Start the Week with Links

Some bloggers use link posts as filler, but other bloggers’ links post are spectacular and I look forward to them every week. Instead of using links as an end-of-week roundup, I figure a Sunday post would be cool to provide some food for thought for the week and to kick off any weekly projects or goals. Kind of a Sunday “executive meeting” and an excuse to clear out those lingering tabs that always end up open in my browser. There’s always interesting stuff to read, but not all of it sparks a blog post.

As in all things in life, the aim is to keep things moving–gut motility, lymphatic fluid, bloodflow, information, browser cache, iteration in daily health routines. The spice must flow!

Are You a Patient?

James Altucher posted some thoughts on civilian life this morning:

I was a civilian for a long time.


I worked in my cubicle, hoping to get a raise … a promotion. Sometimes the cubicle changed and it would be a new title, new company, new “friends”, new employee handbook. New boss to choose whether I flourished or suffered.


Sometimes the boss would look at me: his eyes over his glasses, like I was the worst interruption he had ever suffered. Sometimes he’d laugh at my jokes and I’d feel happy. Sometimes he’d praise me and I’d call home and tell my parents about it.


It wasn’t that he was bad. It wasn’t even I was so pathetic (I was though). But that’s civilian life. I was a civilian. Not aware of the bigger world out there. Not aware I could survive in it.


We have two zones: the comfort zone and the Other zone. Civilians live in the comfort zone.

I’ve been thinking on the line between civilian life and, well, I don’t know what to call the other life yet because I’m not yet there. Not on a day-to-day basis, at least.

I’m definitely still a cubicle civilian, although I have the luxury (?) of an office with a window to the glorious Pacific Northwest. Sometimes the chains are gilded, yo.

But where I’m decidedly NOT a civilian is my health. This past year has been a process of breaking the chains, escaping the rat-race of Western medicine, and learning how to fly free.

I want to try an experiment.

Let’s replace “civilian” with “patient.”



I was a patient for a long time.


I went to the doctor, hoping to get better health … a cure. Sometimes the doctor changed and it would be a new drug, new insurance, new “goals”, new clinical approach. New doctor to choose whether I flourished or suffered.


Sometimes the doctor would look at me: his eyes over his glasses, like I was the worst interruption he had ever suffered. Sometimes he’d laugh at my jokes and I’d feel happy. Sometimes he’d praise my compliance and I’d call home and tell my parents about it.


It wasn’t that he was bad. It wasn’t even I was so pathetic (I was though). But that’s patient life. I was a patient. Not aware of the bigger world out there. Not aware I could survive in it.


We have two zones: the comfort zone and the Other zone. Patients live in the comfort zone.

Just like civilians, patients look to our doctors for the final word. If we’re good, and compliant, maybe we’ll have a chance at getting better. We’ll “admit” that we have a fever, or “deny” that we are allergic to medications.

We’ll receive infusions of weapons-grade immunosuppressants every eight weeks, dutifully billing insurance and denying ourselves a health savings account to qualify for subsidization by the same big pharma company that makes the drug.

Welfare, healthcare-style.

The drugs work, that’s for sure. But there’s a dark side to having no immune system. Inflammation built up. Infections wouldn’t heal. That nagging feeling at the back of my mind that kept saying something isn’t right.

But because I wasn’t yet at a crisis point, my doctors wouldn’t do anything about it. Maybe we would push the treatment out to 9, 10, 11 weeks, but that was it.

I was surviving, but I wasn’t flourishing.

My Western doctors were good people, don’t get me wrong. But they had their own perspective. They didn’t see my life, the little things that worried me every day.

No doctor cares more about me than I do. No doctor lives my life.

Eventually, I gathered my courage and made the decision to take control of my health. To make decisions myself, instead of letting my doctor make them for me. To make decisions that could have major consequences to my health, life, and finances.

Taking charge was scary, I can’t lie. The responsibility now lies with me, not with my doctor or my insurance plan’s rules. It’s me who makes the decisions. It’s me who has to follow through with the decisions I make.

