If I've done this right, I should be able to share this thing I'm typing in Google Keep and share it as a blog post on my 10C blog.
And it seems to work. Right on.
As I mentioned last time I posted, my doctor wrote a prescription for a statin drug because my cholesterol was too high. Even though I told him I wanted to see what a calcium scan first.
Turns out, they're doing something a bit more involved. Not at this place, but it's the same basic procedure. Will admit that I'm a bit more nervous about this than I should be, mainly because they are adding things to my blood and giving me drugs in order to do this procedure. That said, if they're gonna take a look at my heart for calcium, why not check the valves while they're at it?
Maybe I'm also a little nervous about what I'll find out. Either way, I'll know the score and can make a more informed decision about jumping back on the statin train.
On a lark, I decided to log into my health insurance website to make sure I had an up-to-date insurance card, given we changed plans recently. Noticed something important was missing: no Primary Care Physician was chosen. On my current plan, that could have been an annoying, expensive mistake. Which, given what I pay for health insurance—it's more than the mortgage payment on my first house was—would have made me very angry. Glad I caught it. 😬
Meanwhile, I will have to take it easy tomorrow. No coffee or anything that will get my heart racing.
We're almost two years into my experience with intermittent fasting and eliminating sugar and grains from my diet, which I primarily began to reverse Type 2 Diabetes. Where I started from in May of 2017:
After losing 80 pounds in the 10 months that followed, my weight has been hovering around 230 pounds for a little over a year. Which, given the insane amount of travel I've been doing, is an accomplishment.
Earlier this week, my weight finally got below 220 pounds (which is under 100kg). It's the first time I've seen a number that low on the scale in maybe 15 years. The sad thing is: I don't remember exactly when I weighed it, nor do I remember the lowest number I remember seeing this century: 215 pounds. I'm awfully close now.
As of April 2019, here's where I'm at:
What am I doing that's different than before? A few things:
I've stopped doing extended fasts for the most part (more than 24 hours). I usually eat only once a day, though sometimes, when traveling, I will eat twice a day.
The only real concern from my last blood test was my cholesterol. I understand your lipid profile can be easily manipulated, so absent some other information, I'm not concerned. My doctor, on the other hand, immediately wrote me a prescription for a statin.
Last time I visited my doctor, I told him in no uncertain terms I was not taking a statin until I got a coronary artery calcium (CAC) score. This is obtained by having your heart scanned with a very rapid CAT scan device, which quantifies how much calcium you have in your arteries. The higher your score, the higher your risk of atherosclerosis or coronary artery disease (CAD).
I have the CAC score procedure scheduled for the end of next week. Based on that, I can make a much more informed decision about whether the potential side effects are outweighed by the potential benefits.
I just got back from CPX360 in Las Vegas, the series of annual conferences Check Point puts on for their customers, partners, and employees. It's a kind of annual reunion of sorts as this is the only time I see a lot of people I work with. As such, it's as good a time as any to check in on how my health journey is going.
As a reminder, this is what I looked like this time last year:
This week, I looked like this standing next to Check Point's CEO Gil Shwed:
People have been telling me that I'm still shrinking. It can be seen in the face, some have said. Maybe, but I don't really see it on the scale:
My waist has gotten a tad smaller, but not enough that I need new pants yet.
Of course, even with the seeming lack of progress, you have to consider I've traveled roughly 185,000 miles between these two photos. Which means, really, I've kept the weight off for a year. Definitely a victory.
And, my wife recently bought a treadmill that I've started to use when I'm home. A little more exercise certainly can't hurt.
The one concern I still have is my blood pressure, which seems to be a little on the high side. Not as bad as it was a few years ago, but I really want to avoid more medication. I had quit the previous blood pressure medication because it stopped working and it caused insomnia. I was hoping that with continued progress, it would start to come down, but it doesn't seem like the case.
If you've known me for any length of time, you know I've been overweight for most of my life. I've recently made changes in an effort to remedy this and I've experienced some success. It's not the first time I've done it and been successful, at least for a time.
I don't remember exactly when I started being fat, but I was definitely overweight by the time I was a teenager, which coincidentally was around the time the dietary guidelines in the US went "low-fat." The Nutrition Coalition explains the history of these guidelines and the wide impact they have. They've clearly had an impact on me--for the worst.
I alternated between caring and not caring for a couple of decades. In the early 2000s, after one child was born and another was on the way, and I kept gaining more and more weight (I think I was up around 275 pounds or 125 kilograms), I stumbled upon Robert Atkins and the Atkins Diet. There's been a few versions of it over the years, but the basic idea is: limit your carb intake to 20g or less per day, at least at the beginning.
I had a fair bit of success with it. The lowest weight I remember getting to was 215 pounds (about 98kg). However, the Atkins Diet tells you to slowly ad carbs back in. Sure enough, I did. I got lazy, and the weight kept rising.
I do have a picture of myself from 2006 wearing a shirt I still have. It's about the right size, but I was definitely regaining weight I had lost--and then some.
Then, four years ago, I was diagnosed with Type 2 Diabetes. That was a wake-up call for sure, but even then, I didn't know exactly what I was going to do.
