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Real Patient Data on an Insulin Pump Patient Plus 1

22 Jun

I saw a lady in follow up yesterday that was a great addition to our growing list of successful “Real Patient Data” series.  She is a 59 year old obese African American female with high blood pressure, diabetes, high cholesterol and sleep apnea.  I’ve seen her for many years and she has really struggled controlling her diabetes.  She actually ended up retiring a little early from her job over a year ago because she was finding it impossible to care for her diabetes and work at the same time.  We ramped up her insulin for a while and eventually convinced her to go on an insulin pump that should have taken care of things.

After starting the pump we saw a great decrease in her Hemoglobin A1C which dropped from above 12 to10 and then to 9.  The problem is that it got stuck on 9 and we have not been able to lower it much more.  I increased the basal insulin pump rate several times, and it just did not have much influence.  We reviewed her diet and she truly does not eat too much or too badly, but she continue to eat her “heart healthy” oatmeal and cereal for breakfast and other carbs that she has been told for years are good for her.

I have broached the subject of Paleo with her a few times, but she never really considered it.  A month ago I saw her and she was convinced her numbers would be better because she had really stuck to her diet and not cheated at all.  The good news for her is that her A1C dropped!  Bad news is, it dropped from 9.01 to 9.00.  Dejected does not touch where she stood at this point.

I talked to her again about Paleo and asked her what she had to lose?  She is a little different than many patients in that she REALLY wants to control her diabetes, to the point that as I mentioned she retired early to be able to concentrate on doing so.  We went over the entire thing again, I really took the time to explain WHY she could not eat the things Paleo restricts, and she finally realized what I already see…what she is doing is not working!  She agreed to give it 30 days and on her way she went.

She came back yesterday and felt pretty good.  When someone really tries to get better over time, and fails over and over, their confidence gets drained.  She had no confidence that Paleo would work, so imagine her smile when I told her that after 32 days of Paleo, her Hemoglobin A1C had dropped from 9.00 to 7.45, and she had shed 9 pounds.  I might add that we made NO adjustments to her insulin pump prior to starting Paleo, so this can be attributed to her diet as nothing else changed.

Several years of frustration corrected by a simple dietary change.  Will she get off her pump?  Absolutely not.  Will she get her diabetes under control?  I truly believe so as long as she can maintain her current diet.  Will we be able to cut her insulin requirements?  I hope so!  This is a real lady, with a real problem, and real problems controlling it.  She had tried hard the traditional way (heart healthy diet and more insulin) and gotten no where.  I don’t think she’ll be going back to the traditional way any time soon!

I’ll also share a quick story about another patient I saw yesterday.  I had spoken to him and his wife 3-4 months ago about Paleo, and they had agreed to give it a go.  He is mid 50’s and healthy aside from his high blood pressure, diabetes, and the stroke he suffered around a year ago!  They missed their 30 day follow up, so I figured they had not done the diet.  As expected they came in and they did not mention it at all (figure they hoped I had forgotten!)  We went over everything, and his numbers looked great.  His blood pressure was perfect, his cholesterol was lower than treatment goals, and his Hemoglobin A1C was in the “non-diabetic” range.  He smiled, looked at me and said “You see, I don’t need that crazy diet after all!”

That’s when I smiled and said “You are right, your numbers are perfect, and we can be happy with that.  My problem is this…your numbers have been perfect for the 4 years I have taken care of you.  They are always perfect…they were even perfect when you had your stroke!  So are you ok with that, having perfect numbers and having a stroke?”  He looked at me with a little smirk as if to say that I love when I’m right; and I do love when I’m right!

As we talked a little more I discovered that they had indeed taken some of my advice, and changed much of what they ate.  He still ate cheese, but had been able to cut much of the carbs from his diet…just not all.  As we looked at his numbers, we saw that even with these minor changes, we saw improvements in his A1C, Total Cholesterol, Triglycerides, HDL, and LDL.  They are not what I have seen with strict Paleo, but they were something.  I encouraged him to keep trying the best he could, and we would squeeze everything out of his dietary changes that we could.  Take home message: In patient care, 50% improvement is better than no improvement!

I hope these patient experiences do two things for everyone.  First, I hope they encourage all of you doing Paleo to keep doing it, and those considering it to give it a try (especially if you already suffer from chronic disease).  Second, I hope it encourages you to talk to others and try to convince them to change their ways as well.  What better gift to another than to help extend their quality of life and limit chronic disease!

Hope all have a great weekend, and keep a look out next week for the first in a series of collaborative posts with Sarah at ThePaleoMom.com!

-E

 
1 Comment

Posted by on June 22, 2012 in Patient Experience

 

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The Road to Fitness: Exciting Application of Paleo to Weight Loss Surgery Patients

21 Jun

Wanted to share a very interesting and exciting program I will be getting started with tomorrow.  Our local bariatric surgeon Dr. Sam Bledsoe has teamed up with myself and William Albritton, a first class trainer from our local Alexandria Crossfit, to put together an 8 week “The Road to Fitness” class.  Sam and William came up with the idea and asked me to come on board, but William is truly the work behind the program. Dr. Bledsoe has recruited 8 patients who have all had successful weight loss surgery and have lost over 50% of their pre-surgery body weight, but have reached a plateau and are unable to reach their ultimate goals.  They will go through the following program.

