Getting to “Peak Lee”

Before recent asides to indicate the future name of this blog – Stuff I Find Interesting (SIFI) – and to provide a necessary disclaimer, I had told the story of getting a celiac disease diagnosis at an anemic 225 pounds and becoming at least borderline obese at 260 pounds four years later.

Here’s how it happened.

In one sense, the explanation is that my gluten-free diet allowed the damage to the villi in my small intestine to be repaired, which meant I was now absorbing my nutrients.

That’s how I explained it to myself at the time anyway. While I had previously been able to eat anything and in any amount without appreciable weight gain, with newly repaired villi that was no longer the case.

I simply needed to adjust my portion sizes to this new reality. And I also tried to follow the advice in the USDA Food Guide Pyramid (which I had used as the basis for my SMUG Social Media Pyramid.

At its base was the recommendation of 6-11 servings per day from the Bread, Cereal, Rice & Pasta Group.

While I couldn’t have wheat, barley or rye because of celiac disease, I soon had plenty of other options, especially as food manufacturers became more accommodating of the gluten-free diet.

The next level up featured the Vegetable Group and the Fruit Group, with 3-4 servings per day each.

I’m not claiming to have been a model adherent to these guidelines. I’m sure my idea of a serving size didn’t correspond exactly to the USDA’s definition.

But I’m pretty confident the proportion of my diet coming from each of the food groups was reasonably close to the recommendations. I had done media relations work in the cardiology field, so I minimized eggs and drank low-fat (but not skim) milk to reduce my fat and cholesterol intake.

A typical day’s menu looked something like:

  • A bowl of cereal (typically Corn Chex) for breakfast
  • A grab-and-go chicken salad from a restaurant near my office, with a few favorite choices
  • Dinner (various entrees and side dishes)
  • At least a few nights a week, air-popped popcorn as a late-evening snack, with no butter.

Sometimes instead of popcorn I would have tortilla chips and salsa, taking one item from the grains and another from the vegetable group.

While I now know some of those choices weren’t the best, none were wildly out of line with USDA recommendations.

And yet, within less than four years, I found myself carrying around this much extra weight:

As I sometimes joked, I was “working on my ‘before’ pictures.”

In my next post I’ll show some of them.

Keeping the Lawyers Happy

Who am I kidding?

I don’t have any lawyers. I’m just a guy with a blog.

But still, I guess I should clarify what I’m doing here for legal purposes.

I’m not offering medical advice. No doctor-patient relationship is being created.

I’m not a doctor or a medical professional of any kind.

This blog’s purpose is for education. Mainly mine.

Just as I started it in 2006 to learn about blogging, and later shifted to learning in public how to use social media, I’m following the same model for the future.

I’m sharing some things I’ve found interesting, and a lot of them will relate to health, diet, fitness, longevity and disease prevention.

I’ll talk about the things I’ve decided to do based on what I’ve learned, and I’ll share the results I’ve gotten.

I’m not saying what you should do. You need to decide that, in consultation with your trusted health care professionals.

And if you read my posts and have questions, or have a different opinion, or can provide links to studies that cast doubt upon or support something I’m saying, I hope you’ll post them in the comments of the relevant posts.

We all have to make our own health decisions.

Hopefully together we can become more informed in them.

Cadaverous to Corpulent

In the Spring of 2008, I had some amazing things happening in my life, both personally and professionally:

  • I learned that our first grandchild (coming in August) was going to be a girl, and that her name would be Evelyn.
  • We were launching several of our early Mayo Clinic social media channels, including YouTube, Twitter and some blogs (News and Podcast) that have since been replaced by more robust offerings.
  • I was blogging like a crazy man, with 33 posts in April, 17 in May and 24 in June. This was peak SMUG, just after I had rebranded my blog.

But from a health perspective, I was at the start of some disturbing developments.

For several years, I had been giving blood every 10 weeks (or whatever the required waiting period was at that time.) When I went to the Mayo Clinic Blood Donor Center to give my unit of A+ blood (only the best!), the helpful staff would always help me preschedule the next donation.

But in the Summer of 2008, I began to notice that my pre-donation hemoglobin test, which started with a reading of something like 16, was declining a little each time.

I didn’t think much of it when it was 15, and then 14-something, but then it got to 13…and finally, in January 2009, to 12.4.

The magic of that number and why it’s memorable to me is that 12.5 is the minimum level required to donate.

I was officially anemic. They wouldn’t accept my blood.

I thought I should see if there was some underlying problem. Lisa also said she thought I wasn’t looking healthy.

I was at about 225 lbs. and playing pick-up basketball, and so I had attributed my reasonable weight (at 6’6″) as due to getting lots of exercise.

Lisa thought I was gaunt – skinny in a not-healthy way. Haggard. Cadaverous might be overstating, but it made an alliterative headline. And when you look at all of the synonyms, one of them is anemic:

So I went to my doctor, a high school classmate and great friend, Dr. David Strobel, and he started by looking for the most common causes of anemia for someone my age: namely, unexplained blood loss.

Thankfully, I didn’t have colon cancer or a bleeding ulcer. On March 13, 2009, he diagnosed celiac disease.

I recently wrote a post on the Mayo Clinic Social Media Network site about that celiac disease journey that highlights how social media helped me to cope: to learn about gluten free eating and where to find gluten-free restaurants.

The story I didn’t tell in that post was what gluten-free eating to manage my celiac disease did to my weight.

Because I have celiac disease, eating gluten had caused my immune system to attack and severely damage the villi in my small intestine, which made it hard for my body to absorb nutrients.

I was anemic because I wasn’t absorbing iron. I was gaunt because I wasn’t absorbing other nutrients well either, even though I was eating a lot.

