Charged by the Clerk of Court to take the records into hiding, Randall Boothe, an African-American slave, took them by wagon to Greenville & Southampton. After the war he returned them, was freed, and asked to serve as Caretaker of the Courthouse. https://www.virginia.org/listings/SuggestedItinerary/TheContributionofAfricanAmericansinSmithfieldIsleofWightCounty/I plan to interrogate these records in order to learn as much as I can about the African Americans enslaved in early Isle of Wight County. I want to know if they too are my ancestors. I cannot find my African ancestors without learning about my European ancestors. Their records hold the key to my family history. I started the study of my family history in my Alabama Blackbelt homeplace. I then expanded my study to the entire Mississippi Territory. I am now following the migration of both sets of ancestors from the coastal plains of Virginia and Maryland into North Carolina and through Georgia, and into the Mississippi Territory. If you share these ancestors, take the journey with me. There are more resources, but these are a great place to start. https://www.familysearch.org/wiki/en/Isle_of_Wight_County,_Virginia_Genealogy http://www2.vcdh.virginia.edu/gos/index.html
Today, I took “one third” of a morning walk. I am pleased, in fact ecstatic, with the progress that represents. I am trying to climb out of a deep physical hole, one more time. My autoimmune flare was a devastating experience. I felt as though I were going to die, even though I knew I was not. That flare took me, into the pits, physically.
The flare started in my mouth and for weeks I could not eat solid food. I dealt with that by relying on my Vitamix blender.The fatigue and muscle aches and joint pains were combined with sharp blinding headaches.
The flare was complicated by the fact when the first headache hit, my brain stopped sending signals to my limbs. I fell. I damaged my left knee. It is a complex structure including a metal and plastic prosthesis, a bone graft, and cerclage wiring which is now partially broken into tiny pieces.
This structure did not appreciate slamming down on a concrete subfloor covered by a thin layer of carpet. In addition, I sprained two toes on my left foot during the same fall. That left me without a (good) leg to stand on. (That’s a joke, smile).
Once the flare remitted, I started the process of rehabilitation, again. I tried going to aquatic physical therapy but we could not make the timing work. I am doing my rehab program in the instructional pool on my own. I know what I am supposed to do. The challenge is showing up and putting in the work.
I have not been bedridden. I have obtained and prepared my own food from the start. I sometimes go out to shop for groceries and to pick up my medicines. There are numerous supermarkets within my driving range. However, none of them offer items like “grassfed beef bones.” These l have delivered. Once I was mobile, I started to going to the pool. I love the pool.
Still, I missed my morning walks. So today I gave it a try. I am weak. I have lost much of the strength and muscle mass that I developed during my last rehab effort. I am in pain. Both legs are problematic. I waddle and limp. I can’t find a lack rhythm for my stride. There is no cadence that works for me. Nevertheless, I walked for 20 minutes. I consider that an accomplishment.
In addition to physical activity, I have been paying attention to nutrition. I have not strayed far from the Autoimmune Protocol (AIP). Homemade bone broth, cooked in an instant pot is an extremely important part of my recovery.
As hurricane Florence threatened Virginia, I experimented with cooking a whole chicken in the instant pot. I loved it. Today I ordered another whole free range chicken from Whole Foods. Free range chicken is expensive. However, I use every part of the chicken. I waste nothing. They were out of stock. I will search stores closer to me to find the best chicken available. I will continue to do the best that I can to eat clean.
I am trying to increase my strength, flexibility, and overall wellbeing I am coping more effectively with stress than before the flare. I am engaged in the appropriate spiritual and religious activities. I am engaging in appropriate physical activity. I am eating an appropriate diet.
I am celebrating my 72nd birthday day by starting the rehab process over again. I have started over again many times since my first autoimmune diagnosis 62 years ago. The birth defects have increased the difficulty level. Yet, I persist. To persist is my nature. I am not responsible for the outcome. I am responsible for the effort. Today I made an effort to walk. I am pleased by the effort.
My favorite uncle “poisoning cotton” with only a thin cloth covering his nose and mouth in the summer of 1961 is a memory that comes to me unbidden and vividly. I did not believe that the pesticide could poison the insects in his cotton without also poisoning him. When he died in 1962, I blamed DDT and other pesticides used to fight the “cotton bugs.”
