That kid is back on the escalator again!

My job is often full of inappropriate people. A lot of times it can actually feel like I’m babysitting a bunch of rude children, only I’m not really paying all that much attention to what they spend all day doing. I’ve been chided more than once for taking lots of supplements (so much so that I’ve bought little pill keepers and carted things back and forth instead of keeping my bottles on my desk) and I’ve been asked why I spend so much money on food when people spot me carrying bags in from the local organic market. I’ve been asked point blank why I don’t ever partake in birthday cakes. Because we have about a million birthdays every week here. And apparently some people are offended when everyone on the floor doesn’t participate. Even though I pay into the cake fund each month when asked!

Today I got in the elevator with a gentleman who works here on my floor. He turns to another gentleman in the elevator, a friend of his, and asks, “If you don’t mind me asking, why are you putting on so much weight?”

I was mortified for them both. The poor guy was really embarrassed. He so wasn’t overweight, by the way. The offending man turned towards me and tried to explain himself, but I told him that there wasn’t any explanation in the world that he could offer to get himself out of that one.

Xifaxan has been done for some time now. I’m feeling like my old self again. Still low carb, although my doctor has urged me to test the carby waters, so I do every now and then. I have a wrap, I have a bowl of puffed rice. I always react, only not as badly as before. the discomfort is always there but the bloating just isn’t as bad as it used to be. We are waiting it out and I may undergo a second breath test in July, and respectively a second course of antibiotics. I’m really into the idea of regaining my carb tolerance, but not in order to eat them regularly, because I’d like to get back into deep ketosis. I’ve been playing around with my macronutrient breakdown a little bit this month, going back and forth from high protein to high fat. Again, I have no idea what I’m doing, but high fat does seem to rev up my metabolism a little. I realized today that if I look at weekly or even monthly totals, I’m still losing at a very slow rate, but if I look at the long view, or two months to the day since I started weighing everyday, using a heart rate monitor, and burning more calories but less frequently, I have lost 7 lbs. That’s 3.5 lbs per month - that’s quite fast for me.

 

Xifaxan - day nine (or “don’t give it to me - 9×3…you’re out of control, emotional symphony…”)

I wish I really knew what I was talking about when it came to nutrition, but I don’t. I only know that I constantly stride the balance between a biologically driven disaster waiting to happen and someone who learns from experience. I think that’s what most of us are. How much we learn varies. How willing to act on what we learn varies even greater. And how lucky we are when it comes to the efficacy of our application is an entirely different story.

Tonight I will take my 27th dose of Xifaxan, bringing my next to last day of the ten day course to a close. Each day has been different. I’ve felt pretty bad almost the whole time - physically and emotionally. Although I ran my first non-stop mile last weekend, my workouts otherwise have been kind of crappy. I’ve lost interest in work. I am generally weepy and tired a lot. I don’t attribute this to Xifaxan on the whole. I’m curious about a whole host of things. I have my period. I’ve been drinking Diet sodas again. Emma says that the effects of aspartame are worse after exercise and I live at the gym these days. I’ve been getting whole caff coffees rather than half caffs. I’ve been eating a ton of protein. And my carbs have been high - in the high 30s to low 40s.

The weight loss is going well. Its slow but not as slow as it had been. I think I’m losing at a pace that I can accept now. It’s for shame that I would be at or around my ideal weight if it had only come off like this from the start. I’ve lingered for a few days at my lowest adult weight ever. I’m looking forward to getting lower. I hope that a weekend in CT won’t ruin things. I don’t plan on eating off diet or anything, its just hard to know what you’re really getting when you are dependent on restaurants and the B&B kitchen.

I’m incredibly thankful that I had a chance to have a breath test and I’m incredibly thankful that I had a chance to take Xifaxan. And I’m pretty terrified that it won’t work. That’s where I am with that.

How does one shout from the rooftops?

On Monday morning I found out that my hydrogen breath test was positive for small intestinal bacterial overgrowth. Today is my second day on 1200 mg of Xifaxan. I am also taking VSL #3. I am trying to keep my regular low-carb diet with minimal lactose. It’s going well. I don’t feel so great. Kind of like a good day pre-low-carb. A bit of gas, especially at the gym. Some pain. Lots of rumbling, but some of it from places that I’ve never really heard rumbling before. I will start my period soon, so the little bit of bloating could be that.

As I possess my soul in patience and make as little noise as possible…

I really didn’t want the hydrogen breath test - getting it approved, taking it, waiting for the results - to be a big deal. I have been disappointed by so many test results before. But I just found out that the doctor has analyzed my test kit, so I’m all ajitters to find out……

The Hydrogen Breath Test

I’ve fasted for tests before but for some reason I awoke ravenously hungry this morning after a 12 hour fast for the Hydrogen breath test. It’s all very complicated - there are two sets of directions instead of just one and I feel like I haven’t prepared well enough. My dear husband studies the instructions like he’s preparing for the SATs, and I mix up the lactulose solution, which is surprisingly clear. We fiddle with the bag and when he thinks he’s figured it out, I start to drink. There isn’t supposed to be a taste to Kristalose, but to me it tastes like diluted sugar water. We start the test at noon.

