Month: May 2020

Don’t Judge a Book by Its Cover: Ms Lab Rat’s Review of Ketotarian: The (Mostly) Plant-Based Plan to Burn Fat, Boost Your Energy, Crush Your Cravings, and Calm Inflammation

On Friday night, Dawn Elise posted a book recommendation on the Ms Lab Rat comment page. Because I like that gentle reader’s taste in authors, I immediately downloaded her recommendation on my Kindle without getting worked up about the title or giving any attention to the cover photo. If I had so much as glimpsed at the image of the egg centered on the book’s cover, I might have passed over Ketotarian. I am allergic to eggs, and I have not had all that much luck with Keto. What could be in it for me?

I found the narrative voice of the first pages so compelling that I read straight through to the recipe section. No regrets. Who cares if you are up half the night and must sleep in ’til 9 am? I’ll give myself a pass; we’re in Covid-19 Quarantine.


What I like most about this book is that its mission is not to proselytize, but to inform and entertain. Cole is honest about the convolutions of his personal food journey. Through his struggles he has gained the wisdom to refrain from pressuring his reader to follow him in lockstep. For example, he provides Instant Pot recipes, but doesn’t urge you to go out and buy an Instant Pot, or worse, to buy a particular model of Instant Pot (a habit of certain medical professionals-slash-food celebrities that I, for one, find galling.)


Cole covers an impressive span of topics; the index alone makes for fascinating reading. These are 38 entries under H: from hair dyes (47) to hypothalamic-pituitary-thyroid (HPT) axis (134). And while we are on the subject of thyroids, let’s go to page 134. For there I discovered a confirmation of why Keto dieting hasn’t worked for me: “…some people with thyroid problems don’t do very well with fasting, making intermittent fasting a case-by-case tool for people with thyroid issues.”

Cole explains, “The queen of all hormones impacts every single cell of your awesomely designed body. If your thyroid isn’t working well, nothing is. The crazy thing about thyroid hormone problems is that there are many different reasons for them…There are autoimmune thyroid problems like Hashimoto’s disease, thyroid conversion issues like low T3 syndrome; thyroid resistance, which is similar to insulin resistance; and thyroid problems that are secondary to brain-thyroid axis dysfunction.”

I have known I have hypothyroid for thirty years. But have any of my conventional medical practitioners told me I have Hashimoto’s? No. I’m not sure they knew, themselves. I had to go to a doctor who practices functional medicine to find out.

Cole makes a convincing case that western medical schools have dropped the ball on educating doctors about nutrition. “Expecting health guidance from mainstream medicine is akin to getting gardening advice from a mechanic. You can’t expect someone who wasn’t properly trained in a field to give sound advice. Brilliant physicians in the mainstream model of care are trained to diagnose a disease and match it with a corresponding pharmaceutical drug. This medicinal matching game works sometimes, but often it leaves the patient with nothing but a growing prescription list and growing health problems.”

I’m really grateful to Cole for giving me such an in-depth research fueled assessment of the diet he’s had the most success with personally, and for giving me a pass if I don’t think it will work for me. I haven’t had a chance yet to try any of the recipes, but I’ll be sure to update on my Goodreads Page
when I do.

Big News

I just got a call from Dr. A, the neurologist who follows me when I participate in clinical trials at the NIH. She is always a delightful conversationalist. This time, topics ranged from the music of poet Joy Harjo to the mindfulness meditation of Dan Harris to the benefits of exercise. She asked about my Covid-19 quarantine routine, which includes yoga, pilates, qigong, breath work, short walks—and cold showers. Dr. A is one of the toughest ladies I know. But even she didn’t warm to the notion of a cold shower. Instead, she deftly switched topics to the motive for her call — would I be interested in participating in a new NIH study on the effects of diet on MS?


Would I? Of course I would.


As long term readers of this blog already know, this diet study would not be my first rodeo. I had participated in a trial conducted by Dr. Wahls which compares the efficacy of her eponymous diet to that of The Swank Diet. If you have a grain of common sense, you will not be shocked to learn that I found her study to be biased. I joined it in good faith, expressed a willingness to be assigned to either diet, and pressed on when I was assigned the less desirable Swank Diet. I kept scrupulous record of every food I ate, down to the last teaspoon. The low fat Swank Diet may have helped many people with MS, but it didn’t help me. On the last day of the study, I broke my fast with an avocado. Yum! Fat! I’ve been back to eating fats—healthy fats—ever since.


As soon I had control of my own diet back, I switched to the Wahls Diet I’d been waiting for—and I found the recipes lacking. This was a few years ago; I know Dr. Wahls has been tinkering with her diet every day since then. At the time I felt like her focus was entirely on feeding the brain, and not on delighting the palate. I despaired of convincing my family to adopt the diet along with me. While gripped with anxiety about facing a lifetime of stoic meals, I stumbled on this happy website, which is run by two unpretentious women with five autoimmune diseases between them. They call their diet the AutoImmune Protocol (AIP), and that’s the diet my husband and I have merrily adopted. I asked Dr. A if I could remain on AIP throughout the study. She asked a few questions about it to determine if it could fit within the framework of the diet the NIH would want me to adopt. At this point, she thinks it could work. I’m certainly not willing to go back to a SAD Diet (Standard American Diet) to provide a before and after. I have learned my lesson and will never again martyr my diet for science. I will, however, happily chart my progress teaspoon by the teaspoon, if it will help others make well informed decisions about changes they can implement to optimize their immune system.


