Monday, August 13, 2018

Saving Your Life

(*all lab results and personal information shared here has been with full permission of Mr. Wonderful)

Why are we posting this? Because we are not the only humans on the planet who are being given horribly mixed messages about food, lifestyle, activity and exercise, health and well-being. We're not the only people who have been sold a bill of goods around food "choices". We are not the only people told to just "eat everything in moderation and exercise more", and then felt the shame and disappointment when that doesn't work - AGAIN. We know that for us, this is working when nothing conventional thinking has offered us has - in fact even the fad things I have tried (Atkins! Zone!) have all been bullshit in the end. At it's core this is about truth and science and reality. For some of us, moderation isn't "enough". We need clear, bright lines to guide us and keep us safe. We need the freedom of fewer choices in a world that bombards us with half truths and untruths all day long. We need to obsess and think about food LESS, not MORE. The choice of what's on the menu today is already made. Follow the plan. Learn and grow as you go. And never forget to love yourself enough to trust your gut.

I had wanted to do this entry on Thursday last week, which represented the 60 day mark of the Bright Line Eating program to which we committed in June after our drive back from Massachusetts. I had been up there for three weeks. Before I left there had been some intense conversations with Mr. Wonderful about food and lifestyle choices. See, when we first got together, Mr. Wonderful was a single dad manorexic looking guy who drank screwdrivers, smoked too much, and appeared to subsist entirely on chocolate marshmallow ice cream topped with bananas and maple syrup, and a steady stream of road cycling. He was muscled from riding, but his lifestyle choices were not really in line with a long range potential for good health. When I moved in with him in December 1991, I brought with me two kids, three meals a day, and snacks. We both smoked. I quit in 1993, he struggled more than I did with nicotine. I dreamed of being a vegetarian. I tried being a vegetarian. I gained 30 pounds. We rarely used convenience food, but the balance wasn't all that great - meat was a big part of the day, we didn't eat enough vegetable and fruit, and we ate a ton of bread products. Compared to the "average American household" we were doing well. Except that...we weren't.

Meanwhile, my weight ranged on a kiddie coaster scale, and Mr. Wonderful steadily put weight on. He tried to quit smoking, which only added more pounds. Then he did quit smoking, finally, and that added even more.  He rode aggressively and was disappointed that riding didn't have more control over his weight and health - after all isn't that the cure? "JUST EXERCISE MORE! EVERYTHING IN MODERATION!" Then we added alcohol back in. And...more pounds. I ranged from "chubby" to "one point from obesity on the BMI chart". He did the same. I joined the YMCA and learned to swim, and swam daily until I swam a mile on weekdays and two miles on Saturday and Sunday. My laps were neatly recorded in an excel spread sheet. My weight didn't change. He rode his bike when he could. My blood pressure, blood sugar, and cholesterol remained in check. His did not. Not even close. He found himself taking "old-man meds". This was depressing because it just didn't feel like HIM. We tried different things, different eating plans. I would make all his meals...but he is a grazer and would snack. I struggled with snacking myself. Neither of us was happy with our weight, and his blood pressure and blood sugar and cholesterol were alarmingly out of control even WITH medication. I saw myself becoming a widow before I was 60. I could see it coming, like a freight train with me tied to the tracks. In 2015, while living in Plymouth, I recommitted to being vegetarian. I told him I would no longer be cooking meat at home. This worked well, and I think we both had some benefits. We kept dairy in, however. We definitely ate better. We went to the health club 3-4 days a week. I walked every day, 3 miles a day, with the dogs. He joined us on weekends. But it still wasn't enough.

When I moved to NC I had lost a bunch of weight, but whether that was a result of grief, super low thyroid, or vegetarianism I do not know; I suspect all three. Disappointingly, meat sneaked back in - it had made a re-appearance when the young woman we brought with us to help us get settled expressed her need for meat. For her, we said, for her...and began to eat it. Gene continued to snack. He is particularly fond of sugar - candy, starchy vegetables, popcorn, alcohol. I am particularly fond of sugar as well, but in a different form - cocoa powder, potatoes, and wine. It just was not a pretty picture. Having lost weight, I watched myself snack it all back on. After all, I said, work was stressful. I stress-ate. He hit a high of 196#. I was almost back up to 120# - I prefer to be under 110#. The lifestyle was out of control, and I knew that for me it was unsustainable. But what about him? He seemed depressed about the situation and seemed unable to see choices. He talked about genetics, and said this 'was just the way things were'.