-Tomorrow night we kick it off with an Introduction covering the program overview, an introduction to crossfit, and a nutrition review discussing Paleo concepts (Will be encouraged to follow Whole 30 guidelines for first month)

-Over 8 weeks they will be scheduled for a series of physical activities including introductary low level crossfit WODs which will be adaptable to their current abilities and individual/group exercise away from the box

-They will maintain daily food logs which will be reviewed weekly by the coaches

-We will also have several get togethers to exchange Paleo recipes and food

Weight Loss Surgery patients are like any other patient, and the concepts of the Paleo lifestyle are a great way to kickstart their weight loss again, help them reach their goals, and further limit their exposure to chronic disease long term.  We will also be getting a group of people to utilize CrossFit who normally would be very intimidated to even show up for an introduction class.

Win-win all around!

Hope all have a great day, and please wish all our participants luck!

-E

 
2 Comments

Posted by on June 21, 2012 in General Paleo Discussion

 

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Coffee and Gluten: My Current Take

19 Jun

Greetings everyone, it’s been a few days since I’ve posted anything.  On the twitterverse the last few days there has been a great deal of talk about coffee and it’s apparent “danger” particularly with respects to possible gluten related sensitivity.  I love coffee, and I hate to see it get a bad name.  So, lets look at this a little more carefully.

First lets look at the source of this information.  Well, the problem is, there is no real source!  A chiropractor published information form “internal lab research” that 10% of coffee is a protein that cross reacts with gluten antibodies.  That is all the information we have.  I see no research study, no detailed information such as what type of coffee was tested, how it was tested, or how they connect this information to clinical implications.  How many coffees were tested etc?  I did a quick search on PubMed.gov for “coffee and gluten” and I got zero hits.  So basically we have an “expert” stating his findings, and no actual data backing up his claims.  I would be vary wary of accepting this kind of statement as fact until we see more information.  Hopefully more detailed information will come soon, until then I will keep drinking my java.

I would like to note that after a quick we search on google, I was able to find the following organizations who have declared coffee gluten free:

-The Celiac Sprue Association

-The National Foundation for Celiac Awareness

-The University of Chicago Celiac Disease Center

-The Mayo Clinic

Please check the labels of your coffee as not all are gluten free due to processing conditions.  That said, most are clearly labeled if they contain no gluten or gluten byproducts.

Now, is coffee bad for you?  Let’s look at some research with coffee that tells us that the stuff is actually good for us!

-Drinking one to five cups of coffee per day reduces your risk of having a stroke by as much as 25 percent. (Susanna C. Larsson, et al. “Coffee Consumption and Risk of Stroke in Women.” Stroke: American Heart Association Journals, 119, 1116-1123.)

-Women who drink four cups of coffee per day are 20 percent less likely to be clinically depressed than women who drink only one cup of coffee per week. (Michael Lucas, et al. “Coffee, Caffeine, and Risk of Depression Among Women.”  Archives of Internal Medicine, 171 (17), 1571-1578.)

-People who drink more than six cups of coffee per day are 35 percent less likely to have type 2 diabetes than people who drink fewer than two cups of coffee per day. (Rob van Dam and Hu, Frank. “Coffee Consumption and Risk of Type 2 Diabetes.”  Journal of the American Medical Association, 294 (1), 97-104.)

-A Harvard School of Public Health study shows that men who drink six cups of coffee a day have a 60 percent decreased chance of developing a dangerous form of prostate cancer, as well as a 20 percent decreased chance of developing any other kinds of prostate cancer. (Journal of National Cancer Institute)

-Drinking a few cups of coffee a day could lower the risk of developing Parkinson’s disease by as much as 25 percent, according to a study published last year in the Journal of Alzheimer’s Disease. (Journal of Alzheimer’s Disease)

-Coffee moderately reduces the incidence of dying from cardiovascular disease (Lopez-Garcia et al. The Relationship of Coffee Consumption with Mortality” Annals of Internal Medicine 2008

-Coffee consumption found to be inversely associated with total and cause-specific mortality.  Freedman et al. Association of Coffee Drinking with Total and Cause-Specific Mortality. New England Journal of Medicine 2012

JAMA, Archives of Internal Medicine, Stroke, New England Journal of Medicine…we are talking heavy hitters here.  It is very, very hard to get research published in these peer-reviewed journals.  You can never believe everything you read, but starting with a well respected source is always comforting.

Now please understand, I am not discounting the above claims of cross-reactivity of 1/10 of coffee to gluten, I just cannot be convinced without any further evidence.  As in all things, you need to weight the good with the bad when making food choices.  As long as we have a wealth of solid clinical data showing the multiple health benefits of coffee I would be slow to stop drinking based on one article presented without evidence.