Diet should never be about cults of personality. An impartial government study of diet and immunity will be beneficial to all of us with multiple sclerosis, whether our current diet is Swank, Wahls, or the sweet, generic-brand AIP. A diet study came out earlier this month which shows AIP can change gene expression. That’s big news—proof that diagnosis isn’t destiny.

This new NIH diet study is not yet official; it is still just a twinkle in a researcher’s eye. It won’t happen if our researchers can’t find NIH study participants willing to document our food intake (tedious) and swab at least one poop sample (odious). But if I know my NIH researchers, and my fellow lab rats, we will be up for the challenge.


In my experience so far, diet adjustments can be arduous and imprecise and emotional and sadly not entirely curative. I see them as necessary, but not sufficient. A new diet study, if done well, can help all of us struggling through autoimmune disease to direct our efforts toward our best possible outcome, whatever that might be.

Gentle Reader, may you be happy. Stay well!

Home

Glimpses of Gratitude, Covid-19 Style

The other day, I rolled out of bed pretty late, because I just couldn’t stop listening to Sugar Calling, the new Cheryl Strayed podcast. I heard a common thread running through Cheryl’s conversations with Alice Walker, “Whatever We Have, We Have to Work With It,” Judy Blume, “A Terrible Thing Is Happening, but the World Goes On,” and Pico Iyer, “Joyful Participation in a World of Sorrows.” When I finally meandered downstairs to make my ugly happy smoothie (cooked beet, coconut milk, ginger, five spice, spinach, and a few drops of rosewater) my husband presented me with a hand-addressed envelope out of our pile of stalemail—mail that had been untouched for 24 hours since our postal worker dropped it in the slot.
I opened a gorgeous card with a Japanese aesthetic; a collage created with scraps of handmade paper by our friend, the artist Tricia Bath. She’d incorporated a 13th Century quote from Rumi, one that resonated with the thoughts of the contemporary writers I’d heard on the podcast that morning, “Be grateful for all you receive, good and bad alike, for it may be a gift.”
Gentle Reader, I don’t blame you if you roll your eyes over another Rumi quote. Stay with me. All of us have lost something while living through this pandemic. You may assume that if I’m still blithely quoting Rumi, I haven’t yet lost enough. So far, Covid-19 has been less of a challenge for me than it has for those people who have lost their jobs, their loved ones, or their health—or for those people who have kept their jobs, and have had to take on the additional jobs previously performed by their nannies, their children’s teachers, their parent’s caregivers.
Unlike many, I am not overburdened. I am not lonely. I am not grieving. I am not bored. I am not deprived of touch or deprived of keeping in touch—I still have telephone service and wi-fi. All of this is to say, Covid-19 is a catastrophe on a grand scale, and it would be irresponsible for me, the most peripheral of its victims, to dismiss it with a platitude of gratitude.
Except.
Gratitude is not a platitude. Whenever we feel lost, gratitude is our road home.

My father’s roadside signs in Wallingford, CT

When my mom texted our far-flung family with pictures of homemade sign my father had created and posted by the side of their road, the challenge was on. The front of my house is premium real estate for thank you signs. Workers drive by on their way to the VA, Children’s Hospital, and university hospital.

I’d wanted to make signs that look uplifting, but I have crappy eye hand coordination and no visual aptitude; the best I could do was make signs that look kind of Gothic and creepy and desperate. I’m sorry about that.

Without exception, every day I encounter a gift someone has made in response to this Covid-19 catastrophe. If nothing else, I receive the gift of my husband’s delicious cooking, all made within the confines of my many allergies and sensitivities (no dairy, wheat, gluten, nightshades, egg, peanut, walnut, strawberry, mango…etc.)

On my worst Covid-19 day so far, the day of my comeuppance, I came back home laden with guilt and shame, only to be presented with a stalemail package that was unusually light; a gift from my friend, the singer, actress, and writer Barb Timmons. When I opened the package, I discovered this lovely note and origami figure.

Is it a coincidence that both of the stalemail gifts I am mentioning owe a debt to Japanese design? I think not. Mainstream white America has defined itself more by avarice than by adversity, making us less aware of the beauty, power and dignity we all do in fact possess in times of oppression and catastrophe.

I know very little of Japanese culture, but one day, when I had a few hours to spare between appointments at the NIH, I took the opportunity to visit an exhibit at the Smithsonian titled, “The Art of Gaman.” Gaman means “to bear the seemingly unbearable with patience and dignity.” The exhibit featured arts and crafts created by the internees in the Japanese American concentration camps during World War II. These objects were made by average citizens without any trained artistic skills. They were dazzling. They gave me the strength to persevere through whatever challenges awaited me back at the NIH that day.

