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!

January Weights and Measures

Sixth 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

Six months down! Day 180 actually came a few days ago. Halfway there. I promised myself I’d re-evaluate at six months and see how things were going, make any tweaks that seemed necessary, and then finish out the year. Here it goes.

January was about as boring as December when it came to Crohn’s Disease. It’s becoming more and more difficult to remember to log everything because there’s just nothing interesting to note. I’m in remission without medication. My poop is normal. I’m gaining weight. Great, now what?

Well, for one, I went to my gastroenterologist and told her that I was no longer taking medication in order to test a diet. She wilted in her chair like I had just told her I killed someone dear to her. Her tone of voice and demeanor completely changed from cheerful, “you take your pills so you’re a good boy” to “oh my god you killed the family dog”. She said that I really should be on medication because people have flareups when they stop. I mentioned that I did not appear to be flaring up, that I actually felt great, and she said she couldn’t argue with that. She seemed shocked when I mentioned some of the research showing that this angle wasn’t entirely insane. I couldn’t tell if it was the affront of me trying to tell her how to do her job or just her experience with people like me doing stupid things and then begging for steroids a few months later. So with that “resolved”, they drew my blood and I left.

A few weeks later she calls and tells me that my liver enzyme panel was out of whack. Everything pertaining to Crohn’s Disease was normal, but two liver enzymes were elevated: ALT at 121 (normal is 55) and AST at 56 (normal is 40). She asked if I was drinking (I wasn’t) or if I was taking any medication like ibuprofen (I wasn’t). Since I wasn’t taking any Crohn’s medications, it couldn’t be that. So I get to go to a lab in mid-February for another test to confirm the first one, and if that’s elevated the working hypothesis will be either hepatitis or some sort of liver disease.

I, of course, did my own research and discovered a paper from 2008 outlining how some healthy males had pathological levels of ALT and AST when engaging in heavy weight lifting exercises. Since I’m in the middle of a heavy weight lifting regime, this seems like a plausible explanation for elevated liver enzymes. In order to test the idea, I’ll be as sedentary as possible for the 7-10 days leading up to the blood test.

In the weight lifting realm, incidentally, I pushed my weight up to 175 on the squat, but felt that my form was pretty poor. So I reset twice now to work on it. I’d prefer to squat less weight and have a healthy back than go for broke and break something. Weight gain continues, though not at that rapid pace. I’m up to 184 now, so a gain of 10lbs over this month.

Overeating to the degree that is necessary to gain weight is extremely difficult on this diet. I haven’t felt hunger for a month and a half, and my whole body is resisting the idea of eating more. I’ll probably stop overeating soon, simply because I can’t stand it anymore. Sorry, Sean, I won’t be able to race you to 200lbs.

My only six-month gut-check tweak is that for the month of February (to start) I’m going to be taking a Vitamin D3 supplement. I’m curious to see if there’s any effect on energy levels. Getting out of bed in the morning hasn’t been easy all winter, and maybe that has something to do with a lack of sunlight. If there’s an improvement, I’ll keep it up.

Also, I’ve decided to bail out on my challenge to myself to ride a century on a bicycle this year. Further research into chronic cardio exercise like long distance biking has convinced me that it’s not particularly healthy or useful. I’ll be playing in a paintball tournament this year, which means I need to develop sprinting stamina, not be able to spin a bike pedal for seven hours. Previous experience has taught me that training one does little if anything for the other, so there’s no need to punish myself on a bike four times a week. Instead, I get to practice sprinting.

Six months down. Six to go.

December Weights and Measures

Fifth 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

Month five was a relatively boring month. I played in two one day paintball games and didn’t suffer the exhaustion that I did from Fulda. My BM frequency leveled out, aside from one or two, probably holiday induced, turbulent days.

The interesting note from month five comes from the weight lifting program. After a disappointing November in terms of strength gains, I decided to step back and look at my diet more closely. I created a spreadsheet to track calories and discovered, to my great surprise, that I was only eating 2200-2500 calories a day. Subjectively it felt like I was stuffing myself – I only felt edgy hunger in the mornings, and then only for a few minutes before it went away – yet I was actually eating a fairly restrained amount of food.