I made the decision to walk away from the comfort zone of my health-cubicle.

I’m not a civilian anymore.

Not a patient.

I’m in charge.

Are you?


Anticipate the Hangover

When you drink too much, you get a hangover.

When you stay up way too late, you’re tired the next day.

When you eat too much, you get full and uncomfortable.

There are always consequences.

You may not like it. You definitely don’t want it. But the consequence is there just the same.

One of my favorite facts is this: “for every action, there is an equal and opposite reaction.” It comes from the study of physics.

Scientific or not, I like to apply it to everything from human relationships to the way my body reacts under stress.

The reaction may not come out in the way that I’m expecting it, but there’s always something.

In my last post, I explained how I thought ahead to the fancy wedding I was attending, to make sure I had food for the day. That definitely helped cut down on unhelpful consequences like hanger and anxiety.

That wedding also included things like dancing (I’m recovering from pneumonia), talking to lots of people (introvert), and sitting in the sun next to a field of grass (hello, pale skin and seasonal allergies).

When you think ahead, you can usually head off some of the worst consequences my moderating yourself in the moment. Rest after dancing. Take a walk by yourself. Sunscreen and Claritin. Drink water.

Even when you’re taking care of the little things, they still add up.

The next day you wake up with a pollen hangover.

Maybe you’re a little bit dehydrated.

Or you have a sunburn.

Those things take a little while to recover from. And that’s okay.

Make sure to plan for it!

Don’t pretend that you can muscle through it, because you can’t always do that. Take a half day off work, or work from home if you can. If that’s not an option, take into account recovery time when you’re asking for time off or swapping shifts with your coworkers.

Make sure to have water and aloe lotion in the house, so you don’t have to expend extra energy to go get them, energy you could be spending on recovering.

Cook yourself the equivalent of a greasy breakfast and coffee, make sure to stay hydrated, and ride out that hangover.

Expect it. Embrace it. Realize its inevitability and just let it be.

Shamelessly bringing your own dinner to a black-tie wedding

You know all those stories about old ladies bringing tupperware or ziplock bags to parties and stealing leftovers?

You feel bad for them, but at cringe at the same time.

I’m the opposite of those old ladies. I bring my own food to fancy parties. Non-fancy parties, too. Anywhere there’s food that I can’t eat (which is everywhere).

I’ve even started buying my own containers specifically to bring food to parties. (I like the Systema brand because they lock tight to stay closed and are pretty leak-proof.)

This came in handy over the weekend, because I RSVP’d too late to a superfancy black-tie wedding, which meant there wasn’t a dinner ready for me.

But it worked out, because I brought my own food! Sometimes having a cranky gut works in your favor.Never got around to eating the Epic bar

My philosophy with Bring Your Own meals is to keep them as simple and easy to eat as possible. That way, no matter what the utensil situation is, you’ll be prepared. Nothing’s worse than trying to guzzle yogurt out of a container because you don’t have a spoon! (I’ve done that before. Way too messy for a wedding.)

Here is what I packed:

  • Deviled eggs (not shown: make a little sandwich with two whites plus filling in the middle)
  • Pickle
  • Olives
  • Meatballs
  • Epic bar (pork ‘n’ pineapples flavor)
  • Black Medicine coldbrew coffee (do not recommend, try Chameleon Coldbrew or Stumptown instead)

Yes, it’s a little bit weird to whip out a container full of food at a fancy dinner table, but like most things, it’s only awkward if you make a big deal out of it. I would be willing to bet that the people on the other side of the table didn’t even realize I wasn’t eating the steak or fish options.

Maybe the guy sitting beside me thought I was bonkers, but he was too polite to say anything.

And because I didn’t have to worry about what to eat, I had more time to enjoy the party. Win!


In which my approach to diet is turned on its head

My introduction to the microbiome (otherwise known as gut bacteria) came through Elaine Gottschall’s Breaking the Vicious Cycle, the book that unleashed the Specific Carbohydrate Diet on the world. Elaine’s research and writings focus on the biochemistry of how food digests in the gut, and mainly focuses on reducing any undigested food that would feed the “bad bacteria” in our guts.