I did know, even back then, that eating the 45-60 grams of carbs per meal the diabetes educator telling me to eat was not going to be a recipe for success if weight loss was one of the goals. It also seems nonsensical to actually eat sugar and carbs if the goal is to lower your blood glucose.
I had a sense a low carb approach would work, but did not embrace it wholeheartedly. I initially had some modest success both lowering my weight and my blood sugar with a combination of diet and exercise. My A1C even got down to a 6.1%. Unfortunately, as I stopped exercise and not being quite as strict with carbs, my A1C had crept up to a 7.1%.
I'm not quite sure how I stumbled on it, but I was introduced to Jason Fung and his book The Obesity Code about 18 months ago. His more recent book called The Diabetes Code might be a better read if you have Type 2 Diabetes, but they both impart similar information, which I can summarize as follows:
I was intrigued. Given fasting costs nothing and everything else I was doing wasn't working to control my diabetes, much less my weight, why not try it? I started this a little over 18 months ago, working my way up to eating only once a day (sometimes less).
I also changed my diet to be mostly low-carb. The simplest approach (for me, anyway) ends up being the approach popularized by Vinnie Tortorich: No Sugar No Grains (or NSNG). It's not dissimilar to the ketogenic diet, but I find NSNG to have less stigma and easier to explain to people.
My dietary changes were done gradually over the course of several weeks. During times I am not eating, I will drink black coffee or tea, which I initially had with heavy cream, but I ultimately dropped it except when I have coffee during mealtimes. Sometimes, I will have chicken broth for the electrolytes. I also take potassium and magnesium supplements
18 months in, I'd say it's been successful. My stats from May 2017:
As of December 2018, here's where I'm at:
While, if you look at my last status post, you may say, I haven’t made a ton of progress, here’s the things you have to consider:
In light of that, you might say I've done quite well just to maintain the progress I've made. Further, now that I better understand the mechanisms at play and the consequences of falling off the wagon are a bit clearer, I'm sticking with this.
And that shirt I showed a picture of earlier? It's a bit big now.
While it's pretty typical for me to go somewhere between 16-24 hours between eating these days (depending on the day), it's been a while since I've gone much longer than that.
This Labor Day weekend, I ended going longer than I've ever gone before.
It wasn't my intention to go 88.5 hours, but I was feeling pretty good and had no social obligations to eat, so I just kept going.
The only reason I stopped? Because I'm about to hit the road again. If I was going to have any digestive issues that come from reintroducing food after so long, I'd rather be at home--which, it turned out, was a good call.
For those who are concerned that more than three days is too long to fast, there's the story of Angus Barbieri, who fasted for 382 days! That said, I'm aware that there are pros and cons to extended fasting.
I have to say, this has been the easiest fast I've done. It may be because I supplemented with potassium, magnesium, and sodium (via broth). I don't want to give exact amounts of these, as everyone is different, and I'm pretty sure I may want to adjust the amounts given how my system has been eliminating waste, especially after I ate. This is a known side effect of too much magnesium (see Magnesium Citrate). That said, from what I've read, these essential minerals are definitely helpful, especially if you are fasting.
When I felt hungry, which honestly, wasn't often, I drank coffee, tea, or (twice a day) chicken broth with extra salt. Yes, I was craving salt, and I went with it. The second day of my fast, I did have a headache, which seemed to go away after I had a cup of broth.
In general, I had my normal amount of energy during the fast. Mentally, I felt very sharp. My blood glucose gradually reduced during the 3 days as well, from about a 98 mg/dL (or 5.5 mmol) to 69 mg/dL (3.9 mmol), which is the lowest I've ever had!
In terms of weight loss, I lost a little over 5 pounds (or just over 2 kilos) during my fast. Unfortunately, this got me back to just under 230 pounds (or about 104 kilos), a weight I've been hovering around for the last several months.
Will I do this again? Probably, but I'll do it when I'm home and don't have social obligations.
One could look at the weight loss stall I've experienced over the past six months and be frustrated by it. In fact, everyone who actually tries to lose weight eventually hits a stall, sooner or later.
On the other hand, during this time, I've been traveling like a madman, spending more time in shiny metal tubes and hotels than I have at home. This also means constantly changing timezones, which surely doesn't help my sleep any. And yes, this means I sometimes eat more than once a day due to social obligations.
In that context, maintaining roughly the same weight seems like quite the victory. Further, the thing that I'm really concerned about, my HbA1c, is now down to a 5.5%. That means my average blood glucose is continuing to trend downward. And, as I mentioned previously, I'm no longer using CPAP!
If you get right down to it, my ultimate goal when I started more than a year ago was reversing Type 2 Diabetes. And while, yes, I am still taking Metformin, my HbA1c has been in the normal range since at least April.
Meanwhile, I found out something interesting about HbA1c tests, which measure the about of red blood cells with glucose bound to them. Turns out, the healthier you are, the longer those red blood cells live. This can lead to inaccurate HbA1c results if you're not factoring in the age of red blood cells (which I'm pretty sure my doctor isn't).