By the time DDT was first made available for the general public in 1945, scientific research ‘had already shown beyond doubt that this compound was dangerous for all animal life from insects to mammals,”… By 1945 it was well known that once mammals and people were exposed to DDT, the compound became stored in their body fat and could even be found in their milk. DDT had a way of hanging around, even inside human bodies.
Vallianatos, E. G., & Jenkins, M. K. (2015). Poison spring: The secret history of pollution and the EPA. New York: Bloomsbury Press, p. 75.
Reading Rachel Carson’s Silent Spring, published the same year that my uncle died, but to which I was not introduced until I was a college student, convinced me that I had been correct. This video is a brief introduction to the DDT story.
Watch “DDT: From Wonder Powder to Public Enemy” on YouTube
In Silent Spring it was Rachel Carson who introduced the public to the idea that pesticides should be called “biocides.”This work also introduced me to the idea that our governmental agencies would withhold, indeed suppress, scientific information that could save the lives of human beings, citizens.
When I observed the poor showing of the Alabama Blackbelt in the most recently released County Health Rankings, the potential role of pesticides and other environmental toxins came immediately to mind. Even though I am both a medical sociologist and a health and nutrition educator, I was overwhelmed, emotionally and intellectually, by the amount of information that I found. I can only read and write about in small bits. So, this is not a literature review submitted for peer review, it is a rant.
DDT (Dichlorodiphenyltrichloroethane) was introduced to the world as a potent insecticide in 1939. This synthetic organic compound was widely used during WWII and is credited with saving the lives of many members of the Armed Forces in areas where diseases spread by insects were the most dangerous threat to their lives. After the War it became the insecticide of choice for both agricultural and public health purposes. DDT was presented as having only positive benefits for humans.
This means that DDT was everywhere. It was sprayed on fields from airplanes, by machines, and by hand. It was sprayed on children in schools, parks, and swimming pools. Housewives spread it around their homes. And then, as pesticides still do, it drifted through the air to unintended sites (https://link.springer.com/chapter/10.1007/978-1-4612-9863-2_4).
While articles questioning the safety of DDT started appearing in the 1950s, it was Rachel Carson’s best-selling work Silent Spring that brought the controversy to the American Public. Carson’s work has been the subject of many documentaries. If you search YouTube, you will find many relevant clips. This is a 44-minute presentation of the controversy in its historical context, so “get your popcorn.” You might want to make sure that it is organic.
Watch “The Silent Spring of Rachel Carson – Rare Pre-EPA Look at America” on YouTube
According to The Pine River Statement: Human Health Consequences of DDT Use, there is a growing body of evidence that exposure to DDT and its breakdown product DDE may be associated with adverse health outcomes such as breast cancer, diabetes, decreased semen quality, spontaneous abortion, and impaired neurodevelopment in children. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2737010/). Long term exposure to DDT is associated with liver cancer and pancreatic cancer (https://www.ncbi.nlm.nih.gov/pubmed/1573662z). The list goes on and on. I am positive that DDT has contributed to the death of many of my kin. I am also sure that it continues to impair our health.
Perhaps the most important things to remember about DDT include:
- While not acutely poisonous, it “bioaccumulates” in the fatty tissues
- It moves up the food chain
- It is a Persistent Organic Pollutant (POP).
The persistence of deadly DDT is illustrated by the fact that even though it was banned in the US by the EPA in 1972, it is still found in the waters and fish of Alabama in 2018. The list of contaminants in Alabama fish include:
- Chlordane – A chlorinated hydrocarbon used as a pesticide until it was banned in the late
- DDT – Another chlorinated hydrocarbon, DDT was a widely used pesticide until it was banned in 1972.
- Mercury- Manufacturers used mercury in the manufacturing of chlorine, caustic soda, urethane foam and other products. Mercury can also be produced by the burning of certain materials. Once in the environment, mercury is converted to methyl mercury, which is hazardous to humans.
- PCBs- Previously used in the manufacture of electrical capacitors and transformers and in the pressure treatment of lumber, PCBs have been banned since 1979.
Not all DDT contamination was incidental or accidental. What happened to Triana, Alabama deserves special attention. In 1978 the Tennessee Valley Association (TVA) reported extensive DDT contamination in the Huntsville Spring Branch-Indian Creek, a tributary of the Tennessee River. Contamination was also found on more than 1400 acres of the Wheeler National Wildlife Refuge, the largest and oldest national refuge in Alabama. Elevated levels of DDT have also been detected in wildlife in the area.
