50/50

I've spent the last week in Arizona with my parents. I went by myself this year, which was difficult. I missed Jeremy and the children desperately, but my dad is very sick with an advanced case of ulcerative colitis. I haven't seen him since before his diagnosis, so I was shocked by how pale, weak, and wasted he's become, from muscle loss and anemia. The smallest bit of activity wipes him out. He's practically house-bound at this point. Seeing him so sick and in so much pain and misery made me feel helpless and afraid.

I went to Arizona hoping to cheer up my dad and relieve the caretaking burden for my stepmother, but also to act as my dad's nutritionist. He's been waiting for weeks to be approved for a drug called Remicade, which is a last-ditch medication effort before a colectomy (surgical removal of the entire large intestine). He's been run through the wringer by his insurance company, but just before I arrived he was approved. Of course, his insurance will change at the beginning of the year, before he can begin the treatment, so he'll have to go through the whole process again.

My dad had a heart attack five years ago, at the age of 45. That makes two serious life-threatening diseases he's developed by the age of 50. After several years of interventionist medical care I think it's fair to say that my dad is fed up. He's been through many different medications, some established, some experimental, some of which have caused serious allergic reactions or side effects. Confusingly, some of his medications are treating conditions he doesn't have. He's taking statins, for example, even though he has never had high cholesterol. He's also taking a blood pressure medication, despite having never been hypertensive. He's part of a class-action lawsuit against a pharmaceutical company that neglected to report ulcers as a side effect of one of his medications; his doctor believes his ulcerative colitis might have developed as a result of that drug.

I was hesitant, but hopeful, as I approached my dad with nutrition recommendations. Surprisingly, his medical team has never discussed diet as a way to control the symptoms of UC. I say "surprisingly" because, although diet is not believed to be a cause of UC (which is an autoimmune disease), it's literally impossible to have a digestive disorder that is not impacted by food. His doctor told him that his case is too advanced to see improvement from what he eats. In my opinion, such an assertion should not be made until after the patient has made a serious effort to eat differently.

It's also my opinion that when the option to surgically remove a major organ is under serious consideration, every alternative should be tested before that happens. Ultimately, what my dad chooses to do with his body is his decision alone, and I recognize that he is in a desperate situation. But I hoped to offer some ideas that might diminish his symptoms, if only so he will be stronger before undergoing Remicade therapy (which attacks the immune system, with potentially fatal side effects) or be in a better frame of mind when considering bowel surgery.

I worried that I'd have to fight my dad on my recommendations, or that he would simply ignore me, but he was very open-minded. My suggestions included:

• drinking bone broth before meals, to balance the immune system and help restore the mucosal lining of the colon;
• having one or two protein shakes a day, made with coconut milk and gelatin (thanks to Facebook readers for the recommendation on gelatin, which is a good substitute for conventional protein powders);
• consuming 6 small meals instead of 3 big ones;
• replacing vegetable oils with coconut oil, olive oil, and real butter;
• eating grass-fed and pastured meats, cooked rare;
• having plenty of eggs as an easily digested protein source (and no more Egg Beaters, ferchrissake);
• switching to a whole-food iron supplement, combined with vitamin C and folate for absorption,
• a sublingual B-12 supplement to improve energy levels (especially because he takes statins),
• total avoidance of fast food and soda (seriously, that stuff causes diarrhea in people with normal digestion);
• cooking vegetables well to break down the fiber, and mostly avoiding cruciferous vegetables;
• skipping beans, seeds, and corn, which are very hard on the ulcerated colon; 
• elimination of gluten (I said he could try real sourdough bread on occasion);
• cutting back on whole grains, which are generally high in insoluble fiber; I made an exception for occasional oatmeal, which is mostly soluble fiber; and 
• relaxing; eating slowly; not being afraid to eat; pinpointing causes of stress in his life.

He seemed open to trying most of these ideas. I guess he must be even more desperate than I thought. When I look at this list and compare it to how he ate before his diagnosis, I'm floored by what a difference it would mean to his habits. If he's willing to commit to even a few of these changes, I think it could help relieve his symptoms.

