon. If those two events are indeed correlated, and someone could figure out exactly how, a whole lot of people would be able to find relief from a terrible disease. I hope that in twenty years, I'll be able to shutter this blog with a post saying, "They figured it out, go eat X and Y." But for now, it's all up to you to find the diet that works best. My approach might not work for you, but I'm betting there is an approach that will. Don't give up!

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!

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:

Food:

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.

Health

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.

Exercise

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.

No Colitis

Hard to believe that it’s been over a year since I updated this blog, and two years since I started it. Where does the time go?

I’ll probably bump in here once a year or so with updates, just to make sure this information is current and honest. If at year three I have a massive flare up and die from meat clogging my intestines, it’d be a good idea to note that rather than let people believe this all worked out.

Of course, I have yet to have meat clog my intestines, and the title of this post is the summary from my latest colonoscopy: no colitis activity. Yay! Two years “cured”. My pipes looked good enough for the gastro to move me off of the once a year colonoscopy schedule – I go back in two years, August 2013. Awesome. This’ll be the first year I go without a colonoscopy since 2002.

What’s perhaps more interesting than the result is my behavior in the past year. I did not continue to eat only meat. Meat continues to form the basis of my diet; most meals are mostly meat. But I have added back in a pretty broad variety of other things. For the first few months post meat, I added back in some vegetables and drank a TON of Lactaid milk to gain weight. After a few months of that, I was up to nearly 200lbs from a starting weight of 160lbs. So that worked.

There were no apparent Crohn’s consequences from the milk or the vegetables. I did get more gassy and bloated at times, but no flare up of symptoms or pain. I did discover that brussel sprouts are not really human food as much as they are gut-bacteria food, and that if I wanted to avoid generating sulphurous methane at a rate which would astonish a cow, I should avoid them. So brussel sprouts = bad, at least for me.

That brings me up to December 2010. At that point I was getting tired of milk, and had started to break out in acne on my upper back. That seemed like a clear indication that milk, even if it wasn’t going to trigger Crohn’s, was probably not helping overall. I also hurt my back and had to take a break from weights for a while, so there was no point in chugging that much milk.

So I decided to give the starch hypothesis a direct test. I started eating potatoes.

I did experience some discomfort at first, but no real Crohn’s symptoms. It seems that my digestive system had to reset a bit to handle a pile of starch. Again, I would have more gas (as in gas at all; the meat only diet left me without any) with the potatoes, but no Crohn’s flare. I’m still eating potatoes now, eight months later, with no obvious consequences and no Crohn’s activity in my latest biopsies.

Hypothesis falsified?

Was Wulfgang Lutz right? Just eat 72g of carbs of whatever source and you’ll be fine?

I don’t know. One could argue that the year of zero starch allowed my intestines to heal sufficiently to the point where the bacterial mimetic necessary to generate the autoimmune response are no longer crossing the gut barrier, and so the starch hypothesis stands. Or maybe I didn’t need to eat only meat for a year – maybe just dropping the total starch load to some lower level would be sufficient, ala Lutz. Or maybe the starch hypothesis is total crap and I just happened to have a flare up and remission which coincided bizarrely well with a radical shift in diet.

The one thing I have not tested myself with is gluten. Maybe all of the above is a red herring, and removing gluten and various grain proteins from my diet caused the gut healing necessary to shut down the Crohn’s reaction. I was tested for celiac and came up negative back when I was first diagnosed, but frank celiac and gluten sensitive are different levels of response. When it comes to generating totally unscientific explanations for the results of my N=1 experiment, I’m coming to think that it might just come down to avoiding bread.

I did have a few moments of insane cramping and diarrhea over the past year. In each case, I could not ascertain a direct cause. It seemed to happen at random, but usually coincided roughly with some deviant behavior. I really can’t say if this is just me finding patterns in chaos, but when I eat a lot of nuts (pistachios are apparently equivalent to crack cocaine for me), I usually end up in trouble. Unfortunately, I was also eating some fruit at the same time I was gorging on pistachio, so maybe it was fructans in the fruit. I have yet to do any real exclusionary experimentation to isolate which food(s) were sending my guts down the toilet, mostly because “success” involves my guts trying to jump out of my body and down the toilet.

So, there you have it. I’m still “cured” despite adding in a number of foods which a year ago I would have predicted would cause a relapse. Who knows what I’ll be saying in a year or two. I’ll make one golden prediction: I’ll be less certain about the truth of the matter than I was when I started.

In the meantime, though: no colitis!