Think of it this way; If a drug company released “internal lab data” claiming it’s drug superior to another, and left it at that, would you believe it?  They could of course be right, but why not provide more information to help people make more informed decisions.  Without this information it leaves too many questions unanswered to change your behavior.  Including information about the specialty lab which can test you for this condition also should concern us for an underlying connection between the source and the proprietary reference lab.

The world of medical information changes daily, and the internet makes this information spread like wild fire in only a few days time.  When presented with information, particularly information pertaining to your health, always take a step back and examine the source, the credibility of the source, and any information contrary to that which is being presented.

My mind will always remain open, and it may change concerning coffee and gluten if more definitive clinical data is presented strong enough to change my mind.  For now though I see no scientifically based reason to stop drinking coffee.  In fact, I see a great deal of scientific evidence that I should probably drink more!

Yes you are right, a nice hot cup sounds pretty good right about now!

-E

 
16 Comments

Posted by on June 19, 2012 in General Paleo Discussion

 

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Recent Good Eats at the Hacienda!

15 Jun

So much has been going on lately that I have failed to post much of what I have been eating lately.  Tonight is pretty exciting because my friendly FedEx man delivered my new 27 Inch iMac today and I’ve been getting it all set to my liking over the last few hours.  I’m Very excited about the new machine, and hope to really utilize it to make the content of the blog even better.  Enough of that, on to the food!

I love curries, and the other night I really craved a crab curry I used to make before going Paleo.  This recipe is from one of Jamie Oliver’s books and after reviewing it, I figured out it did not need even one alteration to make it compliant!  Now that is convenient.  It’s a classic curry with lots of deep flavors from cumin, fennel, mustard seeds, turmeric, garlic, ginger, etc.  The key for me is to put extra cilantro both in the dish, and on top when serving.  Here is a picture of the ingredients and the finished product. (I served it on top of some cauliflower rice)

Tonight I cooked a Ribeye Roast in my Sous Vide Supreme.  First I seasoned it with my own rub made of spanish smoked paprika, granulated garlic, salt, and pepper, vacuum sealed it, and I let it soak for 24 hours at 130 F and pulled it out tonight.  This cut of meat does not need to cook this long, but I leave it in longer more out of convenience.  The longer soak does not in any way negatively affect the finished product.

Here is the meat after the soak in the sous vide.

Next I heated up the trusty cast iron skillet and seared each side well.

Lastly, here is a shot of the roast cut, and my dinner plate with a side of bacon green beans.  Note how the meat is cooked perfectly medium rare though out, “edge to edge.”  This is what Sous Vide cooking is all about!

So there you have two quick meals I’ve cooked in the last two days.  Keep experimenting guys with whatever sounds good.  Curries are great because they really lend themselves to easy conversion to Paleo.  Hope all are well, gotta hit the sack…

-E

 
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Posted by on June 15, 2012 in Main Entree, Pictures

 

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Why I Do What I Do: Check This Out! (Plus a Little Advice)

14 Jun

I hope most of you read my last post about my high school classmate turned patient who after several years of “gentle” encouragement finally decided to go Paleo and has done great. He texted me yesterday after he read the post and told me he is going strong! He is out of town working, and is faithful to his Paleo ways.

I got a wonderful surprise this morning in my inbox in the form of a comment to this post. Here it is…

Thank you for “bitching” at him to change his life. You have also changed mine, I am his mother and I also have diabetes and he has convinced me to start the diet also. I am feeling so much better and my fasting sugar has gone from 178 to 119 in 2 1/2 weeks and I have lost 5 lbs. Great diet, easy to do and I am proud of him and the support that his wife is giving to him and changing the children’s eating habits also. Thanks again Dr G!

Now tell me, how awesome is that!   My friend had often shared his concern about his mother and his desires for her to come see me.  Of course, I would always challenge him that the best way to help his mom change was to change himself. Well, he has listened, and so has she!

I want to take a moment to really commend these two people for changing their lives and giving Paleo a chance. I do not have diabetes and I can honestly say it would be an extremely difficult diagnosis to deal with. I ask all of you to not only encourage those around you with diabetes to talk to their doctors and try Paleo, but to do so with compassion. Most diabetics do poorly with their diet mainly out of a sense of rebellion; they just don’t want to live the life of, or accept the diagnosis of diabetes. If you do not have diabetes, you simply will never understand what they go through on a daily basis. If you are frustrated with a friend or family member because they won’t “listen,” try to put yourself in their shoes. Compassion, not criticism will ultimately lead to success!

Pass it on…

-E

 
3 Comments

Posted by on June 14, 2012 in General Paleo Discussion, Patient Experience

 

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How an Old Classmate, Now Patient Changed His Life With Paleo

13 Jun

Being a doctor is always hard, but at times it can definitely be harder than others.  Taking care of friends is especially challenging as some of you may have experienced.  Most doctors, I believe, especially those who have long-term relationships with their patients, have more than just a business relationship with patients.  After a while you get to know them well, get to know their whole families (often take care of the whole family!), and you genuinely start to care for their well being on a different level.