I can't say that I don't harbor some resentment toward his doctors. I didn't realize it at the time, but a nutritionist or dietitian was not included as part of his medical team after his heart attack. He saw a dietitian after being air-lifted to the hospital (who told him to eat margarine and Egg Beaters, gag), but otherwise his diet has not been addressed. How can this be?

My dad hopes to stop some of his medications. Every time he sees his doctor he asks to quit something. But he's found, like most people, that it's nearly impossible to stop taking a drug once it's begun. If my dad manages to live a long life he could be on drugs for high cholesterol and drugs for hypertension and drugs for their accompanying side effects for thirty years. Never mind that he doesn't have high cholesterol or hypertension. Doctors are very reluctant to taper off a medication if it seems to be working, and it's certainly easy for a drug to seem to be working if the patient never had those conditions in the first place.

While visiting my grandparents, I noticed that my grandfather's legs are turning purple. He has diabetes, and he takes 26 medications and supplements every day. I asked him if he monitors his blood sugar and he said no. Instead he's taking ALLI, that popular new weight-loss drug. This drug was recommended by his dietitian, who claims that type 2 diabetes is genetic, has nothing to do with sugar consumption or metabolism, and can be managed by pooping out all the fat you eat.

He pulled out his bloodwork for me and I was shocked by what I saw. My grandfather is taking the maximum dosage of diabetes drugs three times a day. His blood shows liver toxicity, and his fasting glucose levels are not healthy. He takes a few different drugs for cholesterol and triglycerides, but his VLDL cholesterol is still too high and his triglycerides haven't budged significantly in ten years. He's not even benefiting from the drugs that are poisoning his liver.

So I broached the subject of approaching his health differently. I talked about cholesterol metabolism and the high percentage of refined grains and omega-6 fatty acids in his diet. I pointed out that a rational approach to drug therapy is to reconsider a medication that isn't working, and to weigh the costs and benefits of each drug. I mentioned that checking his blood sugar is an essential aspect of managing diabetes. I told him that moderate exercise is the single best way to address high blood sugar. I shared my experience of improving my health after measuring just under the limit of prediabetic.

At the end of our conversation he laughed and said, "See you next year!" I was hopeful that I had, at the very least, inspired a bit of skepticism.

The next day, he brought me a jar of marshmallow fluff, several gallons of which are delivered to my grandparents' house each winter (a New England delicacy, apparently). Now, I don't mind indulging in a few holiday treats, but a pound of air-fluffed corn syrup is where I draw the line. When I said no-thanks, he scoffed at my assertion that I shouldn't be consuming pure sugar. "That has nothing to do with your blood sugar," he said. "Besides, it has no cholesterol. Look, it's right here on the label! No cholesterol!"

One out of two ain't bad, I suppose...

chicken tractor fail

Two weeks ago I posted about my unhappiness with our chicken operation.

Well, things got worse.

I keep trying to remind myself that everything we're doing is an experiment. I don't know anything about anything, so every time I try something, it's usually with hesitation and an open mind. Sometimes things work out, and sometimes they don't. Either way, I learn something. 

Paging through the manuals on chicken tractors, it seems that most people have had good success keeping ten grown hens in each tractor of this size. Assuming the birds have fresh pasture, they shouldn't display symptoms of stress or sickness. Way back before we started this process, I expressed reluctance to confine my girls in any way (short of penning them in at night). But the manuals say that hens usually do just fine with this situation. Supposedly they have enough room to exercise, they can establish healthy pecking orders, and with regular rotation they have access to fresh greens, insects, and other fortifications. Supposedly.

This has not been the case for our birds. Though we have moved the tractors regularly and the girls aren't even full-grown yet, they have expressed serious stress, in the form of pecking each other to death. Each morning and night we'd find another dead bird. The girls would irritably peck out each others' tail feathers, and then peck at the exposed skin, and when a bird starts bleeding the rest of the flock go nuts at the sight of blood. Before we knew what was happening we'd lost five chickens.

