Losing Weight in Pattaya

[BeerBelly 1,026]

Motivation

Last night I went to Walking Street and ran into Bushcraft at Le Pub. He hadn't seen me in a while and the first thing he noticed that I had lost a bit of weight. After assuring him my weight loss was by choice, he congratulated me on my success so far.

Thinking about it this morning, I thought it might be a good idea for me to share my motivations and experiences along the way. This could be an extremely long post, so I will try to break it down a bit to make it more digestible.

First off, I want to discuss my motivation. I was diagnosed with type two diabetes years ago and have been on medication ever since. The two main medications are metformin and glyburide (glymide here in Thailand). From what I understand, metformin is supposed to increase your insulin sensitivity allowing your blood to clear out glucose more efficiently, and glyburide makes your pancreas create insulin.

I'll be honest and admit I hadn't really been tracking my blood glucose much and just kept taking the medication I was prescribed, but then something happened. Back in June/July 2020, I started waking up just about every day with numb hands and fingers. At first, I thought this was just poor circulation, but the more I thought about it, I figured it could be the beginnings of diabetic nephropathy, so went out and bought a blood plasma glucose monitor. Basically, this is the device where you insert a test strip into it then prick your finger and place a drop of blood on the strip and it will tell you how much glucose is in your blood at that time.

My fasting blood glucose was high...very high at 206 mg/dL. For reference, 80-100 is normal, 101-125 is pre-diabetic, and 126 and above is diabetic. While on medication for diabetes, it should be less than 140. This was a wake up call for me that I needed to do something to control my blood sugar. The most direct method would be to reduce carbohydrates from my diet. Less carbohydrates in, then less glucose in my blood.

I've attached an image to show how quickly my blood glucose dropped. In less than two weeks it went to nearly the "normal" range. At that point, I was worried that the glyburide could cause hypoglycemia, so I stopped taking it. But after quickly rising and looking a bit erratic, I started taking it again, but at half the dosage I was before.

[BeerBelly 1,026]

What and How do I Eat?

I said I needed to reduce my carbohydrate intake. This just means I'm on a low-carb diet. Some people call it a keto-diet which is short for ketogenic diet. A ketogenic diet isn't a specific diet you follow, though I'm sure there are plenty of books you can buy that tell you it is. It just means that your body is using ketones for energy instead of glucose. You get into ketosis when your body doesn't have enough glucose and your liver starts converting fat into ketones. Since I have a near infinite supply of fat (Didn't name myself BeerBelly for no reason), I'm not at risk of running out of fat to use as energy.

So what foods do I eat and avoid. Meat, fat, and protein are fine. Carbohydrates are not. So no sugar, no bread, no pasta, no beer (I'll talk about that later).

So how do I know if I've had too many carbohydrates? I keep track of everything I eat. I've created some massive spreadsheets to track my food consumption. I populate these spreadsheets with data from the food labels and online sources. I measure things to the gram and it gets logged when I eat it. 

Here is the first three weeks or so of my aggregated food log. During this time, I was pretty relaxed with the carbohydrates limiting myself to 50 "net carbs" a day or so. Basically, net carbs are the total carbohydrates minus the dietary fiber which is not digestible. Since fiber doesn't get digested, it has no direct effect on blood glucose.