Concluding Thoughts

I woke up from my colonoscopy with my traditional confusion and disorientation. I recall the doctor walking up and saying that things looked fine and that they had removed a polyp. He let me take home the pictures from the polyp removal and his writeup about it. Nice guy.

I guess that polyp that my previous gastro thought might require surgery to remove had morphed into a non-problem over the past year. I compared the pictures from my 2009 colonoscopy and the polyp looked fairly different – in 2009 it was white and puffy, in 2010 it was the same color as everything else and looked smaller and denser. I have no idea if these statements make any sense or are even true, given that I’m just comparing pictures on a piece of paper, but there you have it.

I got a call from the doctor’s office yesterday saying that the polyp was benign and everything is fine. I should come back in a year for another colonoscopy.

So here I am. One year after embarking on what I thought was a fairly radical experiment, and the sum total of my medically noted results is “Everything looks fine.” Talk about an oddly deflating experience. On the one hand, this confirms that I am in a medicine free remission, that I am generally healthy and free of Crohn’s activity. That is massively good news and a confirmation of the Hypothesis. On the other… well, everything’s fine. Could just be a fluke. Who knows?

So with that little humbling thought, here are my takeaways from a year of very-low-carbohydrate, zero starch eating:

1) It appears to have been effective at maintaining remission. My first three or four months were quite turbulent and felt as if I was having a flare up, but I stuck with it and the reward is more than worth it. Or maybe I’m just lucky? Epistemic crisis here I come.

2) It is not hard to do, provided that one actually is interested in the outcome. I’ve been continually perplexed by the hangups people have about food and the preconceptions they refuse to let go of in the face of evidence like my lack of dying. How on earth can anyone say, “Oh there’s no way I could do that.” Seriously? There are people on this planet whose entire lives are spent in a brutal daily struggle for food that they eventually lose based on the arbitrary whims of an unfeeling universe, yet the idea of eating a calorically and nutritionally complete diet of meat, eggs and cheese for a year is inconceivable.

A lot of this has to do with not having any stake in the outcome of the experiment. It’s easy to not think through a statement about the diet if the only time you think about it is the once a month you happen to notice what I’m eating, and then make some idiotic claim about how it’d be impossible to handle. It’s not only not impossible, it’s trivial. You simply have to know some basic facts about why it’s a worthwhile approach, commit to a goal, and then do it. Perhaps I’m too impatient with other people’s frailties, but even that is hard to accept because I’m about as frail as they come. So why is it that this wasn’t a disastrously difficult experience for me despite the near unanimous outcry of how hard it must be?

People just don’t ever think about what it means to eat, about why they eat, or they just don’t care about their health enough to do so. If they did, they might find giving up certain foods to be fairly simple. Ignorance is bliss, I suppose. Of course, I was and likely still am one of the ignorant, but man oh man do I hope I wasn’t so blatant about it in the past.

3) Ebringer’s research really, really deserves more attention in the Crohn’s patient and research communities. Maybe I’m a fluky n=1 random event, but I doubt it. Browsing through the mainstream articles and forums is an incredibly depressing exercise in watching the conventional wisdom of “there is no cure, prepare to suffer” stifle people’s attempts to find relief. The CCFA’s criticism of the Specific Carbohydrate Diet was a ludicrous read - I hate conspiracy theories, but it’s like the mainstream doesn’t want there to be a way to manage the disease without constant medication, so anything that promises such must be attacked with tenuous logic and absurd “warnings” like “children might not get enough calories”. What?! Fearmongering bullshit at its worst.

4) Just try it. It’s one year of your life and it may improve every other year you ever live. We like to talk about putting in your time and making investments, but it’s rare that we have the opportunity to do so in our own lives with such a radical payoff. There is no guarantee of success, but there is a guarantee of failure if you do nothing.

I went back and reread my introduction post and I wanted to offer up some thoughts about how my perspective has changed since then.

I relied almost entirely on ethnographic observations to get me to this diet. The only modern clinical evidence I saw was Lutz’s claim of 80% remission with a low carb diet. While this was a happy outcome, I’m now much more leery of relying on such a shaky foundation for diet – I don’t think I posted anything that’s outright false in that introduction, but I far prefer the work of Ebringer as a foundation for low starch eating in inducing/maintaining Crohn’s remission to a collection of random observations about the general health of primitive populations.

Those biases eventually lead me to the “paleo diet” movement that is bouncing around the internets as we speak. Basically, the theory goes that since humans evolved over a time span of millennia, we should focus on eating the foods which most closely resemble those we evolved to eat, while avoiding those which are too recent for humanity to have adapted to. The closer to the present a food was invented or introduced into the pool, the more skepticism it should be viewed with.