When I started working on my small-intestine bacterial overgrowth issues, I also started following the low-FODMAP diet as well, which is also concerned with what foods may or may not feed gut bacteria.

Both of these diets are mainly focused on the food/bacteria interaction, and so that’s what I always focused on, too. When you eat according to these strict diets for so long, following them becomes second nature and I kind of stopped questioning the “why” behind them. They were mostly working, so what’s there to question?

Not much, or so I thought…until I sat in on a lecture on TNF-alpha and inflammation pathways related to cancer and inflammatory bowel disease. Two of the lecturer’s comments stuck out to me:

  1. Microbiome research is mostly correlative, and
  2. The experiments this guy was running with TNF-alpha performed exactly the same with or without interaction from the microbiome.

If scientists don’t know that much about microbiome–gut wall–immune system interactions, that means that it’s entirely possible that these diets are based on partial (or even wrong) information. They work for some people, sure, but does that mean we know the reasons why? Maybe not.

I am very responsive to TNF-alpha blockers, so I would wager that the inflammation caused by TNF-alpha plays a big part in my disease. And if experiments with TNF-alpha gave the same data with or without the presence of a microbiome, that makes me wonder if the inflammation is a bigger deal than the gut bacteria1.

All along, I’ve been approaching diet from the angle that food helps or hurts gut bacteria, which then helps or hurts my own gut and causes inflammation.

Now, I’m now wondering if I have it completely backwards. What if the inflammation comes first? If there’s too much inflammation, that could cause problems with gut-bacteria-interactions, especially if my gut’s layer of mucus was affected.

If that’s true, then I should be working on inflammation first, and microbiome health second.

I will be looking into this.

More to come.


1 At least for me and the other 20% of Crohn’s people who respond well to Remicade and other TNF-alpha blockers.

The Unexpected Importance of Mucus

I’ve only ever thought of mucus as a quick-n-dirty way to measure intestinal inflammation. Looks like the bowel/mucus/bacteria relationship is a bit more complex:

Viscous mucus covers the intestinal wall, disables bacterial movements, and protects epithelial cells from contact with bacteria. Leukocytes migrate into and patrol within the mucus layer executing surveillance functions without any collateral damage. The sticky outer mucus surface offers the opportunity for probiotic strains to grow and build protective interlaced layers, making it even more difficult for pathogenic strains to reach the mucosa.

The inflammation takes place only after the mucus barrier is broken and the defence is overwhelmed

I need to spend more time with the article to tease out a few of the themes, but the authors make an interesting case that the integrity of the mucus lining the intestines is critical in keeping bacteria (both good and bad) from invading the healthy epithelial cells that line our guts.

Which means that part of a healthy gut is a healthy layer of mucus (I know, eww). Mucus is broken down by emulsifiers in our foods, which are added to nearly everything processed. Common offenders include dairy products and toothpaste. The good news is that if you’re following a Paleo, low-FODMAP, or Specific Carbohydrate-type diet, you’re already on the right track. The SCD specifically bans emulsifiers like carrageenan and soy lecithin. Basically, if you aren’t eating processed foods, you aren’t eating emulsifiers.

Just don’t swallow your toothpaste.

Do small changes really work?


Imagine a sunrise.

The world is dark, bathed in starlight. Maybe there are a few clouds lingering on the horizon, fog creeping in. Soon the sky begins to lighten. The stars start to fade, so gradually you barely notice at first.

Slowly, softly, you see the first shimmers of sunlight peeking over the horizon. The shimmer becomes a shine, bathing all you can see in pale colors that morph into one another quickly and seamlessly–grey, blue, violet, pink, golden.

Suddenly the air is bright, and crisp. The sun has crept high over the horizon, throwing trees and rocks and mountains into sharp contrast.

The world has changed.

You can change too.

The modern medical system has trained us to think of medicine as an intervention. You’re sick, or injured–the doctor will ride in on a white horse and save you.

And that’s great–when you’re acutely sick or injured. Emergency rooms are absolutely the place you want to go if you got in a car accident or have a sudden-onset kidney infection.