Date	Calories (kCal)	Net Carbs (g)	Total Carbs (g)	Sugars (g)	Fiber (g)	Fat (g)	Protein (g)	Net Carbs (kCal)	Fat (kCal)	Protein (kCal)	Net Carb (kCal %)	Fat (kCal %)	Protein (kCal %)
2020-07-17	2,640	166.0	173.0	67.0	7.0	166.0	102.0	664.0	1494.0	408.0	25.15%	56.59%	15.45%
2020-07-18	1,787	61.6	65.9	37.8	4.3	97.4	106.1	246.4	876.6	424.4	13.79%	49.06%	23.75%
2020-07-19	2,097	26.5	26.8	10.0	0.3	176.0	94.0	106.0	1584.0	376.1	5.05%	75.54%	17.94%
2020-07-20	2,163	39.8	50.0	11.1	10.2	161.2	121.2	159.2	1450.8	484.8	7.36%	67.09%	22.42%
2020-07-21	2,145	19.5	24.5	6.5	5.0	166.2	117.1	77.9	1495.6	468.3	3.63%	69.72%	21.83%
2020-07-22	1,849	22.1	29.1	10.0	7.0	130.6	123.6	88.4	1175.0	494.4	4.78%	63.54%	26.74%
2020-07-23	1,997	49.5	53.9	9.5	4.4	129.2	129.6	197.9	1163.0	518.5	9.91%	58.25%	25.97%
2020-07-24	2,088	31.3	34.6	13.1	3.3	150.1	129.7	125.1	1350.7	518.7	5.99%	64.68%	24.84%
2020-07-25	1,427	22.1	34.3	14.5	12.2	108.1	79.0	88.3	973.3	316.1	6.19%	68.18%	22.14%
2020-07-26	2,258	35.5	39.7	21.0	4.2	188.8	92.8	142.0	1699.3	371.3	6.29%	75.27%	16.45%
2020-07-27	1,714	32.4	35.5	18.9	3.1	97.0	161.2	129.6	873.3	644.8	7.56%	50.94%	37.61%
2020-07-28	1,996	49.5	61.0	23.8	11.5	125.7	151.6	198.0	1131.3	606.3	9.92%	56.67%	30.37%
2020-07-29	2,547	34.9	44.7	12.5	9.8	174.3	178.0	139.6	1568.4	712.1	5.48%	61.57%	27.96%
2020-07-30	2,202	34.9	51.9	11.0	17.0	156.5	136.5	139.6	1408.5	546.0	6.34%	63.98%	24.80%
2020-07-31	2,065	12.3	20.3	2.0	8.0	127.3	186.4	49.2	1145.5	745.6	2.38%	55.47%	36.10%
2020-08-01	1,638	35.1	47.7	14.2	12.7	115.7	95.4	140.3	1041.4	381.8	8.56%	63.56%	23.30%
2020-08-02	2,334	33.9	34.5	14.0	0.6	151.4	179.2	135.6	1362.7	717.0	5.81%	58.38%	30.72%
2020-08-03	2,011	53.3	63.7	27.8	10.4	136.3	127.2	213.3	1226.9	508.8	10.61%	61.02%	25.31%
2020-08-04	1,993	43.0	43.6	10.0	0.6	96.8	88.7	172.1	870.9	354.9	8.64%	43.70%	17.81%
2020-08-05	2,316	27.8	33.6	16.9	5.7	174.9	141.2	111.4	1574.1	564.8	4.81%	67.97%	24.39%
2020-08-06	1,686	19.7	27.2	10.8	7.5	119.1	113.8	78.8	1071.9	455.2	4.68%	63.59%	27.00%

 

Sadly, restricting my diet does impact my life. It took a while for my girlfriend and friends to get used to me not going out to eat with them. There are restaurants I can eat at, but most dishes are too heavily laden with carbohydrates. I can go to Arno's for a steak, light salad, and Coke Zero, or even to Carl's Jr for their Low Carb Chicken Club and eat there. Thai BBQ (Moo Kata) is fine if I avoid the sauce. 

The one thing I have to keep in mind is no one cares more about my health and carbohydrate intake than I. If a restaurant claims to have keto dishes, but they cannot tell you the carb count, well then I don't eat there.

[BeerBelly 1,026]

The Beginnings of Losing Weight

So after watching my carb intake for about three weeks, I had gone down from 115.3 kg (253.6 lbs) to 109.1 kg (240 lbs), that's 6.2 kg (13.6 lbs) or 2 kg (4.4 lbs) per week. You can see a lot of that was from the first day. I suspect this is just either water loss, or maybe something to do with my digestive process (not to be gross, but think about bowel movements and what is still inside your body). Even so, the trend line for my weight loss at that stage was about 1.48 kg/week.

During this time, I think the body undergoes some changes. A major factor is a reduction in habitual eating. Some would call this food addiction. By putting your body into ketosis (with loads of extra fat to burn), you don't really need to eat for energy, you eat because you enjoy eating. These types of addictions are mental, not physical. If you can get passed the first two weeks, it becomes much easier to stay on your "diet". I put diet in quotes because many people think diet means "weight loss diet", but in my case I just mean types of food I was eating.

