illness

Unwelcome Visitor
07/18/2010 - 20:54

I tried to think hard of the bumblebees with tufts of yellow pollen looped gently on their fuzzy legs hovering above bright pink and golden sunburst flowers in the town square of Uppsala, Sweden. The town market with bottles of fresh red current saft gleaming ruby against the noontime sun. My house, red from the Falun copper mine paint so ubiquitous there, beside the gardens filled with happy people harvesting corn, trellis beans, and the last of the summer’s raspberries. The dark forest paths where birds bathed in glades. My pictures from when I arrived there in August are all idyllic like that. That was another life that I found myself reliving as I lay in the MRI, trying not to hear the whirring buzz of the machine.

I had woken up one night unable to move, on the floor, in a pool of various bodily fluids. Hot and dizzy, I struggled for the phone, stumbling, my ears ringing.

And I will turn my hand upon thee, and purely purge away thy dross, and take away all thy tin

“Possible idiopathic adult-onset seizure.” “Idiopathic”— a pathetic euphemism for the unknown. Was it the tick bite? The strenuous move a mile in the simmering city heat? The fact I had known what stress was doing to me, yet continued to drive myself onwards deep into the late hours of the morning, forgetting to nourish myself in any sense of the word?

In the claustrophobic chamber, I wanted more than anything to be somewhere else, to find another place where I could feel at home.

I have an appointment with the neurologist for more tests. Nobody is invincible. The doctors (and I) doubt very much this had to do with eating paleo, especially since after the move I’d not been eating terribly well.

Eating decently at the hospital was a huge challenge. I threw out the idea of being paleo, but I wanted to make sure I was at least gluten-free, so I didn’t have to add horrible stomach cramps to the doctor’s to-do lists. Gluten intolerance affects 1 out of 100 people...they must have some accomendations? Right?

Wrong. Breakfast passed, lunch passed, and soon became clear that I just wasn’t going to get fed. I begged the nurse for some food and she returned with some juice, the only gluten-free option, she said, “until regular dinner hours.” A well-meaning but obvious ill-informed resident tried to give me a sandwich on white bread. “It’s white bread, not wheat, so it’s wheat free!” he proclaimed.

The first tray was a disgusting Salisbury steak with pasta and flour-laced gravy. Eventually I got some chicken, carrots, and rice, with a sickly sweet fruit cocktail. The next day I must have missed breakfast hours while in the MRI. I was a little shaky from hunger and bleary from a sleepless night sharing a room with a elderly woman with severe dementia...but lunch was coming soon? They passed out lunch trays and I got nothing. They kept saying my food was coming, but it never did. Not until I wandered through the ward and complained to the attending did I get something, but clearly they misunderstood again— the tray included a slice of individually sliced bread, but at least the main meal was edible.

I probably would have been much much worse off if it weren’t for generous friends who brought me food. New York Methodist should be able to accommodate people with very basic food intolerance and allergies, but it’s scary that they would serve those kind of meals to well...anyone. Can’t everyone agree, even the low-fat facists, that sugar and white flour are poison?

I’m hoping to get well and avoid the hospital again- that the seizure was just a fluke. Would be nice not to have anything like that happen again... and to find a place and a life style that prehaps could prevent me from suffering the amount of stress that might have triggered my condition.

Thank you well-wishers across NYC Paleo, Twitter, and everywhere in between!

Comment?: 23
Proton Pump Inhibitors Suck
05/26/2010 - 20:04

In news from stupid-land: The FDA cautions against high dosages or prolonged use of acid inhibitors.

It's kind of criminal that these medicines are still in use, given that the latest studies published in journals show that the cause of GERD is not too much acid. So while proton pump inhibitors might mask the symptoms, they get rid of stomach acid, which we kind of evolved for a reason- to help digest food and to protect against pathogens.

The agency said it would order revised labeling on packages of the drugs to reflect the fact that they have been associated with an increased risk of fractures of the hip, wrist and spine…The drugs have previously been linked to an increased risk of contracting pneumonia and the troublesome bacterium Clostridium difficile, as well as to an increased risk of dementia. A recent study found that the drugs increase the risk of bone fractures by about a quarter. It is not clear what the mechanism of the increased fractures is. Most researchers believe it is due to decreased absorption of calcium from the diet because of the reduced stomach acid, but it is possible that the drugs interfere with bone maintenance.

I am particularly incensed because last year my younger sister started having problems with GERD. She is only 19 and the doctor's recommended Prilosec. Instead she is now paleo and her symptoms have resolved. It's lucky that she knew that the paleo diet could treat GERD and she didn't get on the PPI wagon of dooooom like I did. Here is what I can remember:

It started when I was 18 or so. I was overweight and had terrible stomach problems. My internist gave me Zantec but my mom thought it was unnecessary and I never took it. Over the next two years I lost some weight on a vegetarian and then vegan diet, but the heartburn just got worse and worse. I couldn't sleep or concentrate on my school work. My school doctor finally convinced me to get on Prilosec. The spiel for these pills is that you take them for a month and it helps heal your esophagus, but of course it never works. I try to go off them after a month and the heartburn returns with a vengeance.