But when it comes to long-haul issues, to chronic illnesses, the white-knight method doesn’t work quite as well. A constant stream of intervention becomes an everlasting source of drama.

Drama equals stress.

Stress is not good for living things, especially human beings learning how to deal with chronic illness.

That’s where gradual change comes in. Gradual changes creep into your life like a sunrise, so subtly you often don’t realize it’s happening.

Stress-free. Or at least stress-less.

Most of us know the basics of human health: good nutrition, exercise, and sleep.

Most of us also know that when we start working out regularly, it takes a few weeks to start seeing major changes to our bodies. It takes a few nights to catch up on sleep debt. It takes a little while for our bodies to change.

So why not change your focus? Maybe now you think of your illness as a major crisis1 and are dreaming of a white knight riding to your rescue.

Consider instead adding small, gradual changes to your lifestyle. Getting enough sleep, becoming more serious about exercise, eating more vegetables–all are worthy goals.

Like a sunrise, small benefits can add up over time without you really noticing. Just all of a sudden, the trees are bathed in light, and the world has changed.


1 Assuming that you are not actually having a medical emergency, in which case please go to the emergency room.

Why I Started this Blog


Hippocrates, one of the founding fathers of medicine, said this:

All disease begins in the gut.

For a long time, I didn’t believe him. There are plenty of other places in the body that disease can strike. Eye disease, birth defects, infections, cancer of any body part, the list goes on. I’m sure there’s even a disease for your hair. (There is.)

The gut is only ONE part of your entire body, and there’s no way that only one part would control all the possible illnesses, cancers, and malfunctions that can go wrong in the human body. Our bodies are made of billions of cells, teeming with bacteria and mitochondria, thousands of parallel systems all running together to keep us alive.

There’s no possible way that only the gut makes us sick.

Or so I thought.

I even held on to this idea when I was fighting Crohn’s disease–a disease of the gut.

My own gut was trying to kill me, and yet I poo-poo’d the thought that my gut was the source of my disease. I would describe Crohn’s as a “battlefield inside my intestines,” but surely that didn’t apply to bronchitis and seasonal allergies and warts and whatever.

I viewed my gut disease as a separate entity, something inside of me that wasn’t connected with any other parts. Boy, was I wrong about that.

For a long time, I and my doctors targeted my gut for treatment, without regard for the rest of my body. Massive doses of immunosuppressants, steroids…if you’ve been to a modern doctor for any major illness, you know the drill.

But what I didn’t realize is that while my symptoms were subsiding in my gut, the rest of my body was falling apart. My immune system ceased to function correctly, and caused all sorts of bacterial overgrowth throughout my body. Because of that, inflammation set its insidious claws into my skin, my sinuses, my throat.

My body was a mess.

Hey, but I didn’t have any symptoms.

Counts as a win, right?

Wrong. I felt terrible, even without symptoms. I knew I could do better–knew that there was some type of treatment or approach or something that could make me feel better.

I had a dream that I could get off those high-powered drugs that were killing me slowly with side effects.

When I finally made the leap to treatments outside the realm of modern, Western medicine, I discovered a few things:

  1. There’s no such thing as a quick fix
  2. The right answer doesn’t exist
  3. It’s all about gut health

The more I explored with diet, and the more I talked with my naturopath about my treatment options, the more I tested options and went with what worked, the more I realized that it was all about the gut.

What I ate, how I showered, how much sleep I got…all of it.

Our bodies are a vastly complex network of systems that are all entirely depended on the building blocks that our gut absorbs from food. Without good building blocks, our bodies will break down.

And a broken down body won’t help me lead the life that I want to live.

Which brings me to this blog. I started this blog with the aim of sharing everything I’ve learned about living with a chronic illness. Millions of people around the world are living with diseases like Crohn’s, and more are diagnosed every day.

If I can give you a shortcut to finding ways of living–and medical treatments–that work for you, then I’ve fulfilled my mission.

And most of that is by starting with first principles: all disease begins in the gut.