We tried to isolate the injured birds, thereby reducing the number of chickens in each tractor, but it got to the point that half of the birds would need to be individually isolated, and no matter how few chickens were in each tractor, they attacked each other. We just weren't sure what to do. Obviously our chickens were unhappy. Obviously we were making some big mistakes with the tractors. Obviously they needed to free-range. But how could we make that happen? There is such a serious risk of predation here that half of our Delawares were killed in one night.

On Saturday morning Jeremy and I were discussing the situation, worriedly, while making breakfast. I told him that I'm simply exhausted by the chickens, hopeless about their situation, and wish we could just give them away to someone who can let them free-range. I said, "We're basically running a small-scale CAFO here. How did this happen?"

He said, "It's not quite that bad, is it?"

I said, "Well, this is why factory farms slice off chickens' beaks. We're observing it, right now, why they do that."

I turned back to the skillet then, and Jeremy went outside. When I looked out the window to see what he was doing, this is what I saw.

He had opened the tractor doors and the chickens were wandering freely. So I went outside, spatula in hand, and called out, "What are you doing?"

He looked up and shrugged. "What else can we do?"

I was in a panic, because we hadn't planned for this at all. Are chickens susceptible to electric fencing? Would they stay in the fenced area? No, and no. They stepped lightly through the fence wires and headed off in every direction. And as I watched them peck the earth happily, at ease for the first time since we brought them home, this is how I felt.

But I also thought, "Wow, chicken tending just became fun again."

Like I said, we hadn't planned for this. We hadn't planned for Tuna's predilection for chicken dinners (and breakfasts and lunches and midday snacks). We hadn't planned for predation, or getting them back home at night (we didn't know if they'd go back in their coop by themselves, being so young -- they did, by the way). But seeing my girls getting along, having the space to escape an altercation, establishing a truly healthy and normal pecking order, made me impossibly happy.

I spent the rest of the day grinning like an idiot, and saying over and over again, "This is the way to raise chickens. This is what we should be doing."

It wouldn't be right to say that I lost sight of this. I have always believed that chickens should range freely, but I was also committed to the tractor project, which is supposed to be the best of both worlds. I kept waiting for it to work out, and changing things to make it better, but this project just has not proven true for us. So for now our girls are running wild, and the boys, too.

And y'know? we're probably going to lose some birds, to hawks or coyotes or skunks or Tuna. But we're definitely going to lose most of our birds if they stay confined full-time in the tractors. They'll kill each other from stress and misery, which can't be better than being snatched from a green and verdant hillside.

There are still serious concerns that we need to address. But for now, I'm just happy that my girls are happy. This is how it should be done. Why did I ever think otherwise?

 

case study

Yesterday I noticed that a friend of mine wasn't looking too good. She usually looks extremely good, so I was curious. She said that she's become anemic and has a host of side effects from that condition. I've been anemic in the past, so I was sympathetic. We got to talking about our health histories, and when I started to think of the timeline, I realized that I've put myself through some shit, events that I find it easy to forget sometimes. Is this what we all endure, what we consider normal, in the course of a civilized life?

Age 0 - 15:
I was born healthy to addicted, alcoholic smokers. I had asthma throughout childhood, exacerbated by the fact that my parents smoked inside the house. I took corticosteroids and used inhalers on a regular basis, which my dad affectionately referred to as "speed." I began puberty extremely early, and every time I got sick it went straight to my lungs (typical for asthmatics), at which time I'd be prescribed antibiotics. In early adolescence I was diagnosed with depression, panic attacks, anemia, and irritable bowel syndrome, and medicated accordingly for all of the above.

Age 16 - 18:
I came down with a sinus infection that just wouldn't go away. I visited several physicians, all of whom prescribed antibiotics. The infection got worse and worse, until I realized that something seemed to be growing in my sinuses. I had no health insurance, so I ignored it. Plus, I was 16 years old. It just didn't seem that important.