So I stay on them, but my IBS just gets worse. My allergist, who is treating me for severe asthma gives me an anti-spasmodic for my IBS and tells me not to worry about the PPIs. He says I'll probably be on them for the rest of my life, but not to worry since they are mostly harmless. At least I can eat pizza as much as I want now...

At some point I get really really sick. My doctor at school thinks it's just my IBS, but when I collapse and end up in the E.R. I finally get diagnosed with chronic salmonella. What should have been a one day bout of food poisoning decided to settle down in my weak digestive system. I take heavy antibiotics and recover...sort of. Now pretty much EVERYTHING upsets my stomach and even worse....I get chronic burping "attacks" all the time. I'm sickly in general- I get yeast, urinary tract, and sinus infections constantly. I get tested for all sorts of things like celiac and Crohns, but no dice. I do some research and find that PPIs might be causing some of my problems. Through looking at Pubmed I find out about a small study that effectively treated GERD with a low-carb diet. I try that for awhile, but using foods at the dorm cafeteria. I just end up feeling crappy... and no wonder with the factory farmed meat and gluten-laced sauces.

When I encounter Art De Vany's site through Marginal Revolution, I am intrigued by a more vegetable-heavy version of low-carb. I try it and it helps my IBS, but I'm still on the PPIs. When I try to go off I feel really terrible. I find a site where people tout apple cider vinegar as a cure. I start eating mostly paleo and taking apple cider vinegar diluted in water after every meal. I start eating a wide variety of vegetables and trying fish for the first time. It's not perfect, but I'm finally at the point where I can at least function without PPIs. I do an egg fast for a week. It takes about six months, mostly very low carb, but eventually I find myself...not taking any medicines at all. 

A journey to get rid of heartburn fixed much more than that. At my worst I was on thirteen different medications and dependent on antibiotics every month. I haven't taken antibiotics in two years now...nor had to go to the doctor for IBS, GERD, or asthma. PPIs are hard to kick, but it was worth it.

My sister and my father have been sucessful with this approach as well, though they were lucky that they never took PPIs. PPIs alter your digestive system and it can be hard to get it in working order again.

Comment?: 17
Treating GERD with the paleo diet
01/08/2010 - 14:43

 My story about healing GERD was featured in Marks Daily Apple last year and received a very positive response, but also some comments from people who tried eating paleo for GERD and did not have success. So I thought I'd do a post discussing my experiences further, in the hope that people suffering from GERD can have the same success I did.

I can't really remember a time growing up when I didn't have stomach problems. My diet then was full of Kraft Mac & Cheese, Reeses Cups, and McDonalds. When I got to college it got even worse as I reveled in the dining hall's smorgasboard of ice cream, nachos, fries, and cake. It was that first year of college when I first experienced a terrible unsettling pain radiating from my stomach up into my chest. I stocked up on antacids, but found that they provided only temporary relief. My mother chided me for eating unhealthy and I tried to reform my diet by eating vegetarian and low-fat. I ate Special K with soy milk every day for breakfast, a sandwich on whole wheat bread for lunch, and a pasta salad for dinner. But the pain continued. I booked an appointment at the school doctor and was diagnosed with gastroesophageal reflux disease (GERD).

In many ways I was very unlucky. GERD is among the most common diseases of civilization, but it typically does not strike until people are much older. My father was also struggling with GERD at the same time, so perhaps I have some sort of genetic predisposition to it. Both my parents, who have always been suspicious of medications, discouraged me from treating my GERD with the Prilosec pills my doctor prescribed me.

Prilosec is just one of several proton pump inhibitors on the market, which is a very lucrative market considering the vast numbers of people who are diagnosed with GERD. Proton pump inhibitors function by drastically reducing stomach acid. They are widely considered safe for long term use by doctors. One of my doctors told me I would probably be on proton pump inhibitors for the rest of my life, but assured me that was OK.

At first I was ecstatic that I could enjoy food again, but as time wore on I developed other stomach problems. My doctor said it was just IBS, but one morning I collapsed from dehydration. A test at the hospital revealed I had been harboring salmonella chronically for quite some time. Salmonella is among the most common types of food poisoning, but most infections last only a few days. Apparently my body had been unable to clear my infection, which is not usually the case in most teenagers.

Stomach acid is there for a reason and why doctors prescribe medications that pretty much get rid of it is beyond me. Acid kills germs and while I don't have concrete proof, it's possible my lack of stomach acid predisposed me to food poisoning. They have found in studies that PPIS predispose people to pneumonia and I hope someone will study food poisoning and PPIs in the future.

