Wednesday, October 9, 2013

Me and My Microbiome

In the past year, I have struggled more with my health than at any other time in my life.  It doesn't seem fair, actually.  I'm aging, but I am not old.  I'm too young to have health problems.

For that reason alone, I hate to think that my health could already be in jeopardy, but something happened to my digestive system this summer that has made me re-think that assumption.  I don't know what it was exactly, but I have referred to it as a gastric attack because that's just what it felt like. That didn't seem to be a real problem until June, when this latest attack took me down.   Now, even though I had felt 'vaguely' discomforted in my gut as early in the year as April and May, it wasn't until June that I had the actual attack.

Something inside of me was attacking me, and the result was literally debilitating. For about a week, I couldn't eat and couldn't keep anything inside me.  At first, it was just nausea, but it quickly became diarrhea as well.  I was miserable, to say the least. I don't want to get into the graphic details, so suffice it to say that I stayed close to the bathroom and the bed for a few days.  I took hot showers for relief and eventually used every towel we had several times.  Valery had to wash them as a batch just to keep up with me.

I completely stopped eating and drank almost nothing for days.  It was unpleasant to say the least.  I would get incredibly thirsty and then gulp down water, which would come right back up.  And if I had the discipline to sip it and keep it down, it just led to disruption in my gut and eventually, well, you know, back to the bathroom.  Another shower, another lay-down and it would start all over again.

But, after a week of this, I faced a couple of serious challenges:  my weight and my work.

Even though my weight was dropping, for many reasons, not least among them financial, it was imperative that I get back to work.  For one thing, I just couldn't stay in bed another day. I got restless and up and out of bed.  I managed to keep water down and even ate some chicken soup. Valery wanted me to go to the hospital, but I refused.  I just couldn't see what they would/could do for me, other than collect a co-pay and giving me a scrip for some kind of anti-nausea drugs.  I've been there and done that.

The toughest part was knowing that I had go to both of my jobs even though I had considerably less energy than I have been used to and a lot less than I actually needed to sustain myself.  For weeks I had just enough energy to get me from home to the office and back for days.  I found myself out of breath and needing a rest after simply walking to my car.

And the days that I worked at the restaurant were doubly difficult.  Not only does that job require more physical activity and mental energy than my desk job, but it also means dealing with food.  Over the course of the week that I was so ill, I could barely stand to look at food, let alone smell or eat it.

The actual attack was over by the time we left for Michigan the day after the Fourth of July, although I still had some lingering digestive 'issues' so to speak. I spent the time at the cottage eating well and getting better, stronger every day.  Slowly, I managed to regain a bit of my strength, if not my appetite, literally by forcing myself to eat as many bites as I could stand.  I felt like the guy who takes on food challenges on television.  It was me versus food.

But if it was me versus food, I won.  Or, at least, I'm winning again.

Now, that's something of an old story, actually.  I've been aware of my weight problem for my whole life.  I've just never been anything but thin. I've never been able to gain weight, probably because I just do not have the fat cells required to increase my mass beyond what is required to make a functioning frame.

That said, I think have a wonderful body, even if it's always been lean, because it's always worked so well.  I'm not an athlete, of course, but I have always had what I consider to be a great strength-to-weight ratio.  I've always been a lot stronger than I look, and I have a lot more endurance than anyone has ever really given me credit for.

Looking at me (especially today) it's always been easy to dismiss me as a scrawny weakling.  It's true, I am thin.  'Rail thin' folks say, if they're being kind, or 'emaciated' if they're not.  I've never weighed an ounce more than 133 pounds.  But I am not ashamed of being thin.  The fact is I am both lean and strong.

Working in the restaurant business for most of my life has influenced that.  Especially when I was younger, working as a banquet captain, I always led of my crew by example, energetically carrying heavy tables and stacks of chairs in and out of the dining room.  I brought out the first tray when we served a banquet and the last one too. I brought out the first table and the put away the last one.  The younger kids simply could not outwork me. No one could.  I always worked until there was no more work to do, and took great pride in my ability to be strong enough for that.

This personal history of strength and endurance is why I was so shaken, literally, by the gastric attack this past summer. This isn't the first time that I've had one of these attacks, just the worst.  It started a years ago.  As long as four or even five years ago something changed in my gut and it's just never been the same.  I became concerned about my health for the first time in my life.  In response, I resolved to eat more and gain weight by working out.  Neither of those resolutions were easy to keep, and like anyone on a diet, I just failed to stay with it.

Returning from Michigan in mid-July, as soon as I was able, I resolved to get better.  I knew this meant getting back to eating more and more regularly, but I also wanted to know just what had gone wrong in the first place.  So, I went back to the doctor to see if he could figure out what was wrong with me. I had become convinced that what I'd experienced was a parasite, and news stories in later July and August were describing an outbreak of a nasty bug called cyclospora that was making its way around the country.  Cases had been reported in north Texas, and I was certain that I was among the first cases in Travis county.  After all, it felt like an attack, and it made sense to me that I could have been under siege from this particular microbe.  Supposedly it came from eating fresh fruits and vegetables.

