Saturday, February 23, 2008


I've been sitting here all afternoon just paralyzed with worry. After swearing that we were not going to fret about all this for a couple of weeks, well... let's just say, the resolution didn't make it through to 24 hours.

The fact of the matter is this. Michael really hasn't felt anything like consistently well since, maybe October. He is fatigued and achy all the time. He never has any kind of energy, and the level of general achiness and pain that he's experiencing verge on the intolerable. This is not getting better, although the last few days, when he ate considerably more protein, he was feeling a lot better. He did not eat a lot yesterday. And today, he's so tired that he had to go back to bed, where he's been for the last hour or so.

I feel really alone with this. I'm going to make a doctor's appointment for a couple of weeks from now... probably the soonest that he can get in anyway, but certainly the only time that my teaching schedule will coincide with the doctor's schedule. But I doubt that this is going to result in anything positive. The only thing that happens is that he harps on about cholesterol levels, and since he's never mentioned the words low carb diet to us, I don't think he's going to be supportive about that, either. He's a great guy; I like him a lot, but the fact of the matter is that I don't think that he's treating the real problems.

So where on earth can I get some help? The trouble is, morbity obesity is the worst-treated problem in this country. There are lots of people in Michael's size group, and the only information that you can get on the internet is advice on bariatric surgery (I'm not against this; it's a lifesaver for so many people, but I don't want to pursue that if we can help it). There have to be treatments other than surgery; there have to be common problems of people at this size; there have to be therapies that help with mobility issues... and so on, just the sort of common information that you'd get if you look up... well, about anything really. But all you see is advice to have surgery or advice to lose weight... and, well, duh! I mean, it's not like we're not trying like hell. It's not like we haven't been trying like hell. For years now.

So, just for the hell of it, because I do better when I write this stuff out, let's consider the options.
  1. The achiness and fatigue is psychological. This actually could be plausible, for a lot of depression-history related reasons that I don't want to detail here at the moment anyway. It could be that these things are not all that different than they were, say, a year ago, but he's so much more aware of them that it's incapacitating him. This story has a lot going for it, but on the other hand, it doesn't explain why on earth someone who weighs 520 lbs. and eats 1800-2400 calories and about 30 carbs/day is not losing weight.
  2. The fatigue is a result of long-term protein deprivation. Slightly plausible. Why? Well, some say that one reason why you can have period of no loss on a low carb diet is because your body is basically sucking up protein to replace lost lean body mass, and so you're losing fat but not losing weight. This hypothesis has a few things going for it... for one, it would also explain why I'm not losing weight but yet I feel thinner. It would explain feeling better the last few days and then worse after yesterday, when he really didn't eat much protein. It would not explain the achiness, but that could be a result of general lack of movement. But isn't there some limit to this? Maybe not... and who knows what the protein requirement for that weight is? The Eades' books only go up to 450... and those are minimum requirements. It's a lot of weight to carry around. Certainly I know that my fatigue level has been dramatically reduced since we started eating low carb and more protein... but I weigh considerably less, and we eat about the same stuff every day.
  3. Something is wrong with the way we eat. Well, ok, but what? We eat very little processed food. We take a ton of supplements. The numbers look ok. We drink a lot of water.
  4. There's something else wrong. Thyroid (ok, but thyroid problems are not so common in men, and his last thyroid test showed more like overactivity than inactivity). Something else endocrine (what?). Insulin issues that aren't showing up in his blood sugar readings (like what?). Something relating to the irregular heartbeat (like what?).
  5. We're just eating too much.
  6. We're just eating too little.
  7. We were in a serious auto accident last May. This caused some kind of problem that no one picked up at the time (like what, and why didn't it show up earlier, and why would that have this kind of weight impact?).
  8. Sleep. Ok, this one is a bit more plausible, too. He doesn't sleep well. Lately, he's been waking up to pee in the middle of the night very frequently... like four or five times a night. His back hurts and then he gets up and sleeps upright on the couch, which is not what I'd call restful sleep. He doesn't sleep deeply. This has been going on for some time... he gets maybe a night or two of good sleep and then a lot of bad sleep. Certainly plausible that this would have something to do with fatigue, if not necessarily the rest of it. Weight gain is associated with sleep apnea... although he doesn't have the conventional signs of that, snoring and stopping breathing, that kind of thing.
I don't know. And I seriously have no idea what to do next except wait and see.