So after the first three weeks, my glucose was coming under control and my weight was coming off. Though, I still considered lowering my glucose was the primary goal, I then started to consider weight loss as a secondary goal. After all, with reduced weight, all sorts of other health benefits are gained including lower glucose.

[BeerBelly 1,026]

What Else Have I Done

Aside from changing to a low-carb diet, what else have I done?

When doing my morning weigh in, I never worry about day over day differences. I know this can be damaging to one's motivation that could then lead to going off the diet. So in my weight spreadsheet, I keep track of a seven day difference. So while I weigh myself every morning after a morning piss, I really only consider what they seven day changes are before considering if I need to make any changes.

During my first three months, I ran into some hurdles. Sometimes, I would bottom out on my weight loss. I would see there wasn't a loss week over week, or worse, a gain. So I knew I had to do something about that. Sadly, this means the dreaded E-word... exercise.

I actually purchased an exercise bike early on in my weight loss because I knew I would have to use it. I checked all around Pattaya and most that you find are designed for Thais. They can handle a maximum of 100 kg and are too small.

But then I found Decathlon had a range of exercise bikes available, including one recumbent bike that could handle 150 kg. And while I was originally looking for a recumbent bike, I ended up buying a standard bike that could handle 130 kg. I think the price was 9000 baht and it is VERY well built. It has a built in heart rate monitor, though I don't think it is at all accurate.

I started calculating my basal caloric requirement, they call it basal metabolic rate or BMR, in my weight spread sheet. This is basically a measure of how many calories my body needs if just being a couch potato. Just the calories required to maintain my body temperature.

I figured if my caloric intake is less than the BMR plus calories from exercise, then I would lose weight. So this is kind of a soft goal, simply to burn more calories than I consume, then the weight will come off.

After the exercise bike wasn't enough (or I wasn't using it enough), I purchased a Mi Band 5 fitness  band. This keeps track of my heart rate plus it's got some other features like a step counter. Using the heart rate it can figure out how many calories I've burnt. It's also got different modes, like Walking, Running, Exercise Bike, ... so when I start an activity it will calculate the calories just from that activity. It also uses my phone's GPS to plot my walking on a map. It tells me how long it took me to do each KM, my average pace, cadence, ... all sorts of (useless) information for information junkies.

The Mi Band 5 pairs with a phone app called Mi Fit and since I had that app installed, I decided to buy the Mi Body Composition Scale 2. This scale has some electrodes in it so when you step on it, it will calculate some things like body fat percentage. Not really sure how accurate it is, but it's at least some numbers I can look at and track.

[Bullfrog 2,224]

1 hour ago, BeerBelly said:

I had gone down from 115.3 kg (253.6 lbs)

That was my starting point too. How tall are you??

[BeerBelly 1,026]

Duplicate post removed.

Edited November 1, 2020 by BeerBelly

[BeerBelly 1,026]

Hepatic Glucose Production

What is hepatic glucose production? Well, it is glucose released into your blood stream from your liver. 

I was noticing that even after I reduced my carbohydrate intake considerably to just 20 g per day, my fasting glucose was still pretty high, in the pre-diabetes to diabetes range. In fact, it was higher than my post meal glucose two to three hours after eating. Why is this I wondered. After doing some research, I discovered my liver was fighting me tooth and nail. It really wanted to be an active member of my body.

There is something called the dawn effect or dawn phenomenon where by the liver decides you will need energy to wake up, so it decides to inject glucose into your blood stream while you are sleeping to get you ready for the day. I guess the liver doesn't know about coffee. This seems to be more common among diabetics.

There are things you can do to reduce this. Exercise will help reduce this problem. Also, I changed my glyburide from a morning dose to an evening dose and that seemed to make a big difference.

Finally, one thing that really surprised me was drinking alcohol. On the few nights I've gone out drinking with friends, I noticed that my morning fasting glucose was MUCH lower. I found a study that says hepatic glucose production is hindered by the consumption of alcohol. I have decided at some point, I will consume a glass of wine as part of my bed time ritual if it really becomes a problem, but so far, it seems much better now.

Edited November 1, 2020 by BeerBelly
Accidentally posted when not finished writing.