I have my disagreements with various takes on paleo. I dislike the magical thinking and speculation that it seems to breed, the caveman metaphor, the constant optimum seeking and above all the orthodoxy of thought that any principled approach to eating engenders. However, I like the basic premise and I like how it provides a pretty simple and accurate mental model for selecting healthy food. Sure, maybe a given individual can tolerate gluten better than someone else, but they don’t really miss out on much by eating more meat instead of bread. And if they experiment and have no problems, hell, add it back in.

Generally speaking, I think I went through the process of being a new convert and now I’m back to being a relatively cynical skeptic with some new biases based on some new experiences. We’ll see how well that bears out.

So, that’s it. I did it. I ate pretty much an all meat diet for a full year. I did not die. I did not get scurvy or any evident deficiency. I ate a lot of cow and I’m in apparently good health.

I turned 26 this weekend and for the first birthday in about five years, I didn’t have to take four grams of pills.

Best present ever.

Final monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity. Also added average frequency.

The "Weight Chart Daily Graph" worksheet shows the daily morning weight.

The "BM Score Daily Graph" worksheet shows the daily combined BM score and quantity.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

July was spent largely on vacation. My data for the month is thus somewhat sketchy, but generally speaking I was fine. We went hiking in the Adirondacks again (just like in August of last year) and once again I felt fine walking up mountains. Well, maybe fine is the wrong word – I was able to do it and fight through the pain of walking up the side of a mountain.

There’s not much to say. I feel fine. I weigh about 15 pounds more than I did when I started. My bowel movements are regular, healthy and I rarely get diarrhea. It’s been a year and I’m pretty sure I’m in a drug free remission. Success?

The final colonoscopy is scheduled for July 30^th. I’ll find out then.

(Note: Posting this pretty late because I'm lazy. The next post will deal with the post-colonoscopy review and concluding thoughts)

June Weights and Measures

Elevent monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity. Also added average frequency.

The "Weight Chart Daily Graph" worksheet shows the daily morning weight.

The "BM Score Daily Graph" worksheet shows the daily combined BM score and quantity.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

June featured a long vacation which thoroughly disrupted the data. I went to England to visit my parents, and discovered the wonders of the British dairy aisle. Shockingly enough, each container of “double cream” contained… just cream. No random other crap added in for no good reason. Tasted great and very thick as well.

I was pretty digestively sound in England, returned for a week, and then embarked on a trip to the beach, which also disrupted my record keeping for the start of July. Thus, this entry will be short – except to note one important thing:

My year is almost up!

It’s incredible that July 20 is approaching so quickly. One year without eating anything but animal products and not only am I not dead, I’m feeling fine, have plenty of energy for strenuous activity like paintball and appear to be in excellent general health. Such subjective measures mean nothing, of course. The only real test will be my colonoscopy on July 30^th and what the biopsies show.

I initially intended to make some predictions, but this past year has taught me that I know too little for that to be a worthwhile exercise. I find myself with little confidence in any prediction I can come up with. The polyp found last year might have become cancerous, or maybe it’s gone completely, or maybe there’s been no change. I’m definitively asymptomatic when it comes to overt Crohn’s symptoms like cramping and diarrhea, but I do get a twinge now and then which makes me wonder what’s going on down there. What will the biopsy show? Maybe I’ll look like hamburger, or completely cured, or maybe I’ll just look like a guy with mild colitis like always. Gotta love uncertainty.

Suffice it to say that I’m anxiously awaiting the results and hope that they’re as positive as the experience itself has been. There’s nothing worse than thinking, “Wow, this must be really working!” only to get a cold bucket of medical reality in the face.

My next post will be a look back over the past year, focusing on the things I was wrong about, lessons learned, and what I’ll do with the next year. Till then… one month to go!

The Hypothesis

The Hypothesis

In my travels through life and the internets, I’ve recently had a bunch of people ask me exactly what it is I’m doing, and why I’m doing it. Looking back at my initial explanation post, I realize that it doesn’t really do any scientific justice to my thoroughly unscientific experiment, at least not when it comes to explaining and justifying my course of action through the statement of a hypothesis for testing.

So here‘s the hypothesis:

By eating no starch and no fiber, I will put my Crohn’s Disease into clinical remission by reducing or eliminating the activity of Klebsiella Pneumoniae in my gut.

Ok! But what the hell does that mean? Why do I think this will work? What’s the end game? Let’s start with the most compelling piece of theoretical science, move to the only significant tests of that science, and then on to how (and why) to test it yourself if you have Crohn’s, Ulcerative Colitis or IBD/IBS.