It gets easier as we go as everything is already set up for us. We interrupt Mr. Brett each alarm (spaced 20 minutes apart) and I breathe in a bag. End of story. By 12:30 I want ice cream. By 1PM I really want ice cream. I also have really mild cramping and borborygami that worsens slightly throughout, but is really nothing to write home about. At 2 I am super cranky. I can easily enough blame all of this on drinking the Kristalose, but then we’re really getting into the realm of speculation, considering that I don’t know anything about the nutritional makeup of the stuff. I do have bloating, however, which can’t really be attributed to anything else. I hope it will subside.

As I write this, I have ten minutes left before I breathe into the last tube and that’s it! I can’t wait to have some coffee with cream, and eat breakfast/lunch. Then we’re going to the green market to get lamb steaks from Three Corner Farm and cream from Ronnybrook.

Yours affectionately

Once again I haven’t kept the blog recent. Tomorrow I’ll take the hydrogen breath test for the detection of Small Intestinal Bacterial Overgrowth (SIBO.) I’ll take it at home with my husband helping. We’ll probably watch his anniversary present to me - I finally own the entire Granada television series with Jeremy Brett. If you’re asking which Granada television series with Jeremy Brett, you’re definitely here because of gastrointestinal problems, so you’ll want to read up on tomorrow’s post.
I’m scared of weight gain and cramping due to the test. I’m even more scared of weight gain and cramping all for a negative result. The doctor that I’m currently working with is great - he’s in the Village not too far from my work and he’s already made a lot of really interesting observations and even offered suggestions on the direction to go in once this test is complete.

In other dietary news, the weight loss is once again coming along nicely. Not as fast as I’d like, but I think I must just come to terms with the slow loser that I am. It seems I was pulling off a nice round 1% of my body weight loss per week, but today was an off-day on the scales, which could change everything, or not. Drinking a sugar solution that is sure to give me diarrhea probably won’t help matters.
I’m piloting a new name for the blog, as is obvious from the header. I think it suits - this really is likely to be a year without cake. It’s already April and I haven’t had even one bite. However, dear readers, my identity is sure to remain the same, because it is my business to know what other people don’t know about my stomach.

A little lost

I haven’t been able to stick to 1200 calories. Its easy enough on regular days, but I need a rest day (from the gym) once in a while and its impossible to eat so little then. I have upped myself to 1400. I am hoping that with heavy activity the caloric deficit will average itself out to a good number.

Last night I blew everything by having a glass of wine. Once I had a glass of wine I had four squares of dark chocolate. Then I had a bowl of berries and cream. Then I got into a knock-down, drag-out fight with my husband. I’m not sure why I have to prove these things to myself over and over again. Sugar destroys me from the inside out. It works quickly, from the inside out. First the mood worsens and then the abdomen expands. I am not quite sure what I am doing lately. I don’t know why I can’t just be an adult and stop testing my limits constantly. I feel better than before, and I can keep the bloating and distention under control. But I cannot lose anymore weight. My Tanita tells me that I gained two pounds but lost 3% of body fat. I think I am completely lost. I feel like a body on the fringe of science and nutrition, constantly. I never have an answer. I never find the solution. I think this is the feeling that spurs me on to evil experimentation; I don’t have any control over my body.

I am thinking of doing the Eades Protein-sparing modified fast, but I am not sure. For now I am sticking to induction carb grams and a high-quality protein shake for lunch. I bought a Polar F6 last night. It will be interesting to see how many calories I truly burn during activity.

The sporting life

 I’ve done some math and I actually have been eating more than I thought during my Daily Plate days. As I restricted to 1200 only part of the time, I knew that an average, if taken, would be higher, although I would have guessed closer to 1450. The number is more like 1550 - 1650. Although this means I still should have seen more weight loss than I have, the disparity between what “should be” and “what is” is actually less than I thought. Enter the calorie-restricted, low-carb diet. I’ve never been daft enough to think that metabolic advantage would get me weight loss at any number. I guess I just thought that with an RMR of 1980, I could get away with 1600 - 1700 calories. Now I’m keeping it in the neighborhood of 1200 net, which in the past I had thought was too low. I used to be very hungry on 1200. Now that the majority of my calories come from fat, 1200 is not really so hard. I’m netting 1200 too, not grossing 1200, so on very active days I will be liable to eat closer to 17 - 1800 calories.

Distention is still at bay but I feel a little puffy now and then. I eat things that I know I shouldn’t and I react but not as badly as I used to. I know that means that I am healing, and I know I should not keep eating these things, if I want to continue to heal. It seems that inulin is still a bad idea, although not nearly as bad as it was only a little over a month ago. Wheat is really not a good idea, nor is soy.

I have upped my carbs from induction numbers and I feel water retention. I’m thinking ketosis is a good place for me right now, yet I’m having trouble reconciling my desire for ketosis with my need to work out a lot. I’m doing Pilates most every morning and trying to make it to yoga twice a week, a sculpting class once a week, and cardio most other days. I need to find ketosis above induction numbers but most probably below 40 g. Perhaps a Fage after workouts would help.