[BeerBelly 1,026]

49 minutes ago, Bullfrog said:

That was my starting point too. How tall are you??

5'9" (175 cm)

[BeerBelly 1,026]

Adjustments of Medications

Over the passed three months, I have adjusted my medications several times. I have NOT consulted a doctor about this. I think I have more information about me and my habits than any other person on the planet. Doctors will only go on averages...what would the average person do.

Before starting, I was on metformin and glyburide for diabetes, some cholesterol medication as well as a blood pressure medication. I monitor my blood pressure regularly and it is pretty good both before and after halving my dosage. Cholesterol takes longer to measure and take affect. But last time I checked it was good, though the good cholesterol could be higher. So I have halved that as well. This one was particularly important for me as statin drugs increase insulin resistance and there was a noticeable drop in my fasting glucose after I reduced my dosage. It remains to be seen if it was a good idea or a bad idea. I'll know after my next cholesterol test.

On the subject of dropping glucose after reducing statin drugs,  I had an incident last week. My fasting glucose was 58 mg/dL. This is into the hypoglycemia range. I also had a mild headache. That day, I stopped taking my glyburide completely. My fasting glucose has spiked, but still in the normal range, so I think it is a good trade off.

Another benefit from the weight loss thus far is that I have had to reduce my CPAP pressure three times. I'm very technically savvy and can download and examine my CPAP data and so far it seems okay (though to be honest, the third change was two days ago and I have not checked it yet). If you are familiar with CPAP data, my AHI has been less than 1, usually less than 0.5 since I've changed my pressure settings.

I mentioned earlier that alcohol can hinder my liver from producing glucose, and since my glucose is on the higher range now that I've stopped glyburide, I'm more serious about drinking a glass of wine before bed than I was before.

[BeerBelly 1,026]

Keto Way Of Life

I've had friends ask me "how long do you plan to be on this diet?" and the answer is forever. I no longer consider it a diet and consider it a change of lifestyle. It would be like asking a vegan how long they plan to be a vegan.

The changes I have made include not taking food for granted. For example, ketchup. I love ketchup, but it is high in sugar. So for the very first time in my life, I made my own ketchup. Why? So I could save 3.7 g of carbohydrates per tablespoon of ketchup I use.

In fact, in Thailand, you have to do a lot more cooking and order some ingredients off the internet in order to make keto dishes. I have various sugar substitutes, some kind of expensive, some not so bad as well as different kinds of flour.

I've tried different keto recipes on the internet. I'm a fair cook, so I'm sure I can come up with some good recipes on my own.

Here is a burger bun (recipe off the internet). Each bun has a total of 4 g of NET carbohydrates. I think in the future, I'll be making more stuff like this. If I find or make a recipe I like, then I'll make them in bulk and freeze them.

[BeerBelly 1,026]

November 1, 2020 Status (106 Days In)
Here are my fasting glucose and weight graphs from the beginning to today.

In the glucose chart, you can see a big increase, that was when I stopped taking glyburide, because the hypoglycemia was just too dangerous. As mentioned, it's actually in the normal range, so I'm okay with these numbers. The numbers look erratic partly because the medication changes over time.  

This morning's weigh in put me at 93.9 kg (206.6 lbs) for a total loss of 21.4 kg (47.1 lbs).

I did go drinking last night, which usually means I'll be a bit dehydrated the next day and might go up a little the following day.

And speaking of drinking, I now drink the terrible San Miguel Light. At just 3.2 g of carbs per bottle, I'm okay with it. My fasting glucose this morning was about 5 less than yesterday, so I'm okay with that.

Edited November 1, 2020 by BeerBelly
Change the title

[knortyboy 155]

Excellent report. 

Well done and thanks for taking the time to post it. ?

[jacko 8,814]

Yes thanks for taking the time and making the effort.

I don't want to be a snake oil salesman but a few friends seriously recommend black (fermented)  garlic and claim it has reduced their blood sugar levels allowing reduction of medication. Also blood pressure improvements, again allowing elimination of medication.

Keep it up.

[BeerBelly 1,026]

2 hours ago, jacko said:

Yes thanks for taking the time and making the effort.