Theory

(In the spirit of credit where credit is due, I must thank AJ for telling me about Ebringer’s work and taking the time to talk to me about the implications. I owe him a great debt of gratitude! AJ is also attempting a low starch diet with success in treating his Crohn’s.)

Alan Ebringer, a professor of Immunology at King’s College, London, lead a research team studying ankylosing spondylitis (AS), which is a condition of auto-immune arthritis of the lower back. They discovered that patients with AS tended to have anti-bodies in their bodies to a ubiquitous bacterium called Klebisella Penumoniae (KP). KP is present in everyone’s intestines, but if everything is working properly your body’s immune system should not be required to control it. In AS patients, something was wrong with the way their guts and immune system were handling this bacteria.

Ebringer and his team eventually developed the following hypothesis. I am probably simplifying this through my ignorance of the full meaning of the terms in the papers, but I think I have the gist correct:

90% of their patients with AS produced the HLA-B27 antigen. KP produces a particular enzyme to break down starch for digestion which happened to partially mimic the structure of the HLA-B27 antigen, as well as the structure of several types of collagen in your body. When you eat a large bolus of starch, not all of it will be digested before your KP has a chance to eat some. The KP will merrily eat and reproduce until the starch is gone, at which point they slowly die back until the next meal.

If you have good gut permeability (that is low gut permeability), and little damage to your intestines from your diet, chances are that the products of bacterial action will never cross the tight junctions in your gut and into your body. If, however, you are at all sensitive to gluten, lectin, or any of the other common allergens in the modern diet, or you have recently suffered trauma to your gut, you may have a compromised gut which will allow minute amounts of KP and KP byproducts to by pass the gut wall. Your body’s immune system will respond like it does to any foreign protein – it will being producing anti-bodies which are coded to attack that protein.

But that’s the catch. If you are HLA-B27 positive, your immune response may be confused and attack not only the foreign proteins, but any protein which mimic them. You are now experiencing an auto-immune response, and in AS patients, this manifests itself as chronic inflammation of the spine and pelvic joints.

Ebringer and his team noticed an association between AS and IBS, so they decided to see how Crohnies fared in terms of KP anti-body counts. They discovered that Crohn’s sufferers also had very elevated KP anti-body activity, but they were predominately HLA-B27 negative. So they went looking and discovered that KP also mimics several kinds of collagen which are helpfully present in your intestinal wall: right where you get the colitis that characterizes Crohn’s! They concluded that people who are HLA-B27 positive have a high propensity to develop AS if they compromise their gut, while people who are HLA-B27 negative would get Crohn’s, Ulcerative Colitis, and the other inflammatory bowel disorders.

Ebringer and company developed what they call the “low-starch diet” and prescribed it to their AS patients. Unfortunately, funding for their research appears to have dried up and Ebringer himself has retired. Presumably someone will be along to pick up this line of inquiry, but until then we’re in limbo in terms of further theoretical advances, at least that I’ve seen. I make no claims to being all knowing and all seeing so maybe I’m pleasantly mistaken and there is a full blown clinical trial going on somewhere!

In the absence of that miracle, however, we are left with no published clinical tests run by Ebringer to establish whether or not the low-starch diet would work for AS or Crohn’s patients. Which leads us to the next question.

Testing

There are two “tests” of this theory available, one strong, one weak. I’ll lead with my low card here.

The Specific Carbohydrate Diet was created by Sidney Haas in the 1920s in an attempt to address celiac, Crohn’s and other digestive disorders. It was fairly successful, but it was supplanted once the actual mechanism behind celiac was discovered. This probably buried Haas in the footnotes of celiac disease and the effectiveness of the diet for Crohn’s was lost until Elaine Gottschall wrote Breaking the Vicious Cycle. Since the book was published, many people suffering from various bowel disorders have reported success if they were very strict in following the dietary recommendations Gottschall laid out.

I call this my weak evidence because anecdotes are not data. There are also a substantial number of people who fail on the SCD – adherents might say that’s because the failures couldn’t stick to the program, a view which I tend to agree with, but which must be taken into account when applying proper skepticism. SCD also lacks a specific mechanism for how it treats the diseases it appears to alleviate, which makes it less useful when one is trying to synthesize disparate sources into an overall hypothesis or worldview. So the SCD is intriguing, but barring clinical trials will remain only intriguing for the mainstream.