A 1979 CDC investigation found average DDT levels in residents of Triana, a rural, predominantly black community of about 600 people, nearly 10 times higher than the U.S. population. Between the late 1940s and early 1970s, an Olin Corporation chemical factory discharged approximately 400 tons of DDT and associated waste into the Tennessee River upstream from Triana.
In 1980, the Justice Department, at EPA’s request, sued Olin, asking them to clean up the contamination. In October 1981, the site was designated one of EPA’s top-priority hazardous waste sites for cleanup under the new Superfund program. Superfund is the $1.6 billion fund authorized under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) which gives EPA the resources to clean up abandoned hazardous waste sites. https://archive.epa.gov/epa/aboutepa/olin-agrees-clean-ddt-triana-alabama-area.html
In 1983 the Olin Corporation formally agreed to a multi-million dollar cleanup of DDT contamination around its former manufacturing facility and to provide for health care for the residents of the of Triana.
In another post, I will have more to say about the site where Olin produced DDT. It starts with the list of Superfund Sites in Alabama.
The list of Superfund Sites in Alabama is very educational.
Those of us who were born near the cotton fields, the piney woods, and the pesticide plants of Alabama following WWII should suspect that these toxins affected our health and the health of our children wherever they were born. Forty years after the use of DDT in the US was banned, it is still in the soil, the water, the fish of Alabama. DDT and the other contaminants should be seen as continuing to play a role in the high morbidity and mortality rate in the Blackbelt and among those born there during the heyday of DDT.
- It would be decades before I understood that environmental pollutants play a role in activating genetic predispositions for autoimmunity. I was exposed to pesticides in Alabama and Arizona. In Alabama I was also exposed to the toxic products of pulp mills. In Arizona I was also exposed to the toxins involved in the mining and smelter of copper. ↑
- Harrison, J. L. (2011). Pesticide drift and the pursuit of environmental justice. Cambridge, Mass: MIT Press. ↑
- Triana has been discussed both in the popular press and the scientific literature.O’Neill, L. (1979). A DDT legacy [contamination of the Tennessee river near Triana, Alabama]. EPA Journal, 5, 10-11.High Serum Concentrations of DDT Residues – Triana, Alabama. (1979). Morbidity and Mortality Weekly Report, 28(11), 123-129.Rusiecki, J., Cash, C., Raines, L., Brinton, S., Zahm, T., Mason, A., . . . Hoover, L. (2006). Serum concentrations of organochlorine compounds and mammographic density in a highly exposed population in Triana, Alabama. Epidemiology, 17(6), S89. ↑
- Don’t be mislead by my focus on Alabama. Check out the Superfund Sites in your state. I have lived in five states. They all have areas of significant contamination, at least one in every city or county where I resided. https://commons.wikimedia.org/wiki/File:Superfund_sites.svgSearch for Superfund Sites Where You Live – https://www.epa.gov/superfund/search-superfund-sites-where-you-live↑
I am recovering from an autoimmune flare. I have tried to understand what triggered this flare. The answers seem to be (1) allowing my stress bucket to overflow, (2) skipping my hydroxychloroquine, and (3) reintroducing red pepper flakes into my diet.
The dietary changes are easy to explain. After eight months working on the elimination phase of the Autoimmune Protocol (AIP), I decided to eat red pepper flakes. It was a simple recipe: garlic and red pepper flakes with spinach sautéed in olive oil. My body’s response to the dried red pepper flakes was swift and dramatic.
Soon after the meal my entire mouth was aflame. My digestive system expelled the meal with force. The pain shooting into my head was so intense that my sense of balance deserted me. While rushing to the bathroom, I slipped and fell. I landed so that my left knee, the one with the broken pieces of circlage wire, was reminded that under a thin layer of carpet there is a concrete subfloor. The toes on my left foot were bent in a direction that was more than uncomfortable and two of them were sprained.
The painfully inflamed tissues of my lips and mouth and the headache were soon joined by swollen tonsils, muscle aches and pains, and fatigue. As I focused on how to feed myself. I used the pressure cooking setting on my instant pot to make bone broth. I used my Vitamix to make smoothies and soups. It finally dawned on me that this was an autoimmune flare, probably Sjogrens Syndrome. This was followed by days in which my major activities were directed at moisturizing my eyes, mouth, and throat.
I have plenty of eye drops and gels. I tried several mouth moisturizers. Sugarless gum did help with the production of saliva. The most healing balm was vitamin E. I punctured the capsules and applied the contents directly to lips and gums. When I was focused on my own food and healing that left plenty of time to think about other autoimmune flare triggers.