Either way, I'm surely adding years to my life by lowering my HbA1c. I've definitely reduced my risk of cardiovascular disease:
File this one under non-scale victory that actually does reduce my weight…of my travel bags.
Several weeks ago, I had an appointment with my pulmonologist to follow up on my use of CPAP. It had been two years since I saw him and, well, a lot changed since he saw me last.
He commissioned another sleep study to see how my sleep apnea was progressing. Unlike the last one, I got to do this one at home. The hardest part was picking a week that I was going to be home to actually do it.
A couple weeks after I did the study, I got a phone call from my pulmonologist. On a weekend no less. He told me that while I still met the diagnostic criteria for apnea, I had fewer events per hour than previously (6 events versus 8), and I could try not using CPAP for a while and see how I did. He suggested also monitoring my blood pressure to ensure my blood pressure did not increase as a result.
So I tried it. While it's difficult to totally judge sleep quality when you're constantly changing timezones, I think I can say: going off CPAP did not make a ton of difference. My sleep quality seems relatively unchanged.
Further, my blood pressure seems to be trending lower rather than higher.
I just sent a note to the doctor with the results of my self-experiment. I informed him that, given these results, that I am planning to discontinue CPAP and will continue to monitor and use CPAP again if needed. He agreed with my strategy.
Which means my travels will be that much lighter now that I won't have to carry a CPAP with me everywhere I go. Sure, the airlines treat it as a "free" carryon, but it's still a hassle, especially going through some foreign airports.
While I have gotten rid of most of the clothing from when I weighed 300+ pounds, there is one item I am keeping: a 54 inch belt.
At my biggest, I needed to use the very outer hole in that belt. That hole is 56 inches (or 142 centimeters) out! Yes, I measured. I guess the elastic in the pants I had stretches a bit more than I thought.
As I started losing weight and inches, I punched holes in my belt. After the smaller pants I had kept from years ago started getting too big, I bought new pants…and a belt of the proper size.
That said, I am still using this 54 inch belt as a way to track my progress and remind me just how far I've come. It's been critical since the scale has been relatively stable the last few months, yet my waist continues to shrink (slowly but surely).
The shorts and pants I bought with the 40 inch (about 100 centimeters) waist are now a little loose. And those XXL shirts I have kept for years and started wearing again are…a little big, now.
For most of my adult life, the only places I've been able to buy clothes that properly fit is ordering from the King Size catalog and/or going to Big and Tall sections/stores. You don't realize just how much this limits your wardrobe choices or how expensive this is until you're suddenly able to buy clothing in…a normal store.
In fact, I remember the first time I had done this. I had went to go get pants at Fred Meyer, which is one of the only local stores that has a Big and Tall section. While I did buy stuff from their Big and Tall section, I also bought stuff from the "normal" section as well, including a coat off the clearance rack from the "normal" section!
And then I discovered I could buy clothing from Costco, which was a game changer. Not necessarily for the selection, but the prices. And the fact it's even an option now.
Meanwhile, I may (crossing fingers) have broken through my weight loss stall. I'm about a pound off my lowest weight this year, which I hit about two months ago, but my weight crept back up a little.
And yes, this weight loss happened just after I got back from Switzerland. I guess all that cheese didn't hurt me. :)
It's been roughly a year since I took charge of my health by making two major changes to my eating habits:
This was done gradually over the course of several weeks. During fasting times, I will drink black coffee or tea, which I initially had with heavy cream, but I cut that out except during mealtimes. I will also occasionally have chicken broth for the electrolytes.
The main reasons for doing this are summarized in Dr. Jason Fung's recent book called The Diabetes Code. His previous book, The Obesity Code, was what got me to try it at least. Given fasting costs nothing and everything else I was doing wasn't working to control my diabetes, much less my weight, why not?
A year in, I'd say it's been successful. My stats from May 2017:
As of May 2018, here's where I'm at:
The more important bit of this: My A1C is in the normal range. Granted, I am still taking Metformin, but that means I no longer fit the diagnostic criteria for even pre-diabetes! However, there has been no change in my medications. My doctor wants me to continue taking Metformin until my A1C drops to at least 5.0%. My blood pressure, while definitely a lot better than it was a few years ago, is still mildly elevated.
When I was diagnosed with Type 2 Diabetes, I was also diagnosed with onset sleep apnea. The good news is, from the sleep study I did a few weeks ago, it looks like my apnea has improved: from 8 events an hour to 6. I do, however, still meet the diagnostic criteria. That said, given all the other changes that have taken place, and the relative mildness of my condition, my pulmonologist and I agreed that I should try sleeping without my CPAP for a few weeks, monitoring my blood pressure and symptoms along the way to ensure I don't develop any issues. That's progress!
The one frustrating bit is my weight has been more or less the same for the last few months, plus or minus a few pounds. That said, given the amount of travel I've been doing lately, keeping my weight fairly steady is a positive achievement in and of itself.
Despite the stall, I am slowly but surely shrinking around my middle and other parts of my body. Even if the scale isn't moving, progress is still being made.