When taking care of a friend that process is accelertated immediately.  Around 3 years ago an old high school classmate of mine came to see me.  He is a state trooper, in fact a very good trooper, and works in an area of law enforcement that takes a special person.  Growing up he was skinny as a pole, and I was very surprised to find out that he was a very poorly controlled diabetic.  When he came to see me his numbers were horrible, and he was not caring for himself at all.  That said, it was not all his fault!  He had been diagnosed as a Type 2 diabetic, and was really Type 1.  We tested his pancreatic function and it was essentially non-existent.  We put him on insulin, and so began the several years of too infrequent visits where I steadily yelled at him about having to change his life.

When you are young, skinny and healthy on the outside, and a cop; its very, very hard to change your life.  Youth can make you think you are invincible despite a bad disease, add a badge to that and it’s a nightmare!  He would come in and say all the right things, nod his head in agreeance, and come back the next time with worse numbers.  As his insulin requirements went up I talked to him about switching to an insulin pump.  His wife was worried that he would feel it was a liscence to eat as he wanted.  She was right, but he already thought he held that liscence so what harm could it do?

We put him on a pump and he initially did a little better.  His improvement was of course from the pump, but he was soon able to out eat the pump and his numbers worsened again.  Now before anyone says anything, I had several long and frank discussions with my friend about diabetes, what it would to to him, how his wife and kids needed a dad…all that stuff…even how diabetes would lead to premature erectile disfunction; nothing worked.  He just WANTED his cake and to eat it to (pun intended).  It’s so hard to talk to someone who is young, intelligent, and really knows what is going on; yet does not want to change much of what he is doing.  He hoped that, as his wife predicted, the pump would be his ticket to eating what he wanted.  Despite increasing his insulin, and increasing the amount we bolused him before meals, we got no where.

He started to dabble with CrossFit, that was great, but he still did not address his diet in any significant way.  Now it is easy for people in the Paleo community to just say “change your diet man, it’s easy!”  Most people who eat Paleo do so out of CHOICE…my friend felt he HAD to do it.  It is absolutely human nature to fight anything you feel you are forced to do, and he fought corageously!  Now I think he was right in that he was being forced, but it did not make it any easier.  I continued to see him and do my best to scare him into changing.  When I started Paleo myself I immediately talked to him about it.  He did it for a day or so, even texted me a few pictures of his Paleo meals, but it did not last.

On a recent visit we once again discussed his life and health long term.  He has kids, and life was starting to show him that he is not as invincible as he thought.  We looked deep into his kidney function and I explained that although “normal,” it is nowhere near normal for someone his age.  He realized that his body was changing.  We went over Paleo AGAIN, and he once again told me he would do it.  I didn’t hold my breathe…

I saw him a week ago and for once, he had actually changed.  Even more than that, his MIND had changed that he not only could do this, but that he HAD to.  His wife and kids were with him, she has been supportive, and he finally felt like he was getting somewhere.  More than anything, for the first time I did not have to do any…well, bitching for lack of a better term.  He was on board, he was happy with what he was doing, and he had all the determination in the world to continue.  Essentially I think my friend had finally seen his mortality, and he realized he has way to much to live for not to change his ways.

So what did he accompish in 30 days?

He lost 8 pounds

His fasting sugar went from 198 to 169

His liver functions (AST/ALT) went from 105/51 to 61/37

His Hemoglobin A1C went from 8.46 to 7.32

The numbers are great, but most importantly my friend saw his life for what it is, and he decided to take control of it.  If he follows Paleo the numbers will take care of themselves.  For those who know me they will certainly know who this is about.  He actually ASKED me to be on the blog and wanted a picture posted, but we will withhold for now 😉  He experienced the same thing I did that made me start this blog; the amazement that comes with changing your diet and seeing real results in how you feel followed closely by wanting to tell everyone you know!  I will keep everyone posted on how he does, and once he is a little farther along the way, I’ll try to convince him to write up his experience for all of you. (That statement was absolutely intended to pressure him into doing so!)

-E

 
7 Comments

Posted by on June 13, 2012 in Patient Experience

 

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Real Patient Follow-Up: Amazing Results Continue!

11 Jun

A couple of months ago I posted information on a 65 Year Old Diabetic gentleman who had adatped Paleo and I shared the results after one month of his new diet.  Well, good news, he was back today two months later, and here are his updated results!

Over A Three Month Period:

Weight: He has lost 30 Pounds

BMI: 34.58 (Start), 33.23 (1 month), 30.52 (3 months)

Hemoglobin A1C: Dropped from 7.36(0) to 6.57 (1) to 6.02 (3)

Liver Function Tests: AST/ALT 80/68 (0), 51/39 (1), 40/34 (3)

Cholesterol/Trigs/HDL/LDL: 186/211/45/98, 141/240/33/60 (1), 137/151/38/68 (3)

Now all of this is very impressive, but here is what I found most fascinating.  This was his medication regimen for his diabetes at time 0:

Levemir Insulin 100 Units at night (Long-acting insulin)

Apidra Insulin 20 Units Three Time a Day with Meals (Short-acting insulin)

Glucophage 1000mg Twice a Day

As he has lost weight, he has had to cut is Levemir in HALF to 50 Units nightly, and completely STOP his Apidra with meals. 