Cornflake Girls

I’m still at The Daily Plate and can’t get used to Fitday or any of the other calorie/nutrient counters, but I will say that the environment there is a little stifling. I guess my bad for being annoyed by the very thing that attracted me to the site in the first place - the “calorie in, calorie out” anyone can do it mentality. I wanted it to be true so badly, many times 1200 calories badly. Now that I’m low-carbing it, I’m reading more posts in the forum on the topic and I really can’t believe how close minded people are. No that’s not it - I my mind was super closed on the topic at one time. What I can’t believe is how vocal people are about their close mindedness, and how they can be that way in the face of others who are screaming loudly “this works/worked for me!” they continue to make blanket statements about low-carb, statements that include the words “believe,” and “water weight” and “stupid.” There are also so many low carb apologists. They don’t do it long term, its not very healthy, but they feel just great, and hey it works! but they eat whole grains, don’t get them wrong.

It’s true, all carbs are just fine and everyone should eat them all the time. Or at least just eat the “right” ones, no matter who you are. People who restrict a single nutrient (unless that nutrient is fat) are just crazy and obsessive. It’s not healthy to cut carbs. And its not at all telling that there are currently three active forum topics on the Daily Plate about breakfast cereal (there is only one about chocolate and one about kale.) And one of them is called “Cereal = Crack” and there are over two pages of posts by women talking about how they can’t stop after one bowl and they’re obsessed with Cheerios and they could eat all their calories in cereal and have done so on certain days.

Into week three…

…with the Atkins diet. So far I’m doing good. I’ve had an off-day here or there where there was a bit of bloating, mostly I’m fine. We had a normal weekend - we went out Friday night and Saturday night. I had a great time both nights - I abstained from food and drink (while out) and didn’t have any stomach problems despite my nerves (it was exciting to leave the house for a purely social visit for the first time since August!) I’m still losing weight - down 5.5 lbs now. I’m seeing my gastro on Wednesday; I will be interested to hear his take on my dietary protocol.

What I learned from working in organic grocery

“I confess that I have been as blind as a mole, but it is better to learn wisdom late than never to learn it at all.” - Sherlock Holmes, ‘The Adventure of the Man with the Twisted Lip’

I worked in grocery for around five years before I discovered the accommodating and relatively high-paying (until I moved to New York) world of clerical work-study. Three of those five years were in natural and organic grocery, and two of those were spent stocking, ordering, cleaning, and selling produce. I never heard of gluten sensitivity or candida or even food allergies before the organic market. I listened to countless stories, almost always told by women, about their symptoms: weakness and fatigue, the aches and pains and the often drunken not-of-this world brain fog that shrouded their lives. These things led them on arduous journeys to root out a wheat allergy or a yeast overgrowth. Often it took them months or years and often no one helped them along the way; maybe one or two of them had a naturopath’s assistance. I wonder now how helpful in truth that assistance was. So many people abruptly swinging from one end of the spectrum to the other; omnivores suddenly eating raw diets, vegetarians adding red meat to their menus. I always listened intently to these women while they told their stories. I often asked questions. “Well, what do you eat while you’re trying to find out your allergies?” “How did you know that was ultimately what was making you sick?” These women were always thin and almost always middle-aged. They were sometimes hippies, and other times they could have passed for suburban soccer moms, and they probably were just that, willing to drive east or over the river to the urban fringe to pick up their organic food. Some of them practiced healing arts, as I suppose their experiences empowered them to be more than just well for themselves. Sometimes they espoused all kinds of New Age crap that I couldn’t care less for. Sometimes they didn’t.   I confess now that I didn’t always believe them. It is difficult to explain. I respected their stories, especially the parts where they were symptomatic. Who wants to feel that way? I had lived my whole life feeling like something wasn’t quite right - depression and lethargy despite a natural optimism. I had aches and pains too, and it was always difficult for me to lose weight - my body always seemed like it wanted to hold on to things, especially hurtful things. During the parts of their story where they figured out what was making them sick, I even cheered them on inside, but I don’t know if I ever fully believed them. How could something as innocuous as food make you that sick? Surely the relationship was not causal. Something else was going on. Hormones? Stress? A latent medical condition? I took these stories with a grain of salt, the way I took the stories of women who went on olive oil diets and lost tons of weight.

For the past two years I have felt sick and no doctor has been able to find a cause. In order to cure, a cause must be found. The one causal factor identified, my gallbladder, was removed one year ago, and the procedure only minimally lessened my symptoms. And gradually, all the symptoms returned. I have been back and forth in these two years with food. I have at times felt empowered when investigating my food, happy that I could actually be the one controlling not only the disease but the cure. I have at other times felt helpless and burdened. Food = my fault, again. I can’t just take a pill, get some rest, eat smaller meals. All this time, however, I have secretly and silently taken my strength from the women in the organic grocery store. I am only 32. Probably the age of many of the women I spoke to when they first began to hunt down their intolerances and allergies. Now I realize that the women who lost weight on olive oil probably did so because they put down the sugar and the bread. Now I realize that food can make us all incredibly ill; the same food can make us all ill for different reasons. I feel that I have a lifetime of diet detection ahead of me. But I feel that one day it may be old hat, it may be comfortable, and I may see lasting benefits that will allow me to tell stories that begin with “I went through a couple of very rough years until I figured out that I….”