My new ophthalmologist had given specific instructions for dealing with the dryness in my eyes. She had also left me with a fear of hydroxychloroquine toxicity. I am at risk for the irreversible damage because I have been taking the medication off and on for the past 30 years. The baseline test was inconclusive and I have an appointment with the retinal specialist in November. At some point after the baseline test, I made an unconscious decision to stop taking the medication. In retrospect that was probably not a very good idea.
Having to deal with an autoimmune flare and decisions about medication forced me to deal with my need for a new rheumatologist. I like the one I have but he has moved his office to Colonial Heights and I hate driving on I95. He is also not an Anthem participating provider. So, I must pay what Medicare will not. Since it looks like I may be needing a rheumatologist more often, I have made an appointment with one at VCU Health. The idea of dealing with a new rheumatologist is almost as stressful as the idea of retinal damage.
I was spending long hours working and studying online. I had my first new batch of nutrition consultation clients in three years and I was highly motivated to provide high quality services while meeting all contractual obligations. I was engaging in professional development by taking a course on the human gut microbiome. I was working diligently on DNA genealogy and family history.
I was also working on my physical rehabilitation. I was taking 30 minute walks early in the morning and had also started physical therapy in the pool to help alleviate the pain from the arthritis in my hip. My physical and mental resources were spread very thin.
Then there were unexpected deposits in my stress bucket. Do I really need to say more than DMV? The bureaucracy made an error and I had to jump through hoops to not be fined for it. How about while I was standing in line at DMV, ADT called to say that my alarm was going off. The air conditioning stopped working. The compressor was frozen. When it defrosted there was a pool of water between that concrete subfloor and the carpet that is not yet completely dry. The heating elements in the oven died.
In other words, life just kept marching on while I needed to understand the two additional deposits that the ophthalmologist made into my stress bucket. While I may or may not have retinal damage from hydroxychloroquine, I definitely have two degenerative eye conditions. The diagnosis for the right eye is posterior vitreous detachment (PVD). The diagnosis for the left eye is asteroid hyalosis.
I now understand that PVD simply means that I am myopic, aging, and have already had cataract surgery. There is no treatment for the condition. If I experience an increased number of floaters or a curtain, that should be treated as an emergency. The asteroid hyalosis is not expected to cause any problems with my vision.
Unfortunately, these degenerative conditions which are considered to be relatively benign are interacting with preexisting conditions in ways that I find extremely uncomfortable. I am not blind. I am not going blind. I am extremely sensitive to glare, the kind of glare that comes from the screens of computing devices. After an hour or so my head starts to hurt badly and does not stop. The pain is severe enough that it interferes with my ability to use my brain to work, to study, and to manage musculoskeletal pain.
I have tried various types of filters on my devices. None of them alleviate the problem. I have worked with my optician to try various types of antiglare and light sensitive lenses. They also fail to solve the problem.
The bottom line is that if I want to reduce the frequency and intensity of the headaches, I must change my computer related behavior. As I have come to terms with the need to change my behavior, to drastically reduce my screen time, the level of stress in my bucket has been greatly reduced and the autoimmune flare has abated. Now, I must set some priorities.
There are people I love who fare better with me alive. You know how it works on planes. When the cabin pressure falls and the oxygen mask drops, the responsible adult raises their oxygen levels first. I am still a responsible adult. Whatever has distracted me from saving my own life first needs be removed from my agenda. As in “Girl, Bye.”
I design opportunities for people with complex health challenges to make health promoting decisions about food intake and physical activity. This process involves, obtaining information about current health status, examining current decision making, and clarifying goals. I use the social ecological framework for nutrition and physical activity decisions to identify the types of interventions that will help them successfully achieve their goals. I refer them to appropriate practitioners.
I am going to write about each of these stages in turn, starting with obtaining information about current health status. My current form asks people to list each physician they have seen in the 18-month period prior to their first consultation with me, each test they have been given and its results, all their diagnoses, their prognoses, and their list of prescriptions.
WE WILL CALL YOU IF THERE IS A PROBLEM
As I explained in an earlier blog, many people cannot complete this form accurately. They visit a physician, they provide blood and/or urine, and they submit to various forms of imaging. Then they wait for a call that tells them their results were problematic in some way. They agree to a situation in which no immediate problem means not only no call but no information whatsoever.