If only you could all see the smile on his face 🙂

-Ernie

 
3 Comments

Posted by on June 11, 2012 in Patient Experience

 

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A Physician’s Whole 30 Experience: What I Learned

06 Jun

30 days ago I began a journey that has taken me farther into myself then I knew I could go. Today it ends, and I would like to take you inside my journey and share with you how it has changed my diet, my health, and my spirit.

The Process: Around 9 months ago I decided to change my diet to one based on a Paleo framework. I spent years looking at different diets and my paleo adventure has finally landed me on solid ground. I “gave up” so many foods that I felt I was doing about as much as I could for my health. Despite that, I still had a few strongholds; the biggest of which was Diet Dr. Pepper.

For months I have been recommending a dietary challenge to patients that were interested based on Dallas and Melissa Hartwig’s Whole 30. I would normally feel somewhat strict to recommend the entire plan, and would often tell patients to follow it completely except for the artificial sweetener rule. I did this to give my patients a break, but also because I could not give that up myself. I try hard to live by the rules I preach, so this seemed easiest to me! The more I traveled into my Paleo journey, the more I felt the real calling to participate in the Whole 30 myself. I knew it would be hard, but I just felt it was the right thing for me. My diet has been pretty strict from the beginning, and essentially converting to the Whole 30 meant eliminating artificial sweetener, the small amount of heavy cream I drink with my coffee daily, and nitrates in preserved food. Otherwise, no real change! How hard could that be right?

30 Days ago I started the challenge with confidence and concern. I knew dropping the caffeine in soda would be hard, but I had no idea how bad it would be initially. The first day of the challenge was the worst I have felt in YEARS. I had a terrible headache the entire day, and felt almost in a fog. As the day progressed seeing patients in my clinic became harder and harder, and I almost gave in and drank a soda. What stopped me was the realization of just how bad things were! I felt terrible, all because I drink too many sodas. I pushed through, and made the determination not to drink any caffeine at all until I felt better. That night when I got home I was absolutely cranky (my wife will concur I am certain!) I did the best I could and went to bed as quickly as I could. As I lay in bed, head pounding, I wondered how long I could take it. It was literally incapacitating, and I feared how well I could work another day like that.

I slept off the headache, and awoke to a new day…headache free! I stuck to my guns and chose water over coffee every day for the next 10 days. I have not had another headache since that first day, and I am amazed at just how bad I felt. I felt sick, there is no other way to describe it. After 10 days I started drinking some coffee again, simply because I love coffee, not because I NEEDED it. It was a very freeing experience.

Despite the headache disappearing, I still craved diet soda. After much thought I realized that I drank it mainly to kill my need for something sweet. I had eliminated so many strongholds in my diet, but this one had become my primary one. I can say honestly that this craving for diet soda lasted a good two weeks before I FINALLY got over it. It sucked!

As far as food goes, the Whole 30 was not terrible for me. I eat a pretty clean diet to start with, and my main adjustment was bringing lunch with me from home as not to chance any illegal items when we order out often from the clinic. I can imagine that the shock to the system from a non-Paleo diet to a Whole 30 would be tremendous, and I am glad I did not have to face that!

Due to poor planning on my part, the end of my Whole 30 coincided with a week long family vacation to the Great Smoky Mountains. This was hard, by far the hardest part of the plan. By the time we left though I was over 20 days in, and there was NO WAY I was going to kill it. I sucked it up, and did all I could to stay on track. I ordered as detailed as I could when out to eat, and stuck to safe foods when none were available. Of note, when I do another Whole 30, I will make sure I’m not on vacation during any of it!

So how did the Whole 30 help my health? Here are a few observations:

Acne: I don’t have terrible acne at all, but I do still suffer with an occasional pimple. For three weeks I have not had a single pimple. Pretty amazing stuff.

Energy: I thought Paleo had given me all the energy I needed, but I was wrong that it was all I could have! Although subtle, the increase in energy on a day to day basis I experienced by taking the next step to the Whole 30 was encouraging. I never really got tired, even on the long drives during our vacation which in the past would have sent me shopping for caffeine in one form or another.

Cravings: Again, although I felt my food cravings were gone once I went Paleo, the Whole 30 taught me that my major remaining craving, diet soda, was as strong as ever. It took a good while to get rid of this one, but it was well worth it. Diet soda turned out to be the one little thing I kept for myself, and I had no idea the pull it had on me. I don’t think that drinking diet soda made me feel tremendously bad per se, but I was drinking it for the WRONG reasons. That was enough to concern me and push through the 30 days. Will I ever drink diet soda again? I would be a bold faced liar if I said I would not, but my intake will be cut by 80-90% long term. That is something I can live with, and be very proud of.