The adventure of the very strange solution

This is what happens when one does not keep up with one’s blog. When one’s notes are strewn all over the place, in journals and notepads and one’s daily plate. I will attempt to recreate the best I can the events of the past few weeks.

I passed on the nutritionist’s request for hydrogen breath tests to my gastro. The tests we requested were for a small intestinal bacterial overgrowth (SIBO,) fructose intolerance, lactose intolerance, and sucrose intolerance, in that order, to be administered until a diagnosis is available. My doctor said he approved the tests, but I’d have to pass the request on to the union to find someone who would administer them because he just didn’t do it in his office.  This meant I had to put the ball in the court of my GP, the doctor who told me in December that I needed a really good shrink, because the problem was in my head. This led to a lot of trepidation and anxiety on my part, as I often relived the conversation that we had while holding for him on the phone. My mood had really lifted since the elimination diet - I’m convinced due to the sharp decrease in sugar intake, and it was difficult dealing with the anger of talking to this man again. In the meantime I did a lot of reading, on SIBO and on fructose intolerance. I got more and more interested in the carbohydrate connection involved in an overgrowth. Interestingly, I once had a gastro who tried Xifaxin on me. She gave me 200mg x 3 daily - I still haven’t bothered to pick up the Pimentel book (I really need to) but I don’t think this is even close to the dosage originally suggested. Besides, these days, doctors are experimenting with various courses of the drug - low doseage for a month, higher dosage for a few weeks. She also didn’t ask me to change my diet. When one has a SIBO, carbohydrates basically fuel the fire and encourage continued overgrowth, causing symptoms of abdominal distention and bloating, pain, diarrhea or constipation, as well as sugar cravings. The antibiotics did nothing except produce stool with lots of gas inside, and cause a little pain.

The doctor baited me several times - began to tell me how the test was academic, compared it once to a magic herbal drink that could possibly cure me. I kept my cool with multiple “thank you”s and abrupt “goodbye”s each time. At the end of it all, he claims he spoke with both the head doctor and the Brooklyn gastro in the attempt to identify a testing location and failed to find one, leaving me on my own. He would however, be happy to biopsy my small intestine. I know of course that while a biopsy will find all sorts of malabsorption issues, it will not find a SIBO. I told him I’d leave it up to my gastro and get back to him.

In the meantime, I’ve found Breaking the Vicious Cycle, and have finally begun to read it. I’ve been given “Let’s Get Well,” which I put down almost immediately after I read “Reducing is not for everyone.” Most importantly, I have found Emma Davies, and this post about her experience with the ketogenic, or Atkins diet.

I also picked up “5 Days To a Flatter Stomach,” and read through it. Things began to make sense. Carbohydrates seemed to be the key that ran through all of it.

5 Days
You eat oatmeal in the mornings and yogurt all day. You are grain, fructose and dairy-free until the evening, when you eat large meals of carbohydrates, pasta, potatoes, and fruits for desert. These things are consumed in the evening for their laxative effect - essentially you’re cleaned out by morning, ready to begin your next grain, fructose, and dairy-free day, that is until six o’clock, when you gorge on D-causing foods again. All the while you are exercising, both cardio and toning your belly with resistance bands and sit ups. The author of this book kind of denies that there is such a thing as celiac disease; otherwise it all makes great sense.

Atkins
You eat under 20 grams of carbohydrates each day for two weeks, kicking yourself into a ketogenic state, burning fat instead of your stored glycogen. You drop weight fast, rid yourself of carb cravings, and switch over your metabolism from one that runs on carbs to one that runs on fat. This diet depends on tons of meat and leafy green veggies, with moderate amounts of dairy. This diet includes very few problem foods for me (tomato, garlic)

Specific Carbohydrate Diet (SCD)
I will admit I didn’t read this one all the way through. I know the premise is Atkins-esque, but it is dairy and soy-free, and you are allowed certain carbs, I belive the more complex ones, all the ones I cannot eat.  This book provides a great explanation about why an overgrowth of unfriendly bacteria can cause an individual to lose the ability to process carbs, from simple to complex. This diet depends heavily on meat as you cannot even eat tofu like you can on the Atkins diet.

One thing was clear from the start. My ten years of vegetarianism were over. I didn’t know how I would do this considering that turkey breasts and pictures of happy seafood made me cry in public a few weeks ago, but there didn’t seem to be any way around it. It was a Friday night and I met my husband at our favorite vegan restaurant; we discussed a grocery list. I had a three-part plan. First I was going to do “5 days;” I didn’t think all the fruits and oats would sit well with me, but it would be a good way to bring out a true food intolerance. I realize now this was a funny way of thinking about a program that is so not vetted and based on any actual science, but I have to admit the plan seemed like a good one all around; folks on the internet gave it rave reviews. On Day 6 I would go into Atkins, and if that didn’t work I’d have little recourse except the SCD.