The good news is most people with celiac disease have their villi restored when they eat a strictly gluten free diet, and that was true for me as well.

My iron and ferritin (a measure of stored iron) levels gradually increased.

So did my weight, and not necessarily in a good way. I was eating as I always had, but now I was absorbing all of those nutrients.

By March of 2013, my medical chart says I weighed 117.7 kg, which translates to 259.48 lbs. Two years later I was 117 kg – staying below the dreaded 260 lbs. mark, but just barely. In February 2016 the charts say 117.9 kg.

That’s also when I did the #ScopeScope.

My chart says my blood pressure in the pre-colonoscopy physical was 155/94, but later that year I was “only” 139/92.

The highest I remember reaching when I would weigh before workouts at the local YMCA was 265. But here’s the highest photographic evidence I have, from May 21, 2016:

So my Body Mass Index (BMI) on that date was 30.3.

I was officially classified as obese.

I understand the limitations of BMI, and I never had a doctor tell me I was obese.

But going from haggard to hefty – to the tune of 40 extra pounds – between 2009 and 2013, and then spending four years within five pounds either side of 260, and with borderline or high blood pressure, was not a healthy development.

In my next post I’ll tell why this was so frustrating for me.

Follow along on TwitterLinkedIn or Facebook.

Diabetes is Devastating

As my blog starts its new direction, I had planned on beginning in my next few posts with some background on my health exploration journey, but a news release about a study from Mayo Clinic that came into my inbox yesterday caused me to revise my plan.

The study in the Rochester, Minn. area identified 116 patients with diabetes and 232 who didn’t have diabetes, but otherwise were matched for heart failure risk factors like age, hypertension, sex, coronary artery disease and diastolic dysfunction.

Following both groups for 10 years, researchers found that 21% of the patients with diabetes developed heart failure, while just 12% of the patients without diabetes did.

So while we’ve long known that diabetes is associated with a host of health problems, here’s fresh evidence of another: almost doubling the risk of heart failure, although in this study it didn’t increase mortality.

Still, this new study adds to what already was a grim prognosis, both for individuals with diabetes and for society as a whole. As this paper in the journal Population Health Management put it:

Diabetes and its complications, deaths, and societal costs have a huge and rapidly growing impact on the United States. Between 1990 and 2010 the number of people living with diabetes tripled and the number of new cases annually (incidence) doubled. Adults with diabetes have a 50% higher risk of death from any cause than adults without diabetes, in addition to risk for myriad complications. Reducing this burden will require efforts on many fronts—from appropriate medical care to significant public health efforts and individual behavior change across the nation, through state- and community-specific efforts.

That same paper suggests that in the next decade

  • the total number of Americans with diabetes will increase from 43 million to nearly 55 million,
  • that annual diabetes-related deaths will increase by more than 55,000 and
  • annual diabetes medical costs will go up almost $100 billion.

It all means that preventing (or even reversing) type 2 diabetes is probably the most important thing we can do.

But the statistics are clear: what we’ve been doing as a society for the last 30 years hasn’t been working.

What I’ve been learning and experiencing over the last three years through personal investigation and application suggests that we have more ability to influence this trajectory than we might think.

I’ve read about thousands of patients with prediabetes or type 2 diabetes getting their Hemoglobin A1c levels down to the point where (under medical supervision, of course) they have been able to discontinue taking insulin or diabetes medications, and are no longer considered even prediabetic.

I know some people are skeptical that type 2 diabetes can be reversed, but given the scope of the problem it sure seems worth exploring.

If type 2 diabetes is three times as prevalent as it was a generation ago, this can’t be a genetic problem. Our genes don’t change that fast.

Since changes in our environment and behavior are likely responsible for the epidemic, shouldn’t we look at reversing those changes as much as we can, at least in our personal lives, where we have the most control?

I was never diagnosed as prediabetic, but I’ve made some significant changes and have seen lots of benefits in my own health. I couldn’t have made them all at once, but I evolved them over time.

Type 2 diabetes isn’t the only disease that seems to have potential for lifestyle prevention or reversal. Some of the same interventions seem to work in other diseases, too – mainly because diabetes, as we see in this Mayo Clinic study, is a risk factor for a host of other ailments.

Curious? Follow along on Twitter, LinkedIn or Facebook and I’ll tell you how it happened.

Turning Back the Clock

There’s something about being 39 that causes people to take stock and try to reclaim the physical abilities they had in their youth. I was no different. When I was six months from my fortieth, I decided to start running and training to take off the 20 or so pounds that had crept on over the years. My goal was to dunk a basketball again…something I hadn’t done since I was 19 or 20.

Starting slowly (and a month before the New Year’s crunch, when the gym gets a lot more crowded), I gradually increased my training on the elliptical machine (low impact was good) and started a weight training program too. By March I was touching the rim again, and I continued to make progress, but couldn’t make the dunk.

Finally, the big day arrived: May 15, 2003. I had taken the day off from work, and went to the local Y to play in a pick-up game. Having played reasonably well, I thought, “Why not give it a try?” To my utter amazement, being really warmed up and having stretched, I slammed it down.

I quickly called my wife, Lisa, and asked her to get down to the Y with our videocamera, to document this for posterity. I’m no Michael Jordan (although we are the same age), but here’s the proof that I made it.

By the way, immediately after reaching this pinnacle I joined the gang you see in the background in another pick-up game…and within 15 minutes had broken my left index finger (my first fracture!) That took me out of training for several weeks, and it’s been downhill since.

This summer has been a good training time too, although now because of life events it’s been a week since I’ve gone running. Making time for training needs to be a priority.