I do not believe that this is in the health care consumer’s best interest. This is the first area in which I became a patient advocate. I advocated for myself. “It is my health. The tests were paid for by my insurance (for which I pay), so they are my results and I want them!”
THE 15 MINUTE OFFICE VISIT
Another problem is the general quickness of the typical office visit. It leads some physicians to filter and reduce how much they say during an office visit. They chart more information than they speak. Others throw around multiple diagnoses using medical terminology so rapidly that even an informed lay person has difficulty keeping up. I can’t be the only one who gets distracted or forgets.
COLLECTING THE DATA
Now, I either collect and organize this information for my clients or teach them how to do this for themselves. Collecting the data can be expensive, time consuming and frustrating. The creation of the “patient portal” has solved some of the problems with obtaining this type of information. They eliminate the initial charge for copies and sometimes provide much faster turn around time.
But portals are far from perfect. They require computer skills, computer patience, and the ability to be both patient and persistent with the human beings on the other end. Portals, then, can still be time consuming and frustrating. That’s why people hire me.
I am prepared to deal with the frustrations of collecting and collating the medical data for people who hire me to do so. When we find errors in the data, I assist with getting corrections made. I provide the assembled data in a format or formats of their choosing. For those who avoid digital media, I present the data in three ring binders because they ease updating. For those who live in the digital world, I provide the collated and indexed records in the cloud and on USB.
This service was first requested by an exhausted family care giver when a sister agreed to take a turn caring for their mother. At the last moment she realized that much of her mother’s medical record was stored in her head. We worked to create a usable packet of information for her sister as well as do the paperwork and online forms that would allow the sister to request information from physicians and access portals. It has become one of the services that I provide most frequently, along with helping people learn how to do it for themselves.
Recently I provided this service for a delightful couple getting ready to enjoy their retirement with some long-range travel. They both needed records from Patient First, VCU Health, Bon Secours, and HCAVa. Individually they needed records from several different specialist health care providers. When the time came to decide how they would carry their records, she opted for a bracelet and he opted for dog tags.
On Saturday (August 4, 2018), I lead a workshop in which a group of Wisdom Warriors practiced accessing their patient portals for themselves. I learned as much from them as they did from me. If you have never been in a room with group of nonjudgmental older women discussing their health issues, you have no idea how much we laughed.
They congratulated me on the positive change in my fasting glucose levels since, I started the Autoimmune Protocol (AIP). They noticed the post surgery weight loss They wanted to know if I had experienced any other changes in health indicators. NO ASTHMA. NO RESPIRATORY INFECTIONS.
For years, I have experienced allergenic asthma. Last year the wheezing started in the spring with the pollen. By August every section of my respiratory system was infected or inflamed. I had a sinus infection, an infection in my middle ear, bronchitis, and then pneumonia. Most of my energy went into simply trying to breathe. This year a mild reaction to pollen and dust mites and nothing more.
I believe that attempting to follow the AIP has resulted in the elimination of one or more food items that were triggering the asthma and leading to the extreme respiratory distress. I have hypothesized that the culprit is wheat. The ladies want to know how I plan to test the hypothesis. They have invited me to come back next month.
I plan to start the next workshop by leading them through some tracking exercises. We will work on tracking food intake. This is the first step required to identify any food sensitivities and allergies that may trigger over enthusiastic immune systems.
The next goal is to eliminate potential food triggers from the diet. The AIP is one of many elimination protocols. The key is to select a protocol and stick with it for the required length of time before reintroducing the potential triggers. Changing dietary styles can be difficult.
The elimination component of the AIP is working for me. My autoimmune conditions are in remission (the wolf pack is resting quietly even in the face of daily thunderstorms). I am no longer moving toward type 2 diabetes. And last, but not least, my killer t-cells have their weapons holstered and I have not experienced respiratory distress.
Your comments are invited and appreciated. If you would like to schedule a workshop or an individual consultation, contact me.
I often mention that I have long preferred a nutrient dense whole foods dietary style.
Nutrient dense foods are foods that have a high proportion of nutrients relative to the calories they contain.
It is important to note that “processed” foods are not a single category, but rather a continuum. Rice provides excellent examples. Human beings cannot eat rice until the outer most hull has been removed.