I was a little afraid of five whole days of bloating and discomfort from fruit bowls and oatmeal. Sometime before the whole grain bread and sweet potato spread even came out (we were not about to order from the gluten-free menu on this my last night of blithesome vegetarianism) something like “Fuck it, let’s just do Atkins” came out of my mouth and we built a grocery list of sausage, eggs and cheese for two. I ate an ice cream bar at home after my awesome but bloating vegetarian dinner of mushroom wraps and pinenuts and veggies in soy sauce with lettuce wraps. The total package for the evening blew me up to the tune of the normal extra five inches and I went to bed unhappy about eating animals but hopeful that I would never have to feel this way again. I weighed in Saturday morning at 169.4 pounds. It is not very scientific of me that I did not journal my foods and reactions over the weekend, but I mostly spent the time adjusting to the texture of meat and the absence of a bloated stomach. By Monday morning I had lost three pounds.

Mon. 2/11
166.6 lbs

Breakfast: one thin slice of cheddar, 2 hard boiled eggs, 1 oz crema, decaff coffee with half & half, bite of proscuitto
Lunch: chicken breast, creme fraiche, aioli, duck rillettes, tea with heavy cream
Snack: creme fraiche
Dinner: turkey patty, romaine lettuce, asparagus in olive oil
Late Snack: Devon cream

Tues, 2/12
166.4 lbs

Breakfast: 1 hardboiled egg, italian sausage, one thin slice of cheddar, 1/2 decaff coffee with heavy cream
Tea: stash decaf pumpkin, red vanilla tea with heavy cream
No lunch
Afternoon snack: 2 slices thin cheddar, 1 hard boiled egg, creme fraiche
Dinner: cod filet, broccoli with aioli, maple cheddar

Very itchy nose after dinner! Could this be from the broccoli? All that I can find that diferentiates broccoli from other veggies I’ve eaten lately are glutamates.

Late night snack: mineral water and devon cream

Wed, 2/13
166.8 lbs
1732 calories

Breakfast: 1/2 caf with heavy cream, 2 scrambled eggs with cheddar and proscuitto
Lunch: 5 oz herbed chicken breast, pumpkin tea with heavy cream

At 3:15 my supervisor came by to remind me that I had asked him if I could come by later in the afternoon to go over something. All of a sudden it totally seemed like I had been at the office for a million years. Spaciness? I thought I had been pretty on target today, getting work done pretty quickly.

Dinner: baked chicken thigh, pepperoni, cheddar cheese, spinach, celery stalk with cream cheese

Snack: Devon cream, mineral water

Thurs, 2/14
166.8 lbs
1375 calories

Breakfast: ham omlette with no cheese but I tracked a ham and cheese omlette on the Daily Plate, coffee with heavy cream
Lunch: asparagus, baked salmon, curry chicken salad (a bite) hard boiled egg, crema, 4 olives
Snack: asparagus

My husband and I celebrated Valentine’s Day at the gym! I spent 25 in the weight room and only 20 on the elliptical machine. I thought this would be all that I could do, but I really could have gone my normal 30

Dinner: filet mignon, spinach with salt and pepper, salad with viniagrette (diner in Greenpoint)
Snack: 2 celery stalks with duck rillettes, cheddar cheese

Unfortunately, this evening took an unfortunate turn. I wasn’t bloated after the gym, like usual, but after we ate at the restaurant there was some bloating. We decided eating out wasn’t really in the cards for us at the moment, and I spend the next few days wondering if I’m bloated because of unknown ingredients in my meals or because of my period which starts on Saturday and period-related problems

Fri, Feb 15
166lbs
1566 calories

Breakfast: Spinach and cheese omlette (tracked as ham and cheese,) coffee with heavy cream
Lunch: 3.5 oz chicken breast, crema, vanilla nut spice tea
Dinner: rotisserie chicken from Whole Foods, called “Simple Chicken,” spinach, aioli, celery stalk with cream cheese and cheddar

I tried out a Pilates tape I’d recently purchased and unlike my triumph at the gym, my two months of non-exercise caught up with me here. Also I laid my yoga mat out on the floor and it was way too thin given the painful knot that had popped up in my lower back to herald the coming of my period.