Carol said...

Hi Nina,

I'm back online after having no Internet, phone or cable TV since Thursday morning! It took my cable company 3 days of waiting...they said they would put me on standby, which meant I could not leave the house for fear they would show up! When they finally did show up, it turned out that someone had stolen wiring out of the box...took them 10 minutes to fix it.

I've read your posts and feel bad for you guys! I don't know if it matters, but I do care and wish I had an answer for you.

I have some comments I'd like to post but must take my grandson to work now and then do some grocery shopping. Will be back online later.

Hang in there!


Carol said...

Hi Nina,

Back again...with some more thoughts about this post.

* You mentioned Michael's achiness and fatigue being possibly psychological. I have read that some people who eat low carb do suffer depression from low seratonin, which we get from eating starchy foods. Here's a link to a short article about it:

I didn't search for more but there might be others.

The other thing I thought of is SAD -- Seasonal Affective Disorder -- which I'm sure you know much more about than I do! You did mention today that you finally got above freezing and had some sun. I know that when I lived in Tennessee one winter (1985), I just about went nuts with the constant gray days and lack of sun! I have lived in Tucson most of my life and don't know how you guys who live where there is actual winter do it!

Perhaps Michael has a combination of SAD and low seratonin? And the fact that you both are doing what you believe is right and not seeing any results on the scale must in itself be very depressing!

* You mentioned the long-term protein deprivation and that you guys could be building muscle as you lose fat so it doesn't show up on the scale. There is a lot to this hypothesis, I think. I know I went through periods when no weight loss showed on the scale, but my clothes definitely got looser. That's why it is suggested to take measurements before starting to eat low carb, since that will show better if you're losing fat and building muscle...if the inches are slowly melting away even though no weight loss is showing on the scale.

* For this one about wondering what you could be doing wrong, I still believe that you guys need to eat more calories and MUCH more fat!

* Something else wrong? Something occurred to me...and this is a real long shot!

I have celiac disease, but I never knew anything about it for many years, although I did go though frequent bouts of IBS and colitis when I was a young adult. About 10 years ago, when I decided to put my foster son on a gluten-free diet (because he is also autistic and I'd read online that sometimes improvement is seen in autistic behaviors with a gluten-free diet), I decided to go on the diet with him. Mainly because there were 4 of us then -- 2 of my grandsons I've raised, and Sean and me -- and I did not want Sean to feel deprived since he wouldn't be eating the same as the other boys. I kind of made it a game that he and I would eat a certain way and the other 2 boys would eat differently. I didn't expect that, within a couple of weeks, I would realize my constant achiness was gone! My joints were not back was not GERD went away...and I was sleeping so much better! To test it, I ate some pizza and found my knees to almost instantly swell up and get so sore they almost didn't support me. My hands swelled, too, and I got gassy and the GERD came back! Every time I ate something made with wheat, that would happen. I talked to my doctor and she is very knowledgeable about celiac and so I was diagnosed.

About 2 years ago, I went to Canada to visit my mom and some brothers and sisters who live up there that I rarely see and don't keep in close contact with. (We are not Canadian, but one brother married a Canadian girl and emigrated to Canada. After dad died, Mom was left with 6 kids still at home -- I'm the oldest of 14. She traveled to visit my brother and never came back...four of my siblings still live there, too.)

Anyway, I discovered that my one brother was diagnosed with severe celiac disease, after he got down to less than 125 pounds and they could not figure out why...the docs thought he had cancer...he turned out to be celiac. Once he started eating gluten-free, he gained weight back and is healthy again.