Several months later I was driving my boyfriend's car when the person behind me crossed over the double yellow line and plowed into the driver's side door as I was turning left. I blacked out momentarily. The CT scan showed a minor brain bleed, and I needed chiropractic care for a year, but more interesting to the ER physician were the masses completely filling out my sinus cavities. I saw an ENT doctor, who diagnosed me with precancerous tumors. I needed surgery, but again: no insurance. So he slipped me free "samples" of corticosteroids (for swelling) and antibiotics (for infection) while I waited to be cleared for medical assistance. This took nearly a year, during which time my oxygen saturation level dropped dangerously low. I had no sense of smell or taste and could hardly breathe. I gained 80 pounds in a year from the drug combination.

Finally I received surgery, then another one, then the tumors spread, so I had another one. Then I went on drug treatment. At my peak I was taking seventeen different medications, including several allergy drugs, Xanax, Zoloft, birth control pills, broad-spectrum antibiotics, high doses of corticosteroids, opioid pain relievers, and Meridia, a weight loss drug prescribed to combat the weight gain from the other drugs I was taking, which was recently removed from the market due to its tendency to cause death.

Unsurprisingly, I landed in the hospital with a drug interaction. At that point there was a flurry of activity as my doctors worked to change my cocktail. But I'd had enough. I threw out all of my medications, plowed through the brutal withdrawal, and decided to take a different approach to my health, which mostly centered around a vegetarian diet and getting the hell out of Arizona.

Age 19 - 23:
I got pregnant three months after marrying Jeremy. The pregnancy was essentially normal, but I did not eat well at all, and the labor was complicated. I planned a homebirth but transported to the hospital after 60 hours of malpositioned labor. The drive to the hospital knocked Isaiah's head into place and he was born quickly after we arrived. At the hospital, I caught a resistant respiratory infection that lingered for two months. I had an organ prolapse, and enjoyed PTSD symptoms for over a year. I was diagnosed with fibromyalgia when Isaiah was six weeks old. 

I switched to a vegan diet after Isaiah was born and experienced a profound shift in my health. Most of the physical problems I had to that point disappeared. I lost 40 pounds effortlessly, my skin cleared up, my cycle normalized, I had tons of energy. As a result I became an insufferably annoying and self-righteous evangelist for the vegan cause. (Many apologies...)

I felt fantastic for a year, then became pregnant with Willow and reverted back to vegetarianism. I was horribly fatigued and nauseous throughout her pregnancy. She was born at home after 9 hours of labor and I bounced back from this pregnancy much easier. I adopted veganism again, but never managed to recapture the good health of the first year. On the contrary, I had begun a steady, relentless decline in health despite my hardest efforts to do everything right.

Age 24 - 27:
I tinkered with my diet and exercise program constantly, but I just didn't feel right. I was in college, majoring in holistic nutrition with an emphasis on plant-based diets, but my own plant-based diet was failing me. Gradually I realized that I'd become intolerant to gluten. I felt sick every time I ate. I gained back 20 of the 40 pounds I'd lost. My cycle became very short. I had incredible fatigue. My blood sugar was out of control. My joints and muscles ached. My recovery time between workouts was impossibly long.

So I had my blood and urine tested. I had no discernible vitamin D level, my cholesterol was too low, protein and fat utilization were nil, I was both hypo- and hyperglycemic, my numbers registering just under the limit for prediabetes. My doctor encouraged me to eat meat and back off the grain-based diet, and I was desperate enough to try. I felt better for a while, just eating fish, but not good enough. I started eating chicken, pork, and beef, daily, and that's when I saw real improvement.

Present day:
In the past two years, most of the health problems I've experienced throughout my life have improved. My skin is clear, my cycle is normal, I have a decent amount of energy. I'm never anemic, my digestion is healthy, my weight is stable, my hormones are normal. I no longer experience PTSD, depression, or clinical anxiety. I require no prescription drugs. I take very few supplements. I have perhaps one asthma attack per year.