In the early spring of 2018 I bought into The Food Revolution Network's annual summit. I remember we were in the car and listening to a free live session when the offer to purchase came on. I just bought it. I figured that we could listen when on road trips, and maybe he could find some nugget of hope, some alternative to the depressing idea of out-of-control genetics killing him slowly. Anything to get him away from statements like "I'll probably turn 65, retire, and die." He had reason to be depressed, and good reason to see a bleak future. In April of 2018 his lab work looked like a cardiac event waiting to happen. His weight was at an all time high. His blood sugar was 127+ in the mornings ON Metformin. His blood pressure was around 150/90 WITH two meds. His cholesterol had hit an all time high as well - total was 208, triglycerides 336 ON A STATIN. In short, he was not kidding when he said he might just turn 65, retire, and die. Something had to change.

While I was in Massachusetts he ate no meat - as an experiment to see if he really missed it. The older he gets, the more ethical questions come up for him about eating animals. He isn't a cruel man, and sadly our meat comes with a dose of well-documented cruelty. He didn't tell me this until we were on the way home, listening to more Food Revolution Network stuff. The various presenters talked about the dangers of processed foods, expressed documented concerns about meat, looked at food as medicine; food as the way to health. They described genetics as latent potentials, not die-cast futures. They gave back control to the individual by presenting peer-reviewed nutritional science. Not Pollan's "eat food, mostly plants" ideology which never felt 100% right to me because it really avoids the blatant environmental issues around meat - never mind the cruelty issue for a second - but a more honest "eat whole food, plant based, no meat, no dairy" concept. This sort of eating plan is also well documented and supported in peer-reviewed science.

And then they brought on Susan Pierce Thompson, PhD, creator of Bright Line Eating. As we drove along listening she synopsized her beliefs and her program. Processed foods - flours, sugars, alcohols - are, for many of us, addictive. Whole foods are what we were genetically designed to eat. Flour and sugar are the legal food equivalent of heroin and cocaine. When we stopped for a potty break we discussed what she was saying. It felt very true. Yes, food is addictive. We joke about it culturally, but it isn't a joke at all - the science bears it out. The brain has been compromised. Damaged by the drugs hiding in our food. And most of us have been eating it since we were born.

"We could try it", I said. "I can get her book, and read it, and we can just...try it."

"I have to do something. I'll try it." he said. And in that moment I saw what I had been waiting for - the spark of survival drive that just might be enough to change our future.

Home we came, and I ordered the book. I read it and ordered a copy of The China Study. We discussed the plan. I wanted to make it whole food plant based, and if he really couldn't stand it, he could add in a piece of meat now and then. Three meals a day, portions weighed. Anything not on the list and not at the right time of day is "Not My Food", and therefore off limits. It isn't a choice any more. It's just the way it is. No snacking. No candy. No wine. No cocoa powder. The inner conversations are healthy. "I recognize that you want that, but it isn't yours. Why do you think that you want it? What is something else that would make you feel good that isn't food that's not yours?" Inner family work. Healing. Allowing our brains to recover from lifetimes of addictive foods - literally - and lifetimes of proteins unhealthy for humans to consume day in and day out, three meals a day. Learning food triggers. No blame, no shame, no guilt. Awareness, acceptance, and self-compassion. Being mindful of emotional or behavioral impulses to consume food that isn't "mine". Healing the gut, the heart, the mind. The whole thing.

We began on June 11, 2018. Fresh start. I bought tons of vegetables. I cleared the house of things like honey and maple syrup and gluten free flours. We had a "last binge" and work up shit. And we said good-bye to it all and stepped into a new normal.

At first it was hard, and I was deeply grateful that I hadn't picked up any work hours. The shifts I work are usually 8am-8pm. I leave home at 7am (no later than 7:09 am to be precise) and get back anywhere between 8:30 and 11pm, depending on the day. Being home meant I was free to focus on weighing, planning, and learning what worked. At first eating all of the food the plan demands was difficult. We literally could not finish meals, especially at night. Eventually we have found things that work, and only sometimes are too full at supper now. I will share a typical day at the end of this post. I learned to bite, lick, and taste less (I do taste occasionally, I have peace with that, because I am the cook and I need things to be palatable for a fairly picky man). I had a horrible feeling of shame when I returned from grocery shopping one day and popped a grape into my mouth without thinking. I sat down and thought about this - was that really the end of the world? Was I going to allow that one slip to destroy me inside? Or was I going to give myself an internal hug, and talk about how to avoid a similar misstep in the future, with lots of love and self-compassion? I did the latter. And we moved forward.