Saturday I stayed at 166 even. I bloat, in fact, I’m about as bloated as normal but I googled the ingredients in my Midol and two of them are suspect. Pre-gelatinized starch is not gluten free, and well, starchy. And microcrystalline cellulose is an intestinal irritant in large quantities. Okay, so two pills didn’t contain large quantities, but I am a person who blows up like a balloon and gets super cranky after half a donut or a few pieces of crystallized ginger so maybe I am sensitive. I start to take the prescription-strength Ibuprofin we have here at the house left over from when one of us pulled a muscle for the pain instead. The bloating goes down in a few hours, which is uncharacteristic. I’ve always had heavy periods, bad cramps that keep me home for at least the first day; I even used to vomit from the pain in high school. Frankly, I’m a little bummed to have cramps this bad this time around. I’ve been off processed foods and aspartame for two months. I haven’t smoked in six months. I have been nearly sugar-free the past month and a half, save for inbetween days here and there. As far as the implications of caffeine on my cramps, I didn’t drink coffee from 1998 - 2002, and besides, I really couldn’t tire more of hearing how bad one of the main ingredients in Midol is for cramps! Friday night we should have seen some friends, but I didn’t picture the my first time out as an omnivore I would be bloated and sitting with a heating pad on my tummy, so I stayed home. And out of frustration I had the husband pick up some Equal and I had a low-carb dessert. Then I had three gin and tonics. All in all, on Saturday I had 2190 calories. And on Sunday I still weigh 166.

Saturday I also cried for the animals I had eaten.

So the final verdict on the ketogenic diet and its effects on my meteorism (abdominal bloating and distention?)

There isn’t one. Diet is an iterative process. I’m terrified that “it’s not working anymore,” now that I’m bloating again. But if I want to be scientific at all, I have to admit several things about the bloating.

1. Its probably my period
2. Its probably my period
3. The duration is much shorter than normal
4. Its probably my period

So I’m just going to have to wait and see. My body should normalize by Tuesday or so, and we’ll take it from there. Meanwhile I’m going to keep up with the diet. I got five bloat-free days from this diet, which is five more than I have achieved through any other measure. And today I’m doing okay to boot, so far.

And how about the effects of a ketogenic diet on my weight loss efforts? Well, I didn’t expect the Monday through Sunday stall that I’ve had, but I have to admit that 3.5 pounds in nine days is pretty good for me. That’s about half the amount that I lost in four months of calorie counting on TDP and regular exercise. So again, I’ll keep it up for now.

sort of like a large, phosphorescent dog

“There is nothing more stimulating than a case where everything goes against you,” - Sherlock Holmes, “The Hound of the Baskervilles

And everything is going against me.

I am so tired

of waiting for my life to begin again

all round and emofree

Tonight I saw my nutritionist for a review of my detection diet journal. I was anxious to hear her take on it all. I had known since our last conversation that she didn’t doubt my suspicions of fructose/sugar intolerance, so I wanted to see what she thought about whatever else might have been bothering me.

I don’t think I mentioned it here, but I have done some more research on fructose, and found out that there are plenty of things I was eating during the elimination diet that could have been causing reactions, such as brown rice and even celery. Additionally, thanks to some google sessions over the weekend and during the first part of the week, I’ve come to feel comfortable with a more general diagnosis of carbohydrate intolerance, specifically intolerance to sugar. I also have a new plan to begin at the end of this week, which I will get to in a moment.

My nutritionist had a few recommendations for me. Unfortunately, one of them was to drink more water. I thought I made the disclaimer somewhere that I drank way too much water (80 - 100 oz per day) to write it down. I had a hard enough time journaling at all; I can’t imagine logging each bottle. I guess I didn’t though, because a whole page of my 12 page brief was on the importance of drinking water. I can’t blame her; I really should have written it down. Otherwise, she noted my need for digestive support, since on the few days that I drank some sort of cleansing tea, I had an elated mood. I told her that I would drink it more often but it was often too harsh for me and she said she would get back to me on suggestions for gentler cleansing teas. She recommended a hydrogen breath test which was great because I recently asked my gastro for one; he said it was an obscure test and he’d get it for me eventually but that it might take some time and investigation. He also wanted a note from the nutritionist specifying which test, because I’m an idiot, so now things are in the works for him to get one. I really don’t quite get why anyone would consider the test obscure, especially not a hip young gastrointerologist on the Upper East Side, but I guess nothing is relative. No different than the naturopath in Harlem who thought I should eat an apple everyday even if it hurt my stomach. Now that I’m taking this into my own hands, I just can’t justify the $50 spent at Whole Foods every third day, the tears, the separate dinners, the cravings fought off, etc. etc. on top of the two years of suffering, if I can’t get an equal effort back from the medical community.

Other suggestions were chlorella and keeping off the coffee. She also gave me a DVD on the Emotional Freedom Technique. I haven’t gotten a chance to explore it, but her demonstration in the office was fairly interesting. She asked me to focus on something that really made my blood boil. The thing is unfortunately this is super easy for me; I just have to picture my last visit to my new general practitioner at the union health center. This guy gently kept me in his office for nearly an hour and a quarter, all the while trying to convince me that my stomach problems were psychological in nature. He said there was nothing wrong with me functionally and since I wasn’t losing weight I obviously was not sick, but rather I just needed “a really good psychiatrist to help me get at the root of whatever deep-seated problem” was causing all of my symptoms. I can’t lie. Sadly this was when I still had the energy for working out, and I was netting 1500 - 1600 calories a day with weekly cardio, strength training and yoga and not losing a pound. It really boggles my mind that I sit in my cubicle all week with my master’s degree so brain-fogged and bloated and sore that I can hardly do my work while this guy makes God knows what to not even keep up with the latest research in his field.