Now, while many think that I don't eat either, in fact I eat more fresh fruit and vegetables than I do fast or junk food.  This is because I primarily eat at home, where Valery makes dinner from fresh, whole ingredients. My 'natural' diet, if you will, has a considerable 'fresh' component to it.  It's true that I drink Dr. Pepper and beer more than I do water, and I have a sweet tooth, but contrary to common perception, I don't eat a lot of sweets.  I rarely eat candy or cookies.  I don't eat ice cream because I'm lactose intolerant (though I do cheat every now and then) and I don't eat a lot of baked goods, even though I love bread.

Thinking that I had at last identified the source of my illness, I went to the doctor to get tested.  I was actually surprised by his reaction.  He seemed dismayed by my concern about parasites, believing, as he told me candidly, that it was very unlikely that I had a parasite.  Nonetheless, he agreed to test me and I gave up a couple of vials of blood and went home with a stool sample kit to return the next day. Before leaving, he counseled me that digestive disorders were difficult to track down and that I might just expect to live this way for the rest of my life.  He explained that the 'critters' in my gut may have been 'blooming' and that caused my discomfort.  Eventually, he reasoned, they would subside and I would feel better, only to have them 'bloom' again sometime down the road.  He said that many people, especially those in 'third world' or impoverished places with poor sanitation and health care experienced life-long diarrheal conditions, which they treated with nothing more than rice water.

Needless to say, this didn't sit well with me, and this had nothing to do with my simmering digestive discomfort.  Even though I understood what he was saying, the doctor's advice to just get over it, so to speak, was not what I wanted to her.  I mean, this isn't the 'third world' and I am not an impoverished peasant with little to eat.  Not to make too much out of it, but I am a westerner, with health insurance. Rice water?  Really? The underlying expectation with my doctor is that I don't have to just live with an illness because I have health care.  That's why I'm here, right?

But the tests came back negative.  No cyclospora.  No parasites of any kind.  No disease.  Hmmm. Then why did I still feel lousy?

Critters? Really?  I'm starting to think so.

Last year I read about a study that has been done over the past few years, to try and determine how many microbes were living in a typical human body.  Not so much a count as a census, this effort was trying to establish a baseline for understanding how various microbes live and function in the human body.  Everyone knew going in that there would be a lot of critters, so to speak, riding along with us, but the result was actually pretty amazing.

In fact, there are dozens (if not hundreds) of different kinds of microbes, and they live, literally all over and in us.  There are so many of them that this survey just identified and counted the most obvious colonies of microbes.  It's a lot like exploring the jungle.  Every inch of the territory is occupied by something, and everything is working together to form an ecosystem.  It's incredibly complex and almost impossible to decipher, but just the diversity alone is enough to inspire wonder and awe at the power of life.

Some people take this news as 'icky', as if knowing about the creatures that live on, in and with us makes them feel unclean or overrun with foreign and dangerous micro-agents of disease and discomfort. This may be a natural reaction but it doesn't make a lot of sense.  What does make sense to me is just how complex we humans are.  Not only do we have amazing brains and highly adaptable bodies, we have also created a cooperative farm, if you will, where we provide food to the microbes in exchange for a variety of services that keep us healthy and, well, alive.

It's astonishing and humbling to think of my body as a vast universe for a variety of life forms.  We go hurtling through time and space together, clinging to each other and using all our abilities to stay alive. After all, the microbes are life.  They have the same basic motive we do.  Although things do go wrong and certain microbes can sicken and even kill us, for the most part, these critters get along with us, and we with them.  Now people are even suggesting that we add microbes to our guts using fecal matter from others.

Personally, I am not going to eat fecal pills, but this microbial universe goes a long way toward explaining my gastric attacks, the long periods of discomfort and malaise I have endured, and now, toward explaining why I feel better than I have in years.

The great thing is, today, in mid-October, I feel healthier than I have in so long I can't even remember the last time I felt this good.  After months of playing the weight gain game, I have reached a new plateau: 135 pounds.  Admittedly, I have not stabilized at the weight, just reached it twice in the past week.  But to see that number on the scale, especially after getting all the way down to 121 pounds at the peak of my illness this summer, is rewarding and encouraging for the long term.

Eating well and keeping on my weight is something I will have to work at for the rest of my life, but it's important for me to keep in mind what the goal is, and that's to be healthy.  While it can be a vicious cycle going down, it can also be a positive cycle going up.  The more and better food that eat, the more diversity and nutrients I have in my body for the host of microbes that depend on me.  In turn, they have rewarded me if more energy and strength, which I will turn back into nutrition and exercise.

Me and my microbiome.  It's all good.