For our purposes, the collective anecdote of the SCD community provides a partial test of the hypothesis. The SCD also allows invert sugar (honey) and nuts in the form of nut flours in the diet. I’m somewhat curious about the nut flours, since many nuts appear to have a fair amount of starch in them, and leery of the sugar for other reasons. I wonder if some of the SCD failures have been caused by people falling into the candy cigarettes trap of trying to fake themselves out with “bread” made from walnut flour.

On to the second test of the hypothesis. Wolfgang Lutz was an early low-carbohydrate diet promoter. He practiced in Austria in the 1970s, and wrote a book entitled Leben Ohne Brot, or in English, Life without Bread. The book is fairly standard low-carb fare until the end, where the authors detail how various medical conditions responded to low-carbohydrate diets.

When I hit this part in the book, I started skimming until I hit the gastrointestinal disorder section. That’s when I discovered a truly jaw-dropping graph for any Crohn’s sufferer. If I weren’t suddenly inspired to obey copyright law, I would reproduce the original here, but instead I’ll just describe the results: Lutz claimed an 80% remission rate after six months of nothing more complicated than low carb dieting.

That’s either complete bull or a very powerful, if overly broad, confirmation of the hypothesis. People following Lutz’s diet are allowed 6 “bread units” a day – basically, the amount of carbohydrate in six slices of bread, or 72 grams – and so one can imagine that the diet of the 80% who were successful contained plenty of starch. If so, then the hypothesis would actually be falsified, since the starch and fiber restrictions would be shown to be irrelevant, or at least overly strict. But that information is not forthcoming in the book and I doubt that it would be possible to obtain the food logs of patients from the 70s at this point.

We can’t fully trust the Lutz results because they were not verified via clinical trial. The patient records of a practicing doctor can be considered very powerful arguments in the justification of a trial, but are not themselves as compelling as the results of a well run trial. So again, we must remain skeptical.

Thankfully, we don’t have to leave it at that.

How (and why) to test this yourself

The essence of science is the testing of ideas by experiment. Here we have an eminently testable idea, one you can test in your very own home. You don’t need a particle collider to change your diet and observe the results. Here’s how to run the test:

1) Start eating according to the low-starch diet outlined by Ebringer. This may not be readily available on the internet so I’ll reproduce the basics here:

a. Eliminate grains, sugar, all starchy vegetables and legumes (basically anything that isn’t green and crunchy), fruits and nuts.

b. Replace the eliminated foods with fatty meat and non-starchy vegetables.

Your goal is to completely get rid of all the starch in your diet. All of it – don’t compromise, don’t wimp out, don’t pine away for an ice cream cone and cheat. Your mindset should be that of a boxer stepping into the ring or a marathoner taking the first step in the race – you are in a fight here, a fight where you don’t get to make many mistakes, a fight which quite literally might determine how the rest of your life plays out.

2) Continue this diet strictly for at least six months. Work with your doctor on your medications; most aren’t too happy if you just drop them cold turkey, and if you are on steroid therapy quitting cold turkey can be very dangerous to your health. I’ll say that again: if you are taking predisone or another steroid, do not quit cold turkey!

3) Let us know how it turned out!

Many people respond to the diet proposed with horror. No more cookies? No more cake? No more bread? Are you insane?

My response is simple: no, I’m not insane. You give up all of those things, but you also might get to throw your pills away forever. You get to take your health back forever. Rather than cycling through flare-ups and getting progressively more disquieting reports on your colonoscopies until you eventually end up with a colostomy bag, you can take control of your future and maybe avoid that fate. You can avoid a huge increase in risk of prostate and bowel cancers. You can avoid the late night sessions sitting cramped on the toilet wondering what the hell is going on and when it’s going to end, and the creeping despair inherent in the knowledge that tomorrow you’re going to have to pop several grams of medication just to stay alive.

I can’t promise anyone that this diet will work. I still don’t know if it will work. I can say with certainty that I do not have any symptoms of Crohn’s – I have no pain or diarrhea, I’m gaining rather than losing weight, I feel great – but even if my next colonscopy is so amazing that doctor thinks I lied about the diagnosis I still can’t say with certainty that the diet did it. I’ll probably live my whole life wondering. But at least that life won’t be lived as a slave to a bottle of pills, and maybe, if I’m lucky, enough people will try this diet and diets like it that the mainstream will take notice.

So if you’re still with me at this point, I sincerely hope you give it a shot. By way of offering support, feel free to shoot me an email and ask for help or let me know how things are going. I'm always interested in hearing from people who have tried a dietary approach - whether it worked or it didn't.

Good luck!

May Weights and Measures

Tenth monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity. Also added average frequency.

The "Weight Chart Daily Graph" worksheet shows the daily morning weight.