So anyway, I pictured this Doctor. She asked me to say “Even though I’m really angry with this doctor, I’m fully accepting of myself.” About twelve times. Each time she had me tap on a different part of my face. Then I just repeated the phrase “angry at this doctor” over and over again whist tapping myself on the arm and hand. After a few minutes she asked me to relate on a scale from one to ten, how angry the doctor made me. After tapping myself silly I had to admit I wasn’t really angry at the doctor anymore. My husband asked me later in the train if the technique had really made me less angry. I told him that it had been so tactile and silly that I just wasn’t able to concentrate on being angry anymore, so yes, it actually had.

Last night we ordered Self-Help Way to Treat Colitis and Other IBS Disorders on Amazon. I read about the book on a celiac forum, and on a few other places - all anecdotal evidence; several people mentioned it helped them. The premise is that carbohydrate intolerance, specifically intolerance of fructose and lactose, are genuinely responsible for many cases of bowel disorder, and the author promotes a diet that excludes all sugar except minuscule amounts of table sugar, all dairy except yogurt, and fiber. I didn’t know about their instant “read online” upgrade for only a dollar fifty, so after my husband paid twice the price of the book to have it shipped in two days, I upgraded and started reading. Before he left me and the laptop for bed, we laughed about how it would be nice if for once we paid good money to read something completely new and fresh. Well, besides the premise, which despite being relatively fresh, is nowhere near being completely novel, the diet is incredibly different from anything of which I’ve yet heard. I’ll be making just a few tweaks (leaving things out, not adding them in - I’ve learned the hard way) and beginning it on Friday. Strangely this diet allows white bread and potatoes. I am not sure those things will work for me but I am excited about trying a diet that allows them to see if it suits me. Maybe it will just be a sugar-free, dairy-free week between elimination diets or maybe it will be sustainable. I’m just not sure at this point. I’ll be writing lots about the diet in the days to come.

Of course currently I haven’t exactly gone to Taco Bell or anything, but I have been eating all kinds of organic foods that I shouldn’t, like cheese and chocolate and a banana. Today I even had crystallized ginger in grain-sweetened chocolate. I am so paying for it now. Once the sugar bug was triggered, I couldn’t help myself. At my husband’s office after the nutritionist I stealthily managed five pieces of chocolate into my mouth before I realized what I was even doing. Now that I have empirical proof that what I eat does affect me the next day (and sometimes the next) I really have to work on abandoning the I already feel horrible so screw it mindset I’ve grown used to over the past two years. I’ve begun the habit of measuring my waist and hips each morning upon rising and each night before bed. I used to measure a lot, and take pictures, because I actually needed proof that I was dealing with abdominal distention when I went to see doctors. Until I started doing this, I got a less than pathetic response from physicians who probably just thought I didn’t know that I was overweight. Now I could care less what doctors think about my girth; I figure this type of information will serve me well the next time I’m eliminating. This morning I woke up three inches smaller in the waist and two and a half inches smaller in the hips than when I went to bed last night. Of course, this was not due to weight loss but rather the distention subsiding overnight. Now that its bedtime, the 5.5 inches are back!

I really need wheat, gluten, sugar and dairy-free breakfast ideas. Other than hardboiled eggs. After failing so hard on this diet, I wanted so badly to keep abstaining from soy, gluten and wheat; the main foods that I really never minded giving up. However, thinking about giving dairy up again I realized I would really need a substitute for cereals in the morning and for tea. I found Edensoy unsweetened soymilk tonight - the only ingredients are organic soybeans and water, and it tastes amazing.

no you cannot have the fruit

Intermission

I cheated on Day 13. Which caused a snowball effect. That is still going. I’ve kept it to organic yummy foods but I’m so sick that I could cry. Which is so hard to understand considering how I never got that well while keeping strictly to the diet. I’m going to see my nutritionist tomorrow. If I could just have something a little more expansive than leafy greens then I think I could stick with it for 30 - 90 days.

I have been coffee-free for nearly a week. I just feel sad about that. I have nothing left (legal) that is a comfort for me. Everything is off-limits.

Day 12

“It is certainly delicate,” said my friend with an amused smile, “but I have not been struck up to now with its complexity. It has been a case for intellectual deduction, but when this original intellectual deduction is confirmed point by point by quite a number of independent incidents, then the subjective becomes objective and we can say confidently that we have reached our goal.” - Sherlock Holmes, The Adventure of the Sussex Vampire

Twelve days of longing interspersed by craving and occasional manic episodes where I don’t care if I ever eat anything that tastes good ever again are over. Two remain. And I don’t think I would have the benefit that I do tonight without the rampant cheating that I perpetrated tonight. Okay, so given that my nutritionist gave me dairy back on day five, its not really cheating, but today at Bell Bates I picked up an organic spaghetti squash, three more boxes of Celestial Seasonings Madagascar Vanilla Rooibos, sheep’s milk yogurt, an avocado and a bottle of organic kefir, of which I managed to drink nearly three-fourths over the course of two hours. After the onset of a burning up high in my belly, right below my breast, I noticed that my daily bloating was of pre-elimination diet proportions. This warranted a second look at the kefir label. I think I could have died when I read INULIN…I could not believe I had been so stupid. Inulin is notoriously hard to digest; since I wasn’t taking my probiotic anymore while on the diet, I figured it couldn’t hurt. Just to be sure I looked it up and found that inulins are a “group of naturally occurring polysaccharides (several simple sugars linked together) produced by many types of plants” and “belonging to a class of fibers known as fructans.” (wikipedia) blah blah blah. Inulin is a fructose, one that is “problematic for people with fructose malabsorption.”