We talked about the hurdles. His afternoon habit of returning to the cafeteria at work for a snack and coffee was a hard one; so too the piles of food that seem to grow from the furniture in corporate offices. And the "leftovers" after meetings which he felt guilty about "wasting". I have worked a couple of days and felt myself mindlessly reaching for my Milky Way Midnight Mini "treat". I stop myself, redirect, and get a cup of tea or decaf instead.

Thompson talks about imagining yourself "wearing bunny slippers" during the weight loss phase of her program - take it easy on yourself, worry about exercise later. Losing weight is hard. You release stored up toxins from fat cells into your body. You may be tired. You may experience cravings as the brain tries to get it's drugs back. So reduce your decisions. Don't add in an exercise regimen until it feels right. We had already established personal routines - I walk, he walks and plays table tennis - and we kept those up, with occasional skips if it just didn't feel right. Self-compassion again. No obsessing about anything.

Last week he went to the doctor for a scheduled follow up. I knew he had lost weight, and I knew his blood pressure and blood sugar were down. I wasn't sure what the rest of his labs would show, and I was definitely not sure how his doctor would respond to this allegedly "restrictive" eating plan and lifestyle.

I didn't need to be concerned. After the weigh-in showed a nearly 30lb weight loss, and the blood pressure check revealed a normal BP, the conversation went something like this:

"Wow. I am amazed. What have you been doing?"

"My wife and I are on this plan. She thinks the food is killing us. We eat basically vegan, three meals a day, no snacks."

"Your wife is right. The food is killing us. But...I believe strongly in genetics, especially with cholesterol, so let's do some labs before we take you off all your meds."

I was chomping at the bit, but anxious. What if the doctor was right about the genetics? Would that just throw him back into that defeatist, depressed mindset where he was left feeling out of control of his own life, his own destiny? Would he give up? Head to the snack bar? Run to the store for dead animal parts? I worried. Then the labs came.

8/3/2018 labs show:
Total cholesterol - 145 (highest was 208, normal is under 200).
Triglycerides - 121 (highest was 336, normal is under 150).
Fasting blood glucose - 84 (highest was 134 while ON Metformin!! Normal is 65-99. He stopped taking Metformin in early July because his morning sugars were in the low 80's)

Weight this morning (8/13) - 166.2 (highest was 196). Blood pressure yesterday morning off of one med but still on the second - 127/70. Not perfect...but we are getting there. Blood sugar, which he checks once a week or occasionally after a meal was 107. I think this will come down too, and most days it is down to the mid-80's.

Me - well I've lost ten pounds. I feel really good. I love my food. My skin looks better, my sleep is better, and my tummy is very, very happy (I have IBS but... the symptoms are basically GONE). I don't feel deprived, and he says he doesn't either. I think twice in the last 60 days he's had beef cravings, and has had steak, measured portion of course. When we get closer to goal weight we will add back in things cautiously - for me that may be soon. He would say he misses popcorn. I mostly miss my cocoa powder. But...for me those foods are a slippery slope, gateway drug, danger, and my life is worth more than the fleeting pleasure. There's other things. Like, oh, living healthfully, having more energy, not destroying our bodies with food...all that.

The plan is now easy and feels right. If a thing calls to me I just have a little internal chat about what is and is not my food. It isn't perfect, or always easy - but then when were we promised a simple and easy life?? I think we spend way too much time rewarding ourselves, or making excuses for bad choices. The truth is we don't "deserve" food. Hunger is not an emergency, and there are things in life WAY more important than appeasing some stomping internal child who wants wine, or a candy bar or a piece of meat. Like being alive to see my grandchildren grow. Like not having a slow, lingering horrible death from a preventable disease, but living long enough to get hit by a truck or something. Like that. As Thompson says, this lifestyle isn't "extreme". Extreme is having your limbs cut off or losing your sight to diabetes. Extreme is a health care system that will collapse at some point under the revenue burden of failed "treatments" for preventable diseases. That's extreme. Eating a giant salad for supper...that's fucking simple.