The "BM Score Daily Graph" worksheet shows the daily combined BM score and quantity.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

So may got interesting!

The pain from my mystery steak buffet illness subsided until it was time for the endoscopy. Of course, at that point I was something of a hypochondriac and I was aware of every burp or stomach rumble, but by that point nothing hurt anymore. As I walked into the center I thought, “Great, do I really need this?” Nothing like wasting money on a medical test you don’t need. But I was there and I hadn’t had an endoscopy in years, and ignoring medical conditions has bitten me in the ass repeatedly, so in I went.

The nurse prepping me asked what I was in for. Eventually he found out that I had Crohn’s and said, “Oh I have that too. How do you manage it?” That put me in the awkward situation of trying to explain this great diet that’s working really great except for that whole two day crippling pain episode. I think he was just trying to kill time though, so I didn’t get much of a reaction.

My gastro arrived and started reviewing the results of my blood tests while I was lying on the gurney. My fasting blood glucose was pretty low (73) and he joked that I should eat a piece of bread. Har har. I am somewhat intrigued by the low reading and I’ll probably get around to doing a glucose meter experiment one of these days.

Then they knocked me out. I woke up and the doctor said, “Doesn’t look like anything significant. We took some biopsies, we’ll let you know how they turn out.” Great! Nothing significant. I had just wasted everyone’s time – outstanding.

I went about my life as usual for the next week or so. I started lifting weights again at the end of April, just squatting. I wanted to see if I could break my previous record and didn’t really care about the rest of the lifts. Of course, that’s “not doing the program”, and I wasn’t eating enough, so all in all it was a moderate to severely stupid plan. More on that later.

I got a voicemail from a nurse at the endoscopy center saying, in total, “We got the results of your biopsy and you definitely have GERD. You really need to be on Nexium. Call us if you need a prescription or if you’ve run out.” Since it was a voicemail I couldn’t respond with, “Wait, the doctor said it wasn’t anything serious. What the heck?”

I did a quick research blitz, which lead me to Jonathan Wright, who claims that low stomach acid is the cause of 90% of heartburn cases. I dutifully tried the acid treatment recommendations: take one betaine HCl pill with a meal, see if you “feel a burn”. Keep adding a pill until you either feel a burn or something bad happens, and then back off one pill. As near as I can tell after three tries, the result of taking a stomach acid supplement was nausea and diarrhea. Since I didn’t have visible heartburn symptoms to begin with, I had no way of evaluating its reflux fighting power. Ok, back to square one.

I scheduled an appointment and talked to the gastro. He showed me the biopsy report, which did indeed claim that I had “moderate chronic reflux”. The “chronic” part was surprising, since I hadn’t noticed any reflux or heartburn symptoms at all until that one event. The doc mentioned that some people don’t feel the reflux, and that perhaps I was one of them. He rattled off a few meds I could try, none of which were appealing. He was unimpressed with the acid hypothesis and said that I was too young to have to worry about that. End result: I walked out with a prescription for some drug “if I wanted to try it” and a recommendation for another endoscopy in a year to see how I was doing.

More research. This time I ran across Ricardo de Souza Pereira, a doctor from Brazil who had compared a supplement with a Nexium precursor drug to see which was better at controlling heartburn symptoms. The supplement won hands down. That caught my attention. Dr. Michael Eades (see blog) had apparently come across this before and tried to market it in the US with no success. He’s got a very interesting blog post about that whole process. He also hosts a summary of the study, which helpfully gives the supplement ingredients.

After doing some more research, I discovered that melatonin appears to be the critical ingredient. There’s an anecdote about a woman who was able to control her heartburn with 6mg of melatonin before bedtime. The therapy is founded on the fact that melatonin, often associated only with the pineal gland and sleep, is also secreted by your gastrointestinal tract for unknown reasons. The way it works on hearburn is, in theory:

“However, others concluded that the esophagoprotective activity of melatonin against GERD might be related to the inhibitory effect of this indole on gastric acid secretion and due to stimulation of gastrin release, which might attenuate the gastro-esophageal reflux by stimulation of the contractile activity of the lower esophageal sphincter”

A more recent study (quote above) comparing melatonin with omeprazole had some very interesting results. (Sidenote: omeprazole is basically Prilosec, which, when its patent expired, was trivially altered into Nexium, which was then patented again. Gotta keep those patents. So Prilosec is widely used in research as a stand in for prescription heartburn medications.)

The most interesting, and I think important, dichotomy here is the fact that melatonin generated significant increases in LES tone while the omeprazole only created “non-significant” increases. Since reflux is fundamentally a disorder of acid entering the esophagus, melatonin does a better job of treating the fundamentals of the disorder.