I don't want to be a snake oil salesman but a few friends seriously recommend black (fermented)  garlic and claim it has reduced their blood sugar levels allowing reduction of medication. Also blood pressure improvements, again allowing elimination of medication.

Keep it up.

Actually snake oil is better for you than corn oil. (seriously, animal fat is better than vegetable fat with respect to Omega 6 and Omega 3 fatty acids).

In regards to black garlic and any claims I'm told about, I will always look for a peer reviewed study to back up the claims. So there is no harm saying something. The things I have mentioned in my post (alcohol hinders hepatic glucose production and statin drugs increase insulin resistance thus elevate blood glucose) are not just anecdotal, there have been studies and my experiences matches the conclusions of those studies. I will check out black garlic studies. I have already checked out garlic studies but only have a vague recollection of the conclusions. I think basically it was, yes, but only in high amounts and you can get the benefits easier by other methods.

Garlic in general is a high carb food, especially if you use it in powdered form (concentrated carbohydrates). Of course, I still eat and use garlic, but since it is usually in a small amount, it doesn't really add too many carbs to the final product.

[BeerBelly 1,026]

Blood Work

So yesterday (and today), I got some blood work done to see how things are moving along. The reason I needed to go two days was because I was supposed to fast for a lipid profile, which I did not.

The lab I went to was MT Inter Lab which is on Third Road next to Tony's fitness and down just a bit. I used to go to LifeCare, but during my last visit, I got some very strange results and they never responded to my question in email, so I moved on to this lab.

Glycated Hemoglobin
Yesterday, I tested my Glycated Hemoglobin. This is better known as HbA1C. This a measure of glucose actually inside the blood cells. The normal blood glucose meter only tests glucose in blood plasma, but HbA1C goes a bit deeper.

Red blood cells accumulate glucose over their lives. The more plasma glucose, the more the red blood cells accumulate. For this reason, the HbA1C test is a measure of the average blood plasma glucose over the life of the cells. Since red blood cells last around three months, it's kind of a three month moving average of your glucose levels.

My reading was 5.2%. I'm not really sure what this number means, but there is a formula one can use to estimate what the average blood glucose was over the life of those cells. In my case, the estimate is 102.5, which is very good. The normal range is less than 5.7% and I'm well into that. The nurse there was quite surprised when I told her I was diabetic. 

In general Normal is < 5.7%, Pre-Diabetes is 5.7%-6.4%, and Diabetes is >= 6.5%. The target level for diabetics who are controlling their diabetes is 6.5% or less, so I was very happy with 5.2%.

Nearly two months ago, I went to Life Care and they gave me a result of 12.6% which honestly didn't make any sense. That would mean my AVERAGE glucose level was 315 including two months of being on a low-carb diet.

Lipid Profile

I returned to MI Inter Lab today for another jab, this time I was fasting.

Total Cholesterol: 138 (Desirable is < 200)
LDL (Bad) Cholesterol: 84 (Optimal is < 100)
HDL (Good) Cholesterol: 36 (Poor is < 40, Better 40-59, Best >= 60)
Tryglycerides: 88 (Desirable is < 150)

So, how does this compare to my previous test nearly two months ago? Total Cholesterol: +1, LDL: +13, HDL: +6, Triglycerides: -77. Which means total is about the same, and the bad LDL went up a bit, but still within the desirable range. The good HDL also went up by 20%. Not sure if that outweighs the increase in bad, but since the bad is still within desirable, I think I'm okay. I think the triglycerides went down by so much because of the fast.

Overall, I am very happy with this result. Many people think low-carb diets can increase your cholesterol, but I think that is only speculation, and not based on actual science. I know I'm only one person, but it matches up with what I have read. Considering I'm still within the desirable range for the bad cholesterol, I think I will stop taking my statin drugs until I can test again in about six weeks. As I mentioned before, statins can raise blood sugar, which is still the main concern of mine.

[hyku1147 1,955]

BB - during your diet, did you have enough energy? Did you feel weak?

[DangerRuss 17]

Sounds great that things are better.  Both my parents are diabetic and although I’m a tad over weight, I know I should be exercising more.  Because of Covid, I force myself to exercise for 75-90 min each day. And for the past several years on my 2/3 trips per year to LOS, I make it a point to walk to 80% of the places I want to go.  