As I recovered my stomach was pretty battered and my GERD returned with a vengeance. I was lucky enough that I encountered Jared Diamond's The Worst Mistake in Human History in class and also heard a lecture by an anarcho-primativist. At first I was quite offended by both. As an agricultural economics student I viewed agriculture as the cornerstone of man's greatest achievements and that hunter-gatherer life had been "nasty, brutish, and short." Raised to believe in conservative ideals, I had been taught that the "noble savage" was a myth popular among liberals who refused to accept man's true nature and the glories of classical civilization. Turns out that the truth is somewhere between. Hunter-gatherers, both modern and paleolithic, were and are as diverse as any other humans. They tend to have relatively high infant mortality and succumb to accidents and diseases that modern humans rarely encounter. But they live and lived longer and better lives than most people expect, with plenty of leisure time and without modern health problems.

So when I encountered Art De Vany's writings and Gary Taubes though one of my favorite economics blogs, Marginal Revolution, I was ready for a change. The idea that fat was good and that modern foods might be the culprit for modern diseases was new to me and it took me a long time to learn how to eat paleo. I had no idea how to cook meat, I had never eaten fish, and bagged baby spinach was the only sort of vegetable I'd really dealt with. Candy and ice cream were also my essential study buddies and I felt pretty proud about my soy milk and Special K habits.

So things certainly did not get better overnight. I tried to eat healthy and would succumb to eating junk, but over time I learned how to buy and prepare good food and became educated enough about science and my own body to have more incentive to avoid junk.

In the future I think scientists will look back on PPIs as a huge mistake. They are already finding out that GERD is about more than just heart burn, that adysfunctional immune system plays a role. I have a feeling that's just the tip of the iceberg. GERD is not just run of the mill heartburn and it's not just about repairing an injury to the esophagus. Real solutions should address why the heartburn occurs in the first place rather than masking symptoms.

In the past, studies about diet and GERD have been mired in simplistic dietary dogma, typically measuring total fat and fiber intake. Newsflash, there are many ways to get both fat and fiber, and many types of both. Some are probably good, others are bad. A bright spot in the research is this study: A very low-carbohydrate diet improves gastroesophageal reflux and its symptoms.

It took a long time for me to finally rid myself of all symptoms, but it was very much worth it. I'm very happy to be both pain and medication free now. I worry people will think I adopted the paleo diet to lose weight when I mention the word "diet." While I did lose weight, it was about being healthy and the paleo diet isn't a temporary fix, you have to stick with it. I got off the bandwagon last year while traveling and had GERD symptoms for the first time in a long time. It was not pleasant. Besides that, while eating paleo I experienced a cessation of problems I took for granted as just part of life, but which I now recognize as food related, such as heavy periods, constant bloating, headaches, and asthma.

My father is also a follower of the paleo diet now and has also experienced relief from GERD.

Here are my tips for combating GERD

  1. Don't expect GERD to go away overnight. It took me over six months to completely reduce symptoms.
  2. Learn how to eat wild fish. Omega-3 fatty acids can combat inflammation very effectively. Farmed fish are unfortunately too high in omega-6 fatty acids to be of much use.
  3. Buy quality meat and animal fats. Factory farmed meat is much too high in omega-6 fatty acids, which can cause inflammation. Eating out only at restaurants that serve pastured meat and getting to know the farmers at your local farmer's market is a good way to accomplish this.
  4. Eat nose to tail. I grew up thinking that chicken breasts and steak were all that animals had to offer. I was missing out on the vital nutrients present in the whole animal. Bone marrow, lard, tallow, liver, and all the "nasty bits" should become part of your diet.
  5. Learn how to prepare nutrient rich stock and make healing soups. GERD can make eating uncomfortable, but nutritious soups usually go down well and provide healing nutrients. I will write many posts in the future about stock, but it's mostly just about putting bones in the crock pot overnight. The resulting stock can be pureed with your favorite vegetables.
  6. Eat greens and seaweed. These fight inflammation and provide healthy fiber without the carbs.
  7. Educate yourself both by reading more about the paleo diet and health, and by learning to listen to your own body. I did lots of research about different aspects of diet and trial eliminations for questionable foods like nightshades and dairy to figure out if they had a role in my problems.
  8. Indulge carefully. Find out by trial and error which foods irritate your gut and look to adopt new occasional indulgences that have at least some nutrients, like coconut milk with berries, coconut water, and raw dairy-free chocolate.
  9. Fermented foods are a bone of contention in the paleo community. They really aren't paleo, but eating paleo isn't about food reenactment, it's about looking to the wisdom of the past and finding what works now. The problem with life today is that we are exposed to so many antibiotics and an artificially sterile environment. Most of us probably have inadequate bacteria to assist with digestion. Probiotic fermented foods can help augment your own body's bacterial colonies while you heal. I consumed apple cider vinegar tonics, kombucha and probiotic pills while I was recovering. I have since phased them out since my bacteria seem to be doing the job fine on their own now.

 

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