Juked by Medicine

This still moment on the verge of spring equinox, industrial civilization is taking a rest from its travails of finance and economy. The creaking and groaning vehicle of world banking lurches forward with its latest patch, the Greek fix, but the explosive resignation last week of a Goldman Sachs executive director Greg Smith, posted as an op-ed essay in no less than the New York Times, afforded a glimpse into the dark place where American values crawled off to die, like turning over a rock in a meadow to find the white slithering things that dwell there, and asserting a broad and anguished truth at the heart of our culture: all is swindle.

      In the still moment, the nation is digesting this discovery, and I think it will represent a turning point in the arduous plotline of the crime story that banking has become. It's also the moment of reawakening for the Occupy movement as it now struggles with what it is to become. I doubt that it can avoid turning angrily and maybe viciously political as it focuses its energies on occupying this summer's looming political conventions.

     But in this still moment I want to take a break from purely public issues for a second week and discuss some personal things: nutrition and medicine. I hope it will be of interest to some of you. Last week, after a four year misadventure on an ultra low-fat vegan diet (no meat, no cheese, no eggs), I turned around 180 degrees and resumed eating all those verboten things again. I had been feeling shitty for a long time, in particular with muscle pain, muscle weakness, penetrating fatigue, and some weird neurological symptoms and I decided to take drastic measures.

    This personal misadventure started about four and half years ago when my doctor read me the riot act on my cholesterol numbers. The total was around 290. I forget exactly what the LDL ("bad" cholesterol) was, but it wasn't good, and ditto the HDL ("good" cholesterol) and the triglycerides (oy vay). The upshot was that my doctor put me on a whopping dose of the most powerful statin drug, Crestor 40mg (made by AstraZenica). I left his office feeling like my identity was transformed from a healthy normal person to a prisoner on death row. 

     I thought I had been leading a healthy life. Being self-employed, and master of my own schedule, I was able to work in a lot of exercise. For twenty-five years I was a runner. A hip replacement put an end to that. During that same period, I also swam a mile a day in the local YMCA lap pool. After hip surgery, I walked daily instead of running, kept swimming, and also did at least four weekly sessions in the weight room (including the cardio machines such as the elliptical trainer, easy on the joints). During the temperate months, I also biked many days of the week. Because I got so much exercise, I thought I could eat anything I wanted to, and did. I was a capable cook, having worked in many restaurant jobs during my starving bohemian years, and I could competently put together everything from a butterflied leg of lamb to a flourless chocolate cake.

    After receiving my "death sentence" from the doc, I went straight to the cardio diet bookshelf and found works by two of the chief authorities on the subject: Dr. Dean Ornish, the popular TV celebrity, and Dr. Caldwell Essylsten, a less public but also renowned nutrition guru from the Cleveland Clinic. Both of them promoted ultra low-fat essentially vegan diets. I used them as a guide for learning how to cook for myself in a new way. This largely revolved around vegetables braised in stocks rather than oil-fried in a wok, lots of brown rice and other whole grains (oats, especially), and the substitution of plant (soy) based protein foods like tofu, tempeh, and the various veggie "burger" products for actual meat. Plenty of salads, of course, and fruit. Of the two diet docs, Essylsten was the most severe. You were barely allowed to eat a nut. However, in defiance I ate the same lunch every day for all those years: peanut butter on one slice of our local Rock Hill 8-grain bread. Otherwise I was pretty strict with myself.

     Over the next several years I lost about 20 pounds (from 188 to 168 – I am 5' 10"). By 2011, my cholesterol was down to 110 total (about equal LDLs and HDLs), but I was feeling shitty all the time as described above: lack of stamina, muscle pains, cramps, etc. I was aware that I was getting old, over 60, but I suspected that these were not necessarily natural aging issues. I was having trouble remembering things, names especially, and at times felt like my brain was fogged. I developed neuropathies (tingling and numbness) in my hands and feet. I grew suspicious that these things were connected with the whopping dose of Crestor that I was on. There is, of course,  a body of anecdotal chat on the Web about the evils of Crestor and other statin drugs, and in July of 2011 I decided to taper down and get off the stuff. By September it was out of my system.  My doctor was rather cross with me. He assured me that an LDL level above 70 was a death sentence, should I get back there.

     Over the next six months, the brain fog and the name-forgetting went away, but the muscle issues and fatigue-and-stamina problems persisted. I was still on my nearly fat-free vegan diet. My theory was to see how far up my cholesterol would go on diet alone. In November it clocked in at 220 total and I forget the LDL number because my doctor was shaking his head and making clucking sounds as he reported it, along with his now-standard empirical warning that I was back in the death zone.

    So, all winter I staggered on feeling shitty and eating low-fat vegan. There is for sure a large body of counter-argument on the whole cholesterol issue, led by the author-journalist Gary Taubes (a supernaturally fit-looking dude). This argument states that fat is actually a critical and essential component of human diet, and animal fat in particular, which is crucial for the continual process of cell renewal and the processing of many other nutrients, especially many vitamins. There is also a range of amino acids, the building blocks of proteins, that you can only get from animal foods. All of these things have a bearing on muscle performance and the health of nerve tissue, in which fats are an indispensible component.

     Frankly, I knew about these counter-arguments, but the authority of medicine these days militates the opposite way, and in these nearly five years I allowed the authority of my doctor to persuade me to drive down my cholesterol by all means available. I now regard this as a mistake, perhaps even a personal fiasco. I think I have done a lot of damage to my system and that it will take a long time to repair. But I am back in the realm of meat, cheese, and eggs. And, yes, I do eat a lot of vegetables, especially green and leafy ones, and I am watching my carbohydrates (but not eschewing them).

     I've also come to a conclusion about what started this whole long melodrama. At the time I first got my high cholesterol "riot act" reading, I was also eating a lot of sugar and refined white flour in a certain form. In the evenings, after a day that included at least two episodes of strenuous exercise, I allowed myself to eat Pepperidge Farm cookies and Ben and Jerry's ice cream. I probably ran through a bag of cookies every two or three days and ditto a pint of ice cream. I now believe that my cholesterol numbers were high not so much because of the meat and cheese that I was eating, but because I regularly consumed too much sugar and refined flour. That is my current theory and narrative.

     So, I'm back to an omnivore's diet. (The first time I had real eggs scrambled in butter in nearly five years was quite a moment!) It's been about ten days. I can't say that I've noticed any marked improvements. As I said above, it will probably take a long time to undo the damage done. I'll check in again on this theme after a while and let you know how things are going. I'm scheduled to go in for another routine physical on Friday. I imagine it will be a contentious session. But I wonder if doctors are losing their legitimacy now in a way similar to the other authority figures in our culture: the political leaders, the bankers economists, the business executives. To get back to where I started this blog, all is swindle these days. And medicine, being the life-and-death racket that it is, may be the biggest swindle of them all.

Pic credit: Banksy