Since virtually all weight programs call for increased consumption of food (a gallon of milk a day on top of what you already eat is a common prescription), I decided to increase my consumption of food and see what happened. I added in more cheese to my burgers and started drinking cups of heavy cream to add in even more fat calories. My hope was that this would allow my body to spare the maximum amount of protein for muscle repair.

In the month of December, my weight went from 159 pounds on 12/1/09 to 173 pounds on 1/1/10, a gain of 14 pounds. My squat went from 130lbs to 165lbs, with a steady gain of 5lbs per workout. So it appears that eating more really does solve that problem.

My only concern here is that I’m beginning to suspect I might have some sort of very mild reaction to the heavy cream. It’s difficult to describe, but sometime after drinking a cup of it I begin to feel thirsty and have a sensation of dry mouth. Maybe the lactose in the cream is enough to set off a minor reaction. For now I’m going to continue using cream to supplement fat calories and see what comes of it.

January promises to be an interesting month – I might end up in India for several weeks, eating almost exclusively at a Brazilian BBQ. Oh boy. I’m also going to my gastroenterologist for my six month checkup, and I can’t wait to see what she has to say about my results.

Five months down, seven to go!

November Weights and Measures

Fourth 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

Month four was a much more turbulent month than month three. I started strong, lifting weights and generally feeling energetic. I went to a two day paintball game in North Carolina (Fulda Gap at Command Decisions Warfare) where I played well enough to earn MVP of the 39^th Guards for Warsaw (one of two MVP awards given for the ~500 player side). I had a ton of fun, did not feel limited by my diet at all, and were it not for having to explain myself every time I ate a meal, I probably wouldn’t have thought about it.

I drove home on a Monday, downing a lot of coffee along the way. I woke up on Tuesday completely mentally and physically exhausted. This was different from the usual exhaustion after paintball. I usually go through a several day blergh period after a two day game, which I attribute to the sudden onset and then departure of a very different kind of stress from what I normally experience. After Fulda, I went through several days where I was essentially a zombie. There wasn’t any mood involvement that I could tell – I wasn’t depressed – I was just not awake.

I didn’t experience any bowel distress during the game, but in the Sunday/Monday following I had a few reminders of what it was like to have a Crohn’s flare up. The four days I spent as a zombie were not remarkable on the BM meter. I can only speculate as to why I was so blitzed, but if the sudden combined stress theory holds, then it would make a certain amount of sense. Fulda this year, while a ton of fun, was pretty stressful due to the increased logistical planning as well as spending most of the game attempting to lead a group of good paintballers without screwing up. Maybe I just had to come down.

That weekend I helped my dad and my brother put in a new split-rail fence, and I didn’t feel any particular tiredness. Whatever the problem was, it was temporary.

The next week, I had a several day burst of manic energy, almost as if my body was making up for sleeping through the previous week. I got a lot of stuff done at work, felt like I didn’t need to sleep, and generally felt like I could take on anything.

Very odd.

I continued lifting weights (not on Zombie week) and after a month have added about 20 lbs to my squat. Not much considering, but not bad either. If I didn’t have to keep missing weeks due to random injury or inexplicable exhaustion, I’d probably be making better gains.

I also got my cow from the farm! So far, the cow has exceeded expectations. The ground beef tastes good, the steaks taste good, and one roast was good enough to entice a ten-year vegan into giving it a try. That probably had more to do with the fact that it was farm-raised and humanely treated, but still. Not many roasts have accomplished such a feat.

It’s hard to rate November relative to my “overall wellbeing” baseline of August, thanks to the wild swings. I would say it averaged out to October levels (+3, +4).

So far, so good. I don’t have scurvy, I don’t have any signs of vitamin deficiency, my lifestyle hasn’t been crimped and my Crohn’s is under control. If this keeps up, I don’t think I’ll be changing things at the end of my year significantly. But that’s a very premature judgment to make.

Four months down, eight to go!