[sailingbill 1,031]

Pretty much no flour, no white sugar ,no potatoes. Went from 210 pounds to 165 pounds since moving here.  Dont know what that is in Stone.  No DM, Htn or Obesity.  But the drink will get me. Something gets all of us men. 

[jacko 8,814]

16 hours ago, sailingbill said:

Pretty much no flour, no white sugar ,no potatoes. Went from 210 pounds to 165 pounds since moving here.  Dont know what that is in Stone.  No DM, Htn or Obesity.  But the drink will get me. Something gets all of us men. 

210 lbs is 15 stone 

165 lbs is 11 stone 11 

Definitely needed to scale down there. 

Edited November 15, 2020 by jacko

[BeerBelly 1,026]

On 11/12/2020 at 7:38 PM, hyku1147 said:

BB - during your diet, did you have enough energy? Did you feel weak?

Not sure why I didn't get a notification from your post.

I would say that there are frequent times in which I am tired/sleepy. Though, I can't say it is from lack of glucose in my diet, lack of calories, or lack of sleep.

What I have noticed is that when I am sleepy, it quickly goes away when I go for a walk and my energy generally stays up after the walk. Last night, for example, I walked to Tops (2.7 km round trip). I was sleepy enough prior to the walk that I could have napped, but when I got back, I was all good. I do not typically have trouble getting to sleep even though I go to bed early (around 10:30). The issue I'm having is I wake up early ~5:30 with my back slightly sore. I go pee, then cannot get back to sleep. I've been having issues with my back for a while now, most notably when I sleep in an unfamiliar hard bed.

I wear my fitness band to bed and it "scores" my sleep. Generally, I'm in the lower 25% of sleep quality compared with other users my age. Now that I think about it, I should start tracking my sleep more in my health related spreadsheet.

[hyku1147 1,955]

Walking is a great habit. I wonder if increasing its frequency and duration would improve your sleep quality - and strengthen your lower back?

Taking off all that weight probably added years to your life. Remember The late James Gandolfini ?

Congratulations.

Edited November 19, 2020 by hyku1147

[sailingbill 1,031]

On 11/16/2020 at 5:25 AM, jacko said:

210 lbs is 15 stone 

165 lbs is 11 stone 11 

Definitely needed to scale down there. 

Was boarding a plane and an American GF said if you dont get control you will be one of those wheelchair people in a few years. She pissed me off but was right.   Beer Bellys post about taking control of your own health i liked. Still best to find a good doctor but no need for blind faith. Before moving to Thailand i told my Doc i wanted a CTA. He initially refused saying i have no chest pain and a normal EKG, ekg's are nearly useless. He relented and i found a life threatening cardiovascular condition that can be dealt with. Fired the ass and went to Cleveland Clinic.

As i posted in the past there are some things that will bite you and nothing to be done about it. But if you can fix something do so.

 

[BeerBelly 1,026]

7 hours ago, hyku1147 said:

Walking is a great habit. I wonder if increasing its frequency and duration would improve your sleep quality - and strengthen your lower back?

Taking off all that weight probably added years to your life. Remember The late James Gandolfini ?

Congratulations.

Thanks!

I am increasing my duration and frequency of walking and I'm hoping if I continue to lose weight, things can only get better. Just got back from a just under 6 km walk from Le Pub down Beach Road and back. I'm working on my tracking spreadsheets and I do plan to have some kind of chart to plot distance walked per week, or some such metric that is easy to see. The fitness app is okay, but I like to make my own charts.

Speaking of "adding years to your life", my scale is one of those smart scales and one of the things it does is tell me my "body age". Of course, it's just some function of all the things it measures, or maybe just BMI. But it has gone down from 56 to 51 since mid-October. Also, according to the CDC classification, I crossed over into being "overweight' from "obese" recently. 

[BeerBelly 1,026]

4 hours ago, sailingbill said:

Was boarding a plane and an American GF said if you dont get control you will be one of those wheelchair people in a few years. She pissed me off but was right.   Beer Bellys post about taking control of your own health i liked. Still best to find a good doctor but no need for blind faith. Before moving to Thailand i told my Doc i wanted a CTA. He initially refused saying i have no chest pain and a normal EKG, ekg's are nearly useless. He relented and i found a life threatening cardiovascular condition that can be dealt with. Fired the ass and went to Cleveland Clinic.