I said I would share a typical day...I do a lot of prep when I have time, so the assembly of meals is much simpler now. We have a repertoire of things we like. We often mix and match proteins and vegetables from a core of liked flavor profiles. We weight nearly everything unless we are out, and then we read menus ahead and have a plan, or we bring food. I prepare the veg and protein separately. I find keeping them separate to be easier for me. This is an average day - I am not giving quantities, just know that we each consume the correct amount for our respective x and y chromosomes based on Bright Line Eating:


Soy yogurt (made in our instant pot with this starter from Amazon)
Oatmeal prepared with soy milk
Fresh fruit, usually a combination of berries, stone fruits, and banana
Flax seed and walnuts, ground.
Generous sprinkle of cinnamon or my breakfast blend of cinnamon, cardamom, turmeric and ginger

Lunch (really this is today's lunch for me!):

Roasted cauliflower from last night


Big (really, 8 ounces of salad is a lot!) mixed tossed salad.
Zoodles with homemade red cabbage and bell pepper pickle and Thai peanut sauce

There's always a bunch of vegetables prepped in the fridge, and usually two or three protein choices as well - tofu, tempeh (also made at home now), or bean salads with flavors that lean toward Mexican, Mediterranean, Thai, what have you. Sometimes the vegetables are cooked, sometimes they are raw. Fat is limited, more than Bright Line Eating recommends, based on Dr. Esselstyn's work around heart disease and fat intake. We do consume some fat, however. After reading his work and looking at Gene's labs and knowing his history...I am not kidding, he was a cardiac event waiting to happen!! Our fats are tiny amount of walnuts, maybe a teaspoon of oil in a pan to keep the tofu from sticking, or a little avocado. No big amounts; nothing more than teaspoons. Breakfast occasionally is tofu and a baked potato or brown rice with fruit.

Goodness, this has gotten long. I am SO very good at that. I will end with this...

 This is Gene in December of 2017. 

This is Gene last Thursday night at Barcelona Burger, waiting for his bean burger and salad.

If I had any more feelings in my heart about these images, I would burst. I am proud, happy, relieved. Even if we get hit by a bus and never see old God we tried our damndest to escape genetics and a faulty, flawed, disastrous, horrific food system. And so can you. The journey of a thousand miles begins with a single step.  You can be good to yourself. That doesn't need to involve food.The gratitude, it overwhelms me!

Tuesday, August 07, 2018

And Still With No Solid Plan

This weekend I attended the INELDA End of Life Doula training class in Raleigh. When I signed up I did so because I just felt like it was a thing I needed to do, without a real firm grasp of why or how. I still don't have a firm grasp on the plan...and I am going to just let that be OK for now. I did come away with a deeper feeling of commitment to the dying - and I really hadn't thought that possible. Some people seemed to be walking away with an almost evangelical commitment to this work as a life's calling. I didn't get that spiritual high, but then I can be very pragmatic and skeptical. And, too, many of those expressing commitment with evangelical fervor have less experience in death and dying. For me, this isn't like a new revelation. It's more of a no-brainer. As Susan said "All roads led you here." Although I feel like the work of an End of Life doula is in the first place of extreme importance and in the second something I can easily see myself doing, I still have the many unanswered questions of a natural born skeptic. What about my nursing license? How does the insurance work if you have that license? How can I appropriately balance the "mandatory reporter" nurse side with the "doula: keeper of confessions" side? Which one takes precedence? And on and on and on.

I am a nurse, both by profession in my current iteration and by "calling", for lack of a better word. I feel very strongly about death (and birth, as those who've known me a long time can attest). The excessive medicalization of the two greatest transitions in our existence on this sphere has disturbed me since I came to understand that they were taken from us by the (allegedly well-intentioned, but let's be real - today it's about the money) western medical model. The discovery that this thing had been taken away without any solid reasoning beyond convenience and profit bothered me. It seemed to me, growing up, that both birth and death were extremely natural processes that only quite rarely became complicated enough to require some kind of intervention - and yet we willingly handed them over with a quick brow swipe and a "thank God that's all out of MY hands!" Women drugged into pseudo contentment, feet high up in the air, blue-tinged babies dragged out of dope-lazy birth canals - or worse, women cut open like sides of beef when their labor didn't progress according to the narrow statistical "curve" model created by some sexist, meddling quack named Freidman...grandma dying "peacefully" medicated (or so we are assured by the staff who were probably in another room when it happened) in a nursing home bed while the kids and grandkids were at work and school.

Gone the natural progression of our lives from birth to death, gone the sounds and smells of birth and death in our homes, gone the bedside sitting at both labors, gone the intimacy, the proximity, the depth of these most sacred of passages. Instead most of us continue to cling to the "shallow and complex" life afforded by that dubious miracle that is modern western medicine. Let someone else do it. It's too hard, too scary, too painful. Give me drugs, just get it over with. But research begins to show that our removal from these most basic nitty-gritty beginnings and endings (on both counts) is actually less healthy for us than the relative trauma of intimate participation. Some of us feel that in our bones, and know the trade off isn't worth the loss of intimacy, of selflessness, of the most painful and yet most beautiful expressions of love that occur in those spaces.