A sister up there did not lose fact, gained it...but she started having extreme fatigue and muscle pain. She was diagnosed with fibromyalgia. Her doctor told her that, in his experience, fibromyalgia is related to celiac disease. She started eating gluten-free and most of her fatigue and pain went away within weeks. She said she sometimes eats off the diet and is always sorry, because she goes right back to the fatigue and pain.

So, what does this have to do with Michael?? Well, is it possible that he could have an intolerance to gluten?? The claim is that 1 in 133 people have some form of gluten intolerance.

Earlier today, I went to to look at the Whey Gourmet. I read all labels closely before ever buying anything...and was I surprised to see that Whey Gourment is made with a number of things besides just whey...and one of those things is WHEAT! I would not be able to drink the stuff, no matter how yummy, because I could not tolerate the wheat.

Is it possible that Michael is actually making himself sick -- definitely unknowingly -- by drinking the yummy stuff that contains wheat?? You've also mentioned gravy several times in your posts. Is that made with wheat, too? And some low-carb bread... Could he possibly have a wheat intolerance??

I know this may be a bit far-fetched for you...but for me and others in my family, it would be a VERY real possibility. Maybe you could do an experiment and totally cut out all wheat, including those yummy Whey Gourmet shakes, for a couple of weeks and see what happens?? I think that would be a pretty good test.

There are other whey protein powders available through netrition. Elite Whey Protein comes in a few different flavors and has 23 grams of protein and only 1.5 to 2.5 grams of carb per scoop, but only comes in 5# cans.. Whey Protein Precision Isolate has 24 grams of protein, less than 2 grams of carbs, and comes in 2# cans. Both have some satisfied customers. There are others, too, and I'll bet you could fix any of them up with your yogurt and DaVinci syrups.

* The getting up at night several times to pee can be a sign of of the first that showed up for me when I was diagnosed with type 2. Type 2 diabetes will also make it very difficult to lose weight.

I don't know if any of this has helped you or given you things to think about and check out. Best wishes to both of you as you figure this out!

Nina said...

There's got to be a better way to comment on comments; I've seen other people do it, and I have to figure it out! For now, though... I think you're onto something with the wheat thing but I'm going to try to hit a few of the other things in order.

*Depression: I do think that the weather and darkness are a factor, and possibly the carbs, too (the weather is absolutely a factor for me), but Michael has a long history of depression and related things, so this part isn't a surprise. But it's so hard with something like this to have any idea what bit of it might be psychological and what part is a physical thing. There's just no way to know for sure... which is what drives me crazy about all of these things.

* Protein... we did take measurements back a while ago, but it's hard to measure him very accurately. I'm going to try again in a month. He looks thinner to me... but that could be hopefulness as much as anything else. I also pulled out my bodyfat scale, which I haven't used in a while... meaningless unless you weigh yourself with it for quite a while, but it's another thing to look at anyway.

*I don't think that the wheat thing is a longshot at all (oh, by the way, he is a Type 2 diabetic). I've LONG though that he was wheat (or more accurately, gluten) intolerant to some degree or another, but I'd kind of forgotten about that in with everything else. A whole lot of the symptoms of gluten intolerance are a lot like what he experiences... and he does feel bloated a lot of the time, and I'd say more since we started drinking the protein shakes. Stupidly, it just never occurred to me to check for wheat when I was checking for everything else in the universe on that label. (If this turns out to be the culprit, I'm just going to be beyond irritated; I just went through a whole lot of annoyance to find some other flavors of the stuff plus ordered a lot of low-carb bread. Sigh!) Anyway... in the interests of trying to eliminate one thing at a time, we're cutting out eggs for a few days, and by then I should be able to get some other protein shake, and we can test the wheat idea. We eat hardly any bread anyway, a slice in the morning usually, and I make things like gravy with about a half teaspoon of flour and the rest xanthan gum.