As i posted in the past there are some things that will bite you and nothing to be done about it. But if you can fix something do so.

 

Finding a good doctor is like finding a good handyman in Thailand. They exists, but you have to go through many before you find the good one.

I had a couple of bad experiences with doctors that kind of put me off of them. Back in the States, I got kidney stones quite often. When they happened, my urologist would recommend a procedure to remove them, which I did about 5-6 times. These are not pleasant experiences. Though they are done under general anesthesia, the recovery is quite painful.

One time in Ubon at MM's wedding, I had some major kidney stone related issues. Pissing blood like I've never seen in my life. Scared the shit out of me. I immediately booked a flight to Bangkok and checked into a hotel then called all the hospitals to see which Urology departments were open (it was a Sunday). I ended up going to Bumungrad. They did a bunch of X-rays and I was quite happy with that. They diagnosed kidney stones and an infection. They recommended I go on antibiotics to clear the infection and a procedure to remove the stones. Of course, it would be very expensive there, so I decided to check around.

After I finished the antibiotics, I still had an infection, so went to Bangkok Hospital Pattaya. They did a CT scan, recommended a different set of antibiotics and a procedure to remove the stones.

Both of these hospitals were very expensive, so I continued to look around for a place that could do the procedure. I decided to go to Bangkok and check out Siriraj. This is a high end public hospital, most known for treating the King. I saw the urologist there and he looked at the X-rays and CT-scan. I told him I wanted the procedure to remove the stones and would like to know how much. He recommended I do nothing. Well, technically, wait and see.

I was worried the kidney with the blockage would shut down, but he assured me the kidney is functioning fine and even if it were 100% blocked, it would take months before it was a problem. Also, he told me that every time they do the procedure, it creates scare tissue in the ureter making stones more likely to get stuck in the future.

Up until this point, I had not heard this. I've always been told to get the procedure. So I made my monthly trip to Bangkok to X-ray and check the progress and he assumed me the stone was moving. On my last trip (about 5 months in), he told me they were on the cusp of coming out and two days later I birthed FOURTEEN stones. I have not had an issue with a stuck stone ever since about five years now. Before, it was an occurrence about once every six months.

Three out of the four urologists I had ever seen told me to get the procedure, which I had done many times. Also, my urologist in the States told me what not to eat, which I followed until I got a stone again.

Last time I had to go to the doctor, it again was for a kidney infection. This time, it was not bloody urine, it was a VERY serious infection. Fever, chills, the works. I ended up back at Bangkok Hospital Pattaya. Coincidentally, it was the same urologist I saw there before. He said it was a serious infection and recommended I check into the hospital and get two days (once per day) of 7000 baht IV antibiotics. I told him I would not be checking in (I live with a nurse). After two days, still had the infection, so he recommended seven days. Fuck that...49,000 baht++... I told him he has to find a different antibiotic.

These two experiences have really turned me off from doctors. I recall when the "Food Pyramid" came out telling us that we should eat a majority of grains and skimp on the meats and fat. Since low carb diets goes against this, many medical professionals feel low carb is blasphemy. It goes against their belief system for which they don't have any peer reviewed science to back it up. Twenty years ago, low carb diets didn't have science to back it up either, just anecdotal evidence, however, times have changed. There are a lot more studies these days supporting the health benefits of a low carb diet.

I should also restate that my girlfriend is a nurse and I keep her well informed of everything I'm doing. So if she comes home to find me unconscious, from hypoglycemia for example, she would be aware of the potential cause and would know what to do.

[awesum4 2,333]

2 hours ago, BeerBelly said:

 I recall when the "Food Pyramid" came out telling us that we should eat a majority of grains and skimp on the meats and fat. 

I got very offside with my teacher when I was 12 because I asked him to explain how eskimos were able to live and grow quite healthily on a diet of meat, fish and fat only.

You are doing real well it's been a really interesting thread,   keep it up mate, and all the best for the future.

Edited November 19, 2020 by awesum4