I think it would have been a lot better had I stumbled upon a spoonful of crystalline fructose, considering the low digestibility of inulin for many, however, I feel this is a clear lead. Unlike Sherlock, I can’t wrap things up just yet. Not nearly. Something I’ve been eating all week long has not affected me nearly as badly as the kefir, but has been causing symptoms all the same, namely bloating, diarrhea, and constipation. Or else, I’ve been doing right by my stomach and the bloating and friends are just residual. I can’t really be sure, but I have to make a decision about the next phase based on an educated guess of sorts. I can either continue with limited, clean dairy and move on with adding things in, or I can take out the dairy completely as I will have eggs to make up for the protein. Clearly re-eliminating dairy will be the smart choice, although I’m exhausted with such limited food choices by now.

Additionally I have not given up coffee completely. This I am chagrined to admit, as one of my pet peeves is the treatment of those of us with gastrointestinal distress as stupid children who don’t know how to stop putting harmful things in our mouths. More on this later, but I will be abstaining tomorrow and indefinitely. I wonder who will get my place in the Starbucks line.

Whatever day we’re on now

I’m sick to death of this diet. I thought keeping this blog would help me hold onto an “on a quest” feeling, but its not really working. Today I made flatbread from amaranth flour and arrowroot powder and olive oil. It was amazing. The recipe, from The Complete Candida Guidebook, makes 8 little flatbreads. Of course I ate them all today. I had four for breakfast and was fine. Quinoa flakes for lunch today made me bloat up. I really don’t know if I am supposed to just deal with the bloating, as something like that probably would never go away in two weeks even if I was doing everything exactly right, or if I’m supposed to take the cue since I bloat every time I eat rice or quinoa. I don’t normally eat these things - except out at a restaurant or something. My nutritionist seems open minded enough but she really wasn’t open to me not eating rice, even though I told her this tended to happen.

Week one summation

Having finished Day 7 of the Elimination Diet, I am now half way through the first and strictest phase.

I’ve made a few discoveries, nothing in big neon lights. There seems to be two types of bloating, one that is up high and starts just below my bra, and one that is down lower, beneath my waist. Obviously one type of bloating is occurring in the stomach and one in the colon. This may seem that it should be more than obvious to someone who has lived with bloating for two years, but I really never understood the difference between the two before. I think this may be because the first bloating I ever noticed was the high kind - I probably got the low bloating before but just thought my belly was poking out a lot. Anyway, the only kind of bloating I’ve gotten on this diet is the low bloating. This kind can be sucked in for appearance concerns and often dissipates in a few hours. Which is good - its the high, stomach bloating that is less comfortable, more painful, and more difficult to hide.

Then there’s my mood. Thursday and Friday of this past week I woke up with most strange sensation - a feeling of utter and complete joy. Even getting my period and horrible cramps couldn’t weigh me down. I don’t know if this was some offending food finally being cleansed out of my diet, or if the feeling stemmed from pride in myself at sticking to the regime. I know that with the dairy added back in (my nutritionist went ahead and allowed simple, clean diary such as goat cheese, organic milk, and natural yogurt) I feel like I’m cheating, so its not likely pride. Friday night I spent an hour or so at the health center getting test results (an MRI that was totally normal) and I knew this would bring me down a bit. Then I also got into a spat with my husband, so by the time Saturday morning rolled around, my mood wasn’t as elated.

Speaking of Saturday, I tried what most folks probably wouldn’t while on this diet. I went on a three-hour Circle Line tour around Manhattan with my husband and some friends and afterward we headed out to a movie. Everyone ate popcorn and drank sodas and even though I brought some Fage with me, I was starving, because of course it was an outing of about seven hours total by the time we were all done with everything.

Other ongoing things - still way less gas, now notably less belching. Today unfortunately, I’m actually a bit constipated. I wonder if this is too much dairy. I’ve basically been living on goat cheese and kohlrabi. I guess I’ve found the things I most enjoy and am sticking with them.

I’m looking forward to the end of this diet. I drank coffee everyday until today - I actually went caffeine-free today until tonight. My husband brought home Dr. Weil’s jasmine white so that I could feel like I’m drinking during our Indiana Jones marathon. So that will be my first caffeine for the day, but I figure I won’t have coffee until Saturday of next week. I’ll add it back in after the fourteenth day, when I get to add eggs.

It’s truly amazing how just being able to smell something makes it easier to deal with not having it. The smells of popcorn, orange juice, coffee, and all sorts of other cravings and temptations have really helped.