Drugs, metabolism, weight, and health

I've had a rocky road health-wise since a workplace injury in 2004 led to permanent partial disability, and medical retirement with a fused spine and damaged sciatic nerve.  To deal with the resulting 24/7/365 pain, I was prescribed multiple drugs that helped, but also 'zombified' me to a certain extent.  If I took the quantities prescribed, I found I not only couldn't think creatively - I actually underwent a change in personality.  I tapered off the dosage until I found a balance between pain control and feeling like a human being again, and stayed with that.

In 2009 I suffered a heart attack, likely due at least in part to the aftereffects of my 2004 injury, and underwent quadruple heart bypass surgery.  The cardiologist prescribed a different set of drugs for that, including one that, while it helped my heart, also had the effect of causing severe, uncontrollable weight gain.  (Later, another doctor would tell me, "You can almost watch a patient on [that drug] expand sideways.")  I ended up putting on well over 100 pounds in the course of a year.  Diet and exercise - the latter limited by my earlier injury - did almost nothing to help.  Only terminating my prescription for that drug stopped the weight gain.

It took a thoughtful, dedicated physician in Nashville to isolate the problem.  By then, thanks to multiple drug interactions, my metabolism was pretty much shot.  With his help I went through my prescriptions and cut out more than half of them, including all daily pain management medication (although I kept a supply for bad pain days).  I now take each day only those drugs essential to my heart and circulatory health, and I've learned to live with a higher level of pain.  Unfortunately, my metabolism has not 'reset'.  I'm still carrying around that extra weight, and find it almost impossible to get it off.  (For example, my wife helped me stick to a 1,200-calorie-per-day restricted diet.  Guess what?  I gained three pounds in the first week - and I wasn't cheating!  Scratch that option . . . )

I've slowly but surely come to the conclusion that if I don't get rid of the pounds, they're going to get rid of me.  They're adding to the load on my heart, bringing me to the point of being pre-diabetic with serious (and worsening) insulin resistance and showing most of the symptoms of metabolic syndrome, and putting additional strain on my injured spine and damaged nerve.  I've got to do something drastic, or face death within the next year or two.  It's as simple as that.  The risks involved in doing something are more than offset by the risks if I do nothing.

It seems the best alternative short of bariatric surgery is to try water fasting.  I've been encouraged by the work of Dr. Jason Fung in Canada, among others, which has produced remarkable results in some (but not all) people, and I've read extensively on the benefits and dangers of fasting.  (A good introduction to the subject may be found here, if you're interested.)  I'm aware of the real risks involved in so drastic a diet, but since bariatric surgery results in equally serious risks, I think they're acceptable under the circumstances (particularly given the alternative if I do nothing).  If fasting helps to not only lose pounds, but also reset my metabolism, as it's claimed to do, then so much the better.

I've been preparing for this step for some time, with the invaluable help of my wife, Miss D., who's been very supportive.  I've just undergone the most extensive series of blood tests I've ever had in my life, to analyze just about every aspect of my metabolic, digestive and circulatory health and provide me with a baseline of where I am now.  (To my amazement and indignation, my medical insurance is quite happy to cover the tens of thousands of dollars it will cost for bariatric surgery - but it won't cover blood tests to help me fast!  I have to cover those costs myself.  Oh, well . . . gotta sell more books, I guess!)

I hope that today will be the last day I eat solid food for at least the next 30 days.  This initial period will show me what my body will tolerate.  There are a number of options.

• If I can make it for as long as 30 days without eating, I'll re-evaluate at that point, with more blood tests and medical consultation.  If I can continue, great;  otherwise I'll eat for a while, then tackle another 30-day fast.
• If my body proves incapable of handling that long a fast, I'll find out what it can handle, then work at fasting for that length of time (say, a week to ten days), interspersed with roughly equal periods of (light) eating.
• If blood tests and other indicators show that fasting is making other problems worse, I'll have to re-evaluate the whole thing, of course.  However, given the success others have had with this approach, I'll hope for the best.

I'm telling you all this, not in order to solicit sympathy, but to help other readers who are suffering similar problems.  I'm aware of at least a dozen of you who are facing the same sort of problem.  I hope I'll succeed in tackling mine, and if I do, I hope that'll encourage you to tackle yours.  For the rest of my readers:  I hope this will help you realize that there are people who are not sick because they're fat - they're fat because they're sick.  There's a big difference.  I've seen and experienced some of the contempt directed at fat people, and it hurts - particularly when one isn't this way out of choice.  Please keep that in mind when you see someone who's obese.  They may have problems about which you know nothing.  As Scout reported Atticus Finch's words in 'To Kill a Mockingbird':  "One time he said you never really know a man until you stand in his shoes and walk around in them".  I've often wished some of those making the rudest, most dismissive comments could spend a few days in mine.  I don't think they'd enjoy the experience.

Tomorrow morning it's cold turkey - or, rather, no cold turkey for me!  I'll be grateful for your prayers and good wishes over the next few months.  If this works, I hope to be a considerably slimmer, healthier, happier me by this time next year.  I'll let you know how it goes.

Peter