Weight Loss: After changing to a Paleo diet I lost 25 pounds without really trying at all. During my Whole 30 I lost 5 more pounds, so that is 30 pounds overall…not too shabby!. My BMI has dropped from 30.6 to 26.3. I still have some way to go, but I’m very pleased with the overall drop so far.

Mood: I have noticed a definite improvement in my mood during the Whole 30. I’m generally a pretty positive guy, and I really like what I do. Still, everyone has times when stress or anxiety get to them. This would happen to me typically when the work day would zoom out of control, or the kids would act up. I think two things led to the improvement in my mood:

—Knowledge of Health – Just knowing that I was doing something very important for my health was so invigorating. Diet, weight, and emotion are intertwined to the point they are indistinguishable. Negative emotions can be crippling, but positive emotions can fuel you to the max. I knew I was getting healthier every day, and that made me feel awesome.

—Feeling of Health – Besides knowing I was healthier, I FELT healthier! For all the reasons above, as well as sleeping well, I just had a general glow of health to me. Other’s noticed and made comments, and that will help anyone feel better! I don’t think I can really explain this, you just gotta try it to find out!

Must Have Foods: Many people are looking for the foods that are key to a successful Whole 30, and I will give my humble opinion. Here is what I couldn’t live without.

-Avocados – There is no better snack alone, or added to a protein than one.

-Coconut Milk – Such a great milk substitute for any occasion.

-Dried Fruit – Watch this as it can be a sugar substitute for you, but in moderation; often saves me

-Eggs – What else can you say about the totally versatile egg?

–Homemade Beef Jerky – Sometimes you just need beef!

Big picture: So what is the big picture benefit to me from my Whole 30? There are several things I would like to point out. First, it truly allowed me to put the focus back on using food as nourishment for my body, and not as a pleasure per se. Now look, I love food, and that will never change. But it’s so hard to separate sometimes the difference between what you eat to fill a “void” or “craving” in your life, versus what you eat to adequately fuel your body. You can easily fuel your body with wonderful, real, and delicious food which means you don’t have to turn to food for anything other than that. As I say, Real Food for Real Health.

Limiting my diet to this real food also brought back something else that I feel we often lose; the real taste of food. We are inundated with flavors that we quite frankly were not ever supposed to experience! As you will all (if you are smart!) soon read in the Hartwig’s book It Starts With Food the food industry has created foods that are fattier, saltier, and sweeter than anything nature can provide. This kind of numbs our taste buds to real food. Take for example marinating a steak such as in a sugary Teriyaki sauce. If you have a wonderful cut of beef, why take away from the flavor at all with anything more than a little salt and pepper? Why not taste the meat for what it is, and the glorious fat for all it can be? Are “smoked” almonds really better than raw almonds? Is a maraschino cherry better than a super ripe fresh cherry? Is a tub of store bought greenish faux-guacamole better than home made, or just a freshly sliced ripe avocado? If you really taste things, the answer is no for all these.

The reason that the food industry has designed foods to be fattier, saltier, and sweeter than nature intended is that they are taking tasteless and inedible food and creating a “food” for you to eat, and for them to make money off of. By design the Whole 30 takes all that away. What you are left with it food as God intended it to be. The Whole 30 gave me my taste buds back!

Lastly, the Whole 30 taught me that once again, even when I think I’m doing my best, I am not! It’s not good enough to do Paleo and hang on to dietary strongholds. The effort to bring about even more change in your life can produce serious dividends. I learned that and am so glad that I did.

So, you only have two things left to do. First, commit to doing your own Whole 30 right NOW! And second, pre-order the Hartwig’s book and soak it up as soon as you can. I will be doing a full review of the book once I am finished, but I am taking my time to really gain everything I can from it. I am not a paid spokesman, and I gain nothing from you getting their book. To the contrary, it is you that has everything to gain from reading it.

Please consider doing the Whole 30 challenge yourself. Ask yourself these questions…is what you are doing right now working? Are you happy with how you feel? Could you use more energy? Are you sleeping soundly? Are you worried about chronic disease? Are you sick and tired of being CONTROLLED by food? It’s just 30 days…

JUST….DO….IT!!!

-E

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Posted by on June 6, 2012 in General Paleo Discussion

 

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Keys to Paleo Success Part 4: Being Conscious

03 Jun

In the final part of this series on my keys to Paleo success we will talk about consciousness; not being awake, but being alert!  Together with cooking, understanding, and patience this will conclude the series on keys to success.  How conscious you are on a day to day basis may ultimately determine just how successful the Paleo lifestyle will be for you.

Eating: It’s fairly obvious that you must be supremely aware of what you are eating to be successful.  There are certain areas though that I think are more important as they are the most likely to make you slip up. 

Although I don’t encourage calorie counting to my patients, I do ask my patients to be conscious overall of how much food they are eating.  Eat slowly and enjoy your food that way you give it time to settle and for your natural sense of satiety to kick in.  It is not uncommon to overeat even while eating clean.  There is a sense at times that since the food is clean, you can eat as much as you want.  Although technically true, try to be aware of what your body really needs and not just what you think it wants. 