In any event, after reading up on that I went to the store and started taking 6mg of melatonin before bed. Again, since I have no obvious heartburn symptoms, this experiment is very difficult to judge. As far as I can tell, the only result has been MUCH deeper sleep. That was a welcome side-effect, since I’m usually the sort of sleeper who will wake up if a mouse farts in the house next door. I’m still looking for studies on the long term effects of melatonin supplementation, but so far I’m happy. We’ll see how it goes.

Since GERD is a clear indication of dietary failure, I went back and reviewed my food choices up until now. My clear reliance on dairy might be a significant contributing factor, but it’s really damn hard to get enough fat without dairy. So I’m not sure if I can give that up as of yet.

I had always been intrigued by the specific carbohydrate diet, which I suppose I am now doing a rather extreme version of, and thought, “Well they eat yogurt. I should see how.” The end result of that line of inquiry was me making homemade yogurt for the first time. It came out pretty watery, but after letting is strain through a cheesecloth for a couple hours it thickened up into some pretty decent (super sour) greek yogurt. I bought a tub of full fat Fage yogurt at the grocery store and my stuff tasted about the same, just a bit more sour. I suspect this was because I fermented mine, or at least tried to ferment mine, for 24 hours, whereas the commercial operations probably only do it for half as long.

If the Klebsiella Pneumoniae connection is true, I really don’t want lactose getting into my large intestine, so I might have to start fermenting my own yogurt from here on out. I need to make some modifications to my system before that’s really a sustainable activity, but it’s actually a pretty simple thing to do.

A final note on weight lifting. It turns out that only working one exercise and not eating a lot of food still results in you stalling. I can’t seem to get 170lbs for 3 sets of 5 on my squat. Since this is a pathetically weak squat for an adult male, I suspect that it just happens to be the weight at which underlying form issues are exposed to the point where I can’t force my way through it. So I guess I’ll be working on form for a while, eating a lot more and doing the damn program.

Ten months down, two to go (holy crap!)

April Weights and Measures

Ninth monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity. Also added average frequency.

The "Weight Chart Daily Graph" worksheet shows the daily morning weight.

The "BM Score Daily Graph" worksheet shows the daily combined BM score and quantity.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

April was uneventful up until the weekend of the 17^th and 18^th. I was driving back from VA after a weekend of paintball and noticed a sign advertising 20oz Porterhouse steaks for $14. I demanded that the whole team pull off the highway and eat dinner there, so we did. It turned out to be a steak buffet (they have those!) and everything seemed to be great. I ate some steak, a porkchop, and a piece of meat from some stew thing.

Within a few hours I was burping like crazy and felt like the top of my stomach was bloated. The next day, Monday, everything I swallowed hurt like hell as it entered my stomach. I ignored it for Monday, but when things continued on Tuesday I capitulated and went to a GP. She referred me back to a gastroenterologist in the region.

I got my medical records from my previous gastro and went to my appointment. The new guy flipped through everything, raised an eyebrow when I told him I wasn’t taking any medications, and then dropped an offhand bombshell when he said, “Well there’s some debate as to whether Pentasa actually helps people with Crohn’s.” So what the fuck have I been doing for the past five years?

He seemed slightly bemused by my approach but was otherwise supportive and even mentioned a couple of probiotic supplements that he had heard worked well. Overall, I think I definitely came out ahead by switching gastros: closer to my house, more supportive, less rushed and actually appears to be willing to listen when I talk rather than wait for me to shut up.

Anyway, the pain subsided in a day or two and now I just burp all the time. This is, of course, annoying, and I will be getting an endoscopy in early May to rule out any serious problems. Meanwhile, I get to wonder how it is a diet which is usually a cure for this sort of problem appears to have given me massive indigestion. Hmm.

Nine down, three to go. Wow.

Eighth monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity. Also added average frequency.

The "Weight Chart Daily Graph" worksheet shows the daily morning weight.

The "BM Score Daily Graph" worksheet shows the daily combined BM score and quantity.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

March was insane.

I spent two weeks in India eating nothing but the continental breakfast (cheese/egg omelet, dry bacon, dry sausage) and then gorging at a Brazilian BBQ in the evening. At first, I felt somewhat self-conscious about eating tons of meat while people literally an 1/8^th of a mile away were starving in abject poverty, but that went away on the second night when one of the BBQ chefs mocked me for not being able to eat enough meat. Game on after that.

By the third night they recognized my face and I barely had to order. I just walked in, they sat me down where I normally sat, and food started to appear. Wonderful!