Still, I am human, with an imperfect body and an imperfect understanding of my changing needs. Two issues have not budged. One is a blood sugar imbalance, and the other is a sleeping disorder. They may be connected, since hypoglycemia can cause spontaneous night wakening. I have identified dietary factors that contribute to my being hypo- or hyperglycemic, and they are all carbohydrate-based. My heart races when I eat rice, potatoes, and bread, regardless of whether those foods are "whole." Sugar, needless to say, is poison to me. When I eat meat, eggs, some dairy products, and vegetables, I can go hours without eating and suffer no ill effects, and my blood sugar doesn't rise abnormally after eating. So that's my focus for now.

Just as important is overall lifestyle. I cannot be inactive. I maintain a regular yoga practice, work my ass off on farm projects, and hike regularly. I commit myself to healthy relationships and dismiss those that are toxic. I express my emotions and look for opportunities to be creative. I keep my priorities straight. I try to avoid rigid ideologies or damaging self-concepts. I keep that window open, in all aspects of my life. I have a multidimensional understanding of health that views diet as just one point on the spectrum. So even when I'm sick, I think of myself as healthy.

But I have this history, and it's a curiosity to me, and an embarrassment. I'm only 28 years old and I've run my body through the wringer. Some of the things I've experienced have been out of my range of control. I didn't have a choice about what I ate as a kid, and very little say in my activity level. I didn't decide that my parents would be smokers. The car accident wasn't my fault. But for most of the rest of it, I had nobody to blame but myself.

I didn't have to take all those antibiotics. I could have researched the issue and realized with one quick Google search that antibiotics are useless for 98% of sinus infections. I turned over my will to another authority -- always a dangerous choice.

I didn't have to let that disease get as bad as it did. I ignored it for too long.

I didn't have to take all those drugs. There are many, many other ways of handling the conditions I suffered, that do not require the consumption of pharmaceuticals with serious side effects.

I didn't have to become vegan. More importantly, though, I didn't have to become so fanatically vegan that I ignored all the signs pointing to the diet failing me. And I didn't have to focus on diet to the exclusion of all other health parameters.

Similarly, I didn't have to become so ideologically pro-homebirth that transporting to the hospital for completely legitimate medical reasons resulted in a traumatic event. I have a nasty history of black & white thinking.

Above all, I didn't have to somatize the circumstances of my life into ill health. I do believe that's much of what I was doing. Sickness was the way I expressed the traumas I was too lazy or unconscious to confront. Being sick was one way I expressed how very tragic I felt. Pretty pathetic, if you ask me!

I can't say that I'm over it. When I get the flu I want to curl up in bed and be waited on hand and foot. That's my shameful reality. But in the rest of my life, I am goddamned bored with being sick. I can't spend any more time in bed, expressing my fucked-up history through joint pain and indigestion. I have to be conscious and present enough to certify that I'm not repeating that fucked-up experience for my own children. I have to be strong, and I have to believe that it's acceptable to be strong, that I don't have to apologize for it. I'm not there yet, but I've identified the need.

The situations I outlined above are receding for me. When I described some of this to my friend (I promise it was a seriously abbreviated conversation by comparison!), I felt like I was talking about another person. I felt like I was outlining a case study, a clinical trial, some sad sack who couldn't get her shit together. I felt angry at that person, because she wasted so much time, and so much life, feeling sorry for herself, when the answers for healing are so simple, it's possible to simply fall into the practice. But I felt conciliatory, too, because I know this story isn't over. I'm doing things right now that are wasteful and misguided and miserable.

This is not to say that I'm a hypochondriac, or that everything I experienced was a result of "creating my own reality" or a similar New Age concept. Many of the conditions I've experienced have concrete, definable causes -- and solutions. I don't believe in "blaming the victim," and I would never point to another person's ill health and say, "That's because you haven't dealt with your traumatic history." But in my case, I can trace the whole of these experiences to psychological deficiencies, as well as physical ones.

And I'm admitting this here because I know I'm not the only one with this sort of history. I am comfortable with the finality of death, but I believe in healing in the meanwhile, and I believe we heal through Truth, with a capital T. I don't have it all figured out, but this is some of mine.

What's yours?