When you are shopping at the grocery always be aware of this; even when you have multiple food choices, there is almost always one that is better than the other.  For example choosing a leaner cut of meat will be better than a fattier cut.  By all means, eat a ribeye at times, but fit in some leaner meats as well.  I want you to also read every label you can in the grocery.  Even when you think that you know what is in there, check again.  Are there nitrate free choices for some of your meat choices?  If so, try to get them as often as you can. 

Also take the time to ask your grocer, or preferably a butcher or meat farmer where the meat you are buying is from, what it is fed,  and how it is raised.  Do not feel obligated to eat only grass fed meat; although optimal, it is not possible or practical for many people out there, even myself at times.  Lastly, look at anything that is processed in any way with skepticism.  As my goal is 90% compliance with my Paleo diet, I very rarely blatantly eat what I know is not good for me.  I look at what I consume that is processed, or not prepared by me as being unclean, and it accounts for my 10% fudge factor. 

Eating is an absolute joy for me, and it should be for you as well.  When you do it consciously, ALL the time, it can be fun and enjoyable instead of the dread it has become for many.

Feelings:  I want you to be completely aware of how you are feeling at all times.  Before you eat make yourself aware of just how hungry you are.  While eating, enjoy how the food makes you feel, and eat slowly enough to feel how full your meal is making you before you overeat.  Tie your feelings together with eating in every way that you can and it will really help you be more successful.

One key are of feelings I want you to be aware of is how certain foods make you feel, especially pay attention when you cheat.  Everybody reacts differently to foods, and even to non-Paleo foods.  I have learned over time what kinds of foods I can and can’t cheat with if I expect to feel well.  Keeping a food diary early in your journey will really help with this are of your lifestyle.  You want to be able to look back and say “I feel really sluggish, what could I have eating in the last few days to cause this?”  Is your stomach more unsettled than usual?  It’s probably something you ate!

Another thing to really pay attention to when you cheat is WHY did you cheat?  If you are like me, emotional eating can be a problem.  Don’t just look back at cheats and see how they made you feel, but look at what emotions led to you cheating.  Over time you can analyze what circumstances or emotions trigger cheating so you can control them.  You want cheating to make you feel GOOD when you do it because there is no guilt involved, but that will take time and patience to achieve.

Are you hurting somewhere that you normally don’t day to day, or after a workout?  I’m not talking about typical soreness post workout; you know when something is not right. People come in to the office all the time and complain to me about something.  I talk to them about it, and come up with a plan to figure out what could be causing it.  Commonly the patient then says something along the lines of “It’s not that big a deal, let’s just not worry about it.”  Symptoms are your body’s way of talking to you.  People who ignore their symptoms are the one’s that end up with medical conditions or injuries that could likely have been prevented with earlier intervention.  If you feel something is wrong, there probably I something wrong.  Instead of just living with it, how about calling your doctor, making an apt, and getting it sorted out!

Food and feelings always go hand in hand.  Get a good hold on both concerning all aspects of your life and your diet and you will be happy you did.

Sleep:  This is such an important part of your life, I don’t want you to overlook it in any way.  The number of people out there who chronically get too little sleep is staggering.  Do something for me, for the next month keep a sleep log.  You can get great little apps for your smart phone if you would like, but it’s easy enough to do on your own.  Here is a link to the sleep diary Sleep Diary my sleep center gives out to patients and it is very useful.  I want everyone to be very aware of how much sleep they are getting and how much they are not getting.  Everyone is also different with how much sleep it “enough” for them.  The sleep literature says normal sleep is anywhere from 6-10 hours a night, but you have to see what is best for you. 

The most common cause of chronic fatigue is a very technical sleep diagnosis known as ISS, or Insufficient Sleep Syndrome J.  Do you suffer from this?  Well, do the sleep log and see how many hours of sleep you are getting.  Then ask yourself this question: “Am I more tired in the day than I feel I should be?”  If the answer is yes, make a concerted effort to increase your nightly sleep by at least one hour and keep logging your sleep.  Do you see an improvement in how you feel?  If you do, then keep getting more sleep.  If you don’t, or you have trouble falling asleep, don’t settle for how you feel please.  Look up a board certified sleep physician and make an appointment.  You will NEVER feel or be your best if you are not sleeping enough.  Insufficient sleep does more than make you tired, it is dangerous and increases your risk of chronic disease.  Most people simply go through life dealing with how they feel and not trying to fix it.  Become conscious of your sleep patterns and sleep volume, and make adjustments to improve them if needed. 

Ultimately you can read every book and follow every blog, but nobody out there is talking directly to you.  Only your body is talking directly to you, but you have to learn to be conscious of it and adjust to its needs.  Always remember that success with a Paleo lifestyle is up to you, and nobody can change that.  Don’t fall victim of thinking you can’t do it “right” so why bother, or that you are doing all you can.  Are you really?  Is there some place you can improve your health?  Do you have strongholds you are still not willing to give up? 

You want to succeed with your Paleo goals?  Learn to cook at home, be patient with yourself, acquire the understanding of why Paleo is right for you, and become conscious of every aspect of your life. 