We are not weakened by catastrophe. We are strengthened. Maybe not right away, but eventually. Gentle Reader, today is Mother’s Day. If you have not received a gift today, indulge yourself by giving one.

I am grateful for your time. Be well.

Covid-19 Comeuppance

A true friend in the Time of Covid-19 is the friend who keeps track of your Day 14’s. The friend who texts at 9:01 am to ask, “Is this the anniversary? Is everything OK?” 

Today was a Day 14 for me…y’all know what I’m mean about a Day 14? It’s the 14th day after an event that didn’t used to have the potential to kill you, but does now. Highlights from my Day 14 Calendar include March 5 (14 days after a party conversation with someone returning from Covid-struck Italy), March 17 (14 days after an unwanted kiss from a nursing home denizen), and March 20 (14 days after exposure to a medical receptionist bronzed from her recent cruise.) 

Gentle Reader, you may have noticed all my aforementioned Day 14’s took place in March; I was very much an early adopter to the whole stay-at-home physical distancing thing. Up until now, my blog could be read as a great big Covid-19 Told ‘Ya So!

That would be a false impression. 

Two weeks ago, I had a painful comeuppance. I’d been congratulating myself on making what can only be considered a drastic lifestyle change; I’d gone from visiting some form of medical facility on an average of 3.5 times per week to preparing to stay the heck away from physicians and hospitals for the foreseeable future. 

I had downloaded my telemedicine app, accumulated the maximum refills on all my prescriptions, ditched the MS medication that was compromising my immunity, ditched the daily catheterizations that were leading to relentless UTIs. I was so done with being a part-time patient. So what if I had three auto-immune diseases? I’d been learning to cope with disease through a magical combination of an autoimmune diet, yoga, qi gong, and tai chi. I was ready to go physician-free! 

It did not occur to me that I was continuing to engage in a reckless practice that had, in the last six months, landed me once in the optician’s office and once in the ER.

You know the saying: fool me once, shame on you, fool me twice, shame on me? There is no saying for fool me three times, because the thrice-fooled are dead fools. Except, apparently, fools like me.

On the morning of April 16, I was feeling Covid-19 savvy for actually opening a new set of daily contact lenses instead of reusing the ones I’d worn the day before. The last time I’d seen my optician, she’d insisted that daily lenses weren’t made of the same material as the little slips of plastic that used to last me over a year. She’d commiserated with me about all the darn packaging waste, but promised that if I returned the spent packaging to her office, her office would forward it to the manufacturer, which claimed to have an environmentally sensitive plan for re-use. I dropped what would be my last two empty contact lens cases into the cloth storage bag within my bedside dresser, and proceeded to go about my day. I didn’t get very far before the inciting incident occurred. I was back in the bathroom, about to brush my teeth, when my husband called out something funny from his study; I laughed, then rubbed my eye. Like you are not supposed to do during Covid-19, and this is yet another reason why—out popped one very jagged half of the daily contact lens I had recently inserted. 

I poked around for the other half. Washed my hands. Poked around some more. Washed some more. Squirted contact lens solution. Rolled my eyes in front of the mirror. Rolled my eyes in front of my “eye-phone”—taking the most grotesque selfies imaginable. I called a nurse for any tips. The nurse’s tip: stay away from the optician. Stay away from the ER. Covid-19 likes to travel on the eyes. I called my primary care physician. She advised me to recruit my husband’s help. 

My husband is an upright guy. The man would chew glass for me. And I tell you…he’d probably prefer to chew glass than to mess around with searching for a contact lens shard in my eye. It was just too—nasty. Nonetheless, he stoically entered a ghastly new discovery phase in our marriage as he positioned himself above my head and squirted a continuous stream of contact lens fluid into my eye. To no avail. Our romantic New Year’s Eve agreement had been that we stay away from the ER in 2020. And now this man was suggesting we go to the ER. I decided to give it another round on my own. 

By 3pm, I’d had enough. My eyeball felt ragged. I hated letting down my primary care doctor, and my nurse. I hated endangering my husband. I hated endangering myself. But if this contact lens shard wasn’t showing up, an eye infection would be on the way. I countered my husband’s offer to drive me to the ER with a proposal that he drive me to our local optician. He liked that idea much better. It would be safer and cheaper. There. I’d managed to make one good decision to partially redeem my irredeemable self.  When I called the optician’s office, I recognized the voice on the other end as a technician I rather liked. Suddenly I no longer felt as though I were entering a realm of certain death, because I didn’t want to imagine that likeable guy as being in danger. 

My husband got me to the building five minutes after I got off the call. The technician was standing at the door, wearing a mask and gloves. It was strange to walk into an empty waiting room. I was the only patient in the building. In less than five minutes, the doctor was able to extract the shard that had eluded me for hours. The darn thing had been tucked underneath my eye at approximately the 7pm position. The doctor recommended I stop using contact lenses for the duration of Covid-19. The experience was sufficiently traumatic, so I’m taking his advice. 

My new Covid-19 look is a mask…and fogged up glasses. 

Stay well, Gentle Reader. May you and your loved ones keep your Covid-19 Calendars clear!