The death of simple and deep. We are trading out the painful reality of human existence for this artificial alternative that allows us to remain "above all that", allows us to move forward lacking awareness (of self or of others), avoiding pain, running from reality. Abandoning the people who love us at the very moment when they most need us. Abandoning ourselves.

I am idealistic. But at my core very, very simple. Why is there injustice? Because we have allowed ourselves to fall prey to propaganda spin, turning "us" against "them", produced by a bunch of white men in suits who have no interest in our awakening to the truth that there is no "them", there is only us, thereby lining their pockets with our blindness. Why is the food killing us? Because we got over-involved with some magic chemical voodoo to "fix" food, resulting in processed crap that destroys our bodies, with a huge shift in the macronutrient percentages we have successfully eaten for 50,000 years. Why is birth so hard? Because we allowed more magical modern voodoo to bring us these trojan horse gifts that transform the majority of births into a loss of feminine power and a destruction of immediate bonding with newborns. Why is death so scary and taboo? Because we gave grandma to the hospital or the nursing home to "protect" ourselves and our children, so now grandma doesn't die in the living room, cared for lovingly by her deeply exhausted family, thereby depriving us of the experience of the good death.

Don't get me wrong. I am GRATEFUL for much of what we have. I am glad that, after 36-48 hours of protracted naturally initiated labor, there is an OR. I am grateful that there are places we can turn to when our loved one, dying at home, becomes terminally agitated in a way that we cannot control. I am less grateful for white men in suits and Monsanto, but that's another tale for another day. I am glad that WHEN THERE IS REAL NEED there is help at the ready.

But the decisions about when and how to intervene...those are much more complicated. How is it that a patient can spend some number of hundreds of days in a hospital bed, have innumerable procedures performed on them, each time with no explanation to the family that the patient will not regain function, will not improve, will never speak, will never swallow...the only reason is a padded bottom line. Otherwise the compassionate thing, the morally right thing, would be to sit down with that family and tell them the truth - she/he has had a massive stroke/horrible heart attack/whatever it was that put you here. She/he will not have any sort of meaningful recovery. She/he will not speak again, will not be able to communicate, will continue to decline. There is nothing we can do, and the best hope we CAN offer you is hospice at home, or transfer to a long term care facility that can support you through her/his end of life process. Her/his death. It isn't a dirty word.

I suppose the dirtying of the words birth and death goes back to that so very American puritanical prudery and skewed religiosity so particular to us here. Birth means someone got pregnant, and if someone got pregnant, someone probably had sex. And sex, like death, is a thing we both obsess over, desperately want, and despise at the same time. Death means someone is dying, and what if the Christians are right and he/she goes to hell, but what if nothing happens and it's all for nought (untrue - even if there is no heaven and no hell, there is still the NOW, and the NOW matters so very deeply because we are all so connected...but I digress), and how do I feel about the ending of life and so on and so on - again simultaneously obsessed with and fascinated by, yet terrified of and repulsed by. Plus there is decay and odor, and grandma might soil herself and someone might have to clean it up.

There I go ranting again.

My point here, today, is this - I still have no solid plan. I came away with a lot of good information. I feel like the independent "hanging a shingle" death doula track may not be right for my anti-social self. Most people seem very able to give elevator speeches and "reach out" to the community with death cafes and stuff - like Norwex parties only for death do you keep that from becoming self-promotion? I simultaneously like and am concerned about that idea of the death cafe. I am pretty sure half the people in the room can give the first names of their table mates. I only remember 3. Faces I remember, but not names. It was sort of like work, really. Are you dying? Yes? OK. You definitely have a name, and I will remember it, and use it. Are you the immediate support? Yes? Good. I will probably remember your name, and will use it after asking you if it's ok and confirming what your loved one prefers to be called. Are you an administrator? Yeah. I'll get back to you on that whole name thing later, maybe in a year or so. All this "networking" nonsense? Nobody networked 50,000 years ago and people still died and got born attended by invisible people mostly lost to history. As it should be. Handing out of business cards, "making connections"...really? Are we entrepreneurs selling ourselves, or are we servants called to care for the dying and their families? I lose it in there somewhere. I'm here to serve, not sell. But first I need to take the first step. Whatever that looks like. I just still have no plan.