Do you have specific keys that have helped you?  Post a response and share your experiences with everyone else.  If you have specific questions, always feel free to email me at PaleolithicMD@gmail.com.  And as always, share this blog with anyone out there who you feel could benefit from learning more about the Paleo lifestyle. 

-E

 
3 Comments

Posted by on June 3, 2012 in General Paleo Discussion

 

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Keys to Paleo Success Part 3: Patience (and the Paleo Cheat Hypothesis)

31 May

Today I will talk about one of my downfalls; not just with Paleo, but with life in general! I am guilty of not having much patience in life, and at times I think it hurts me in many ways. Let’s look at how patience is important to Paleo.

When you start down the road of a Paleo lifestyle, you are bound to have ups and downs. It is very hard, if not impossible to have the willpower to be perfect. Often you slip up and don’t even know it until much later. Even the definition of what is and is not paleo is fuzzy in certain areas so who is to know for sure where all of your choices will settle out.

I am a perfectionist, and that can be good in some places. When it comes to eating Paleo though, I have learned to avoid the temptation to think that I can be perfect. I think of my eating as a fuel meter that ranges from 0 to 100.

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It is unrealistic that I can keep this meter pegged down at 100 all the time, and if I make that my only acceptable goal I will fail. I’m not saying that you should not care, or try to eat clean, but you must be patient with yourself. Life is after all to be enjoyed, and occasionally that may mean deviating from the Paleo path. I don’t do this often, but I have in the past, and I am certain I will again. The key is that when I choose to “cheat,” I do so very deliberately and with no remorse. I keep my fuel gauge as close to the 100 mark almost all the time, so I will allow for episodes of dietary indiscretion in rare instances.

When I started Paleo I was gung ho crazy to be perfect. One important part of Paleo I had not yet learned to appreciate is trying to eliminate stress from your life. If you place so much pressure on yourself to be perfect that a cheat will literally ruin your week, you have to reset your priorities a bit. I was guilty of such behavior, and I was taught early to change my ways by my biggest cheerleader…my lovely wife. One night about 4 months into changing to the Paleo lifestyle we took the kids to Dairy Queen. I can say honestly up to this point I had been 100% compliant to my knowledge, and it was becoming almost an obsession. For me, an obsession is easy to come by, and not healthy at all. We pulled through the drive thru and I ordered my kids some ice cream. As I looked at the menu, I just decided on a whim to order a Peanut Buster Parfait. I’ll be honest…I ate it all, and it was SO good. That night I could not sleep I felt so guilty. I had not planned it, and I felt weak to just order something so half-hazardly and eat it! I moped much of the next day and into the evening, and my wife, knowing me all too well, asked me what was wrong. She knew what was wrong, but asked anyway. I explained to her my guilt, and she simply asked me what I would tell a patient in that situation. It was easy to know that I would tell them that we all make errors, and you just move on.

This episode was very good for me in many ways. First I realized that even though I ate ice cream, it did not change my Paleo values in any way whatsoever. I picked up the next day and carried on with my clean diet. This showed me another aspect of food no longer controlling me. Food can control your behavior, but it can also control your reaction to your behavior. I essentially forgave myself for eating the Dairy Queen, and moved on! I never really looked back (remember the fuel gauge) and that’s something I had always had a hard time with.

This also led me to develop what I call the Paleo Cheat Hypothesis, and it goes like this. If a caveman walked into a cave way back in the day, and stumbled upon a Peanut Buster Parfait from Dairy Queen, would he taste it and reject it on principle? NO WAY! I have no doubt he would have eaten it and gone back home to tell his family! I know, I know, it’s a little silly, but just the same way that occasionally a prehistoric human found a comb of pure honey, we can occasionally gather edibles that are not the healthiest. It’s gonna happen to you eventually. You have two choices; either fester over it forever with the belief that you should have been perfect, or just let it go and move on. Just keep that gauge between 95-100 as much as possible, and everything will be ok. Always be patient with your fallible human self.

In addition to patience with yourself, you need patience with your progress. We all want to get healthier, fitter, happier, more energetic, and for our biomarkers like weight, blood pressure and cholesterol to improve. That said, it won’t happen overnight, and may not happen ever to the extent that we want. Don’t make demands on yourself and make them a prerequisite for success. Your goals are important, but so are the lessons that the journey will teach you. Use every day to learn from your successes, and your failures. Remember that going Paleo is a lifestyle, and a lifestyle lasts your whole life!

In life we all want to believe we can and should be perfect, and that we can be that way now. I advise all my patients to try to be all that they can be. This means pushing yourself, redefining what you feel you can achieve, but also to do this with a good deal of patience and appreciation for the journey. You will never be perfect, you weren’t designed to be perfect, and don’t be fooled into thinking there is anyone out there who is. I’m certainly not, and I’m actually kind of proud of that. In fact, my imperfection has taught me to be a better Christian, father, husband, doctor, and person overall.

-E

 
4 Comments

Posted by on May 31, 2012 in General Paleo Discussion, Uncategorized

 

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