Anyway, while there I managed to lose about 7 pounds. I was dizzy half the time, probably from the malaria medication, and slept poorly. I literally fell asleep while typing an email and woke up 20 minutes later with giant red mark on my forehead where it was resting on the desk. Incredible to experience real jet lag like that.

Ironically, after all the warnings about not drinking the water and intestinal parasites and whatnot, I think I may have actually gotten diarrhea from Continental. As soon as I landed in India, I had to go to the bathroom. After a few days of this, I took some antibiotics and it cleared up immediately. I was fine for the rest of the trip. Then, immediately on landing in Newark, I had to take a crap. I only waited a day before taking the remainder of my antibiotics, and it cleared right up. New hypothesis for traveler’s diarrhea: it’s actually the airline food.

The second half of March saw me falling ill for the first time since I went on the diet. It was a run of the mill cold with a touch of fever. I can’t report feeling any real difference in the cold compared to what colds were like prior to the diet – alas, eating like this is not magic.

I have not restarted my weightlifting program, though I want to. I’ve been playing a lot more paintball in preparation for the tournament in June and so I tend to be tired and sore from that for half the week. We’ll see how that goes.

Hard to believe it, but I’m ¾ of the way there. Eight down, four to go!

February Weights and Measures

I just got back from a two week trip to India, so this is pretty late. I might make an interim post or handle that experience in the March report. You'll notice in the dataset that the first fifteen days of March are all the same - I didn't log anything over there and thus there's a two week hole in my records. I just filled it with something that seemed to be average.

===========================

Seventh monthly roundup of measured data and analysis.

Data

Since blogger is annoying in how it handles images, I’m going to upload an Excel (2003) spreadsheet. Here’s a link:

http://www.forefrontpb.com/phildiet/Diet%20Records.xls

The "Weekly Graphs" worksheet shows the weekly average of weight and the weekly average combined BM score and quantity. Also added average frequency.

The "Weight Chart Daily Graph" worksheet shows the daily morning weight.

The "BM Score Daily Graph" worksheet shows the daily combined BM score and quantity.

I'm keeping a food log and notes in a written notebook, which for the sake of putting off an annoying task, I will scan and upload when I'm done rather than every month.

Analysis

February was uneventful. My second liver test came back normal in all categories. Whether this was because I stopped working out for a week prior to it or for some other reason I’ll never know.

The log is getting more and more difficult to keep, simply because I appear to be functioning normally and who the hell writes down everything they eat and every bowel movement they have? Sometimes you want to go back to whatever you were doing when you get out of the bathroom rather than hunt down a notebook and try to quantify the crap you just took.

I had to switch to a new notebook, having filled the original, and I flipped back through my old notes to see how things have progressed. I certainly have come a long way from August and September. It’s hard to remember the transition period clearly, although the log shows that it sucked. If a very low carb diet is generally effective in maintaining a Crohn’s remission, and a study organized where many people attempted to follow the diet, probably the hardest part for people will be getting through the first three months without losing hope (or too much weight; 6’3” and 151 pounds doesn’t feel healthy at all) or thinking, “This is bullshit; I’m crapping my brains out.”

That brings up the question of how I’ll ever be able to explain this approach to people. In a society that values a solution in a pill, especially one that promises a quick return to the imagined “normal” where one can eat whatever with no consequences, can an individual ever make a case for a low carb, low starch, low fiber approach without instantly turning away 95% of their audience?

Probably not. Maybe I’ll write a book titled, “The Crohn’s Cure: There isn’t one, deal.” I can see that being popular with publishers.

Anyway, I stopped overeating about halfway through the month and promptly lost five pounds, then stabilized at 180. My workouts have suffered since the week off, which seems to have interrupted my scheduling. Also, I’m going to India for two weeks on March 1, where I won’t have any access to weight training equipment, so there’s some sense that I’m just wasting time working out now. Oh well, I’ll jump back on the horse when I get back.

I suppose the only negative thing is that it’s getting harder and harder to wake up in the morning. Unfortunately, there’s a furry confounding factor in all this (my cat) who likes to make sure that I never get more than 4-5 hours of uninterrupted sleep on a given night. Is my diet making me tired or is it my cat? I’ll have to experiment with shutting her in the basement for a few weeks and see if that actually helps things.

I was very lax with my vitamin D supplementation this month, and I won’t be taking any in India, so I’ll have to resume that when I get back. Maybe that will help. Maybe I’m deficient in something else. Or maybe chronic lack of sleep just makes you tired?

Seven down, five to go. Over the hump!