The process that produces brown rice removes only the outermost layer, the hull, of the rice kernel and is the least damaging to its nutritional value. The complete milling and polishing that converts brown rice into white rice destroys 67% of the vitamin B3, 80% of the vitamin B1, 90% of the vitamin B6, half of the manganese, half of the phosphorus, 60% of the iron, and all of the dietary fiber and essential fatty acids. Fully milled and polished white rice is required to be “enriched” with vitamins B1, B3, and iron. http://www.whfoods.com/genpage.php?tname=foodspice&dbid=128
Even though it has been processed through the removal of its outer hull, brown rice continues to be a “whole food.” White rice is not a whole food. It has gone through stages of processing that involve removing nutrients and replacing some of them through the process of “enrichment.”
Food manufacturers take the processing of rice further. They precook both brown and white rice to make instant or microwaveable rice. That often involves adding some form of oil. It can sometimes require additional enrichment.
At what is now the far end of the spectrum, manufacturers will go beyond simply precooking the rice. They will include oil, salt, sugar, unnamed spices, and other “food additives.” Let’s look at the ingredients in Uncle Ben’s trademarked Ready Rice Jambalaya.
On the real-world package, this list of ingredients is too long for me to read without adjusting my eyeglasses. That immediately violates one of the most important “food rules” that I have adopted. The longer the list of ingredients, the more highly processed the product is likely to be. For people who need a number, I suggest the “five ingredient” rule from Michael Pollan’s Food Rules. This blogger lists each of the 64 rules from Pollan’s book. Pollan drew these works from previous works such as In Defense of Food.
Marian Nestle’s Food Politics remains the first work to read when trying to understand how individual food choices are influenced by the food industry in ways that many grandmothers never imaged. Even with our staggering rates of obesity, human beings only have so much room in their stomachs. To provide profits to their share holders, food manufacturers compete for that limited stomach space through the use food science and psychology. They wage expertly enticing advertising campaigns and they influence the food policies set by our government agencies.
In this short video on navigating the supermarket, Michael Pollan and Michael Moss introduce the distinction between whole foods, processed foods and ultra-processed foods.
Watch “Navigating the Supermarket Aisles with Michael Pollan and Michael Moss | The New York Times” on YouTube
A 2016 research article in the BMJ offered the following definition of ultra-processed foods.
Ultra-processed foods were defined as industrial formulations which, besides salt, sugar, oils and fats, include substances not used in culinary preparations, in particular additives used to imitate sensorial qualities of minimally processed foods and their culinary preparations. https://bmjopen.bmj.com/content/6/3/e009892
This study found that almost 60% of the calories in an average American diet come from these ultra-processed foods. They provide 90 percent of the excess sugar calories that Americans consume. The high consumption of added sugars in the US is seen as contributing to excess obesity, type 2 diabetes, dyslipidemia, hypertension and coronary heart disease.
Scientists are investigating the role that the additives in ultra-processed foods play in health with recent research linking them to cancer. It should also be remembered that a small, but not unimportant, number of people are sensitive to or allergic to these additives, even one at a time.
12 Common Food Additives – Should You Avoid Them
The first elimination diet should be the elimination of ultra-processed foods. Only by eliminating this manufactured food like products will are people able to determine if the industrial components have a negative impact on their health. Once they have successfully eliminated these edible food like substances, they will be able to try dietary styles, like the Autoimmune Protocol, that require the elimination of certain whole foods.
For some people the switch to a nutrient dense whole foods diet is enough to dramatically improve health indicators. For those who require more extensive protocols, it is the necessary first step.
- Added sugars are sugars and syrups that are added to foods or beverages when they are processed or prepared. This does not include naturally occurring sugars such as those in milk and fruits. When nutritionists a(nd nutrition educators talk about the high rate of sugar consumption, we are usually talking about the added sugars that are often invisible to people who do not read labels or understand the potential health consequences of ultra-processed foods. ↑
- I did not miss the genetically modified notice. That is simply a topic for another day. ↑
(If you buy from Amazon using one of the links that I supply, they will not pay me a small commission. I am not a good salesperson and did not make the cut. Not a problem. ALWAYS TRY YOUR PUBLIC LIBRARY.)
I am a health and nutrition educator, as well as a medical sociologist. I consult with both individuals and organizations on the creation of health and wellness programs. I am my most important client. While recovering from a recent spine surgery, I was Inspired by the philosophy of Miss Harriet Tubman as presented by GirlTrek.org. I am saving my own life first!
In designing a wellness program for myself, I started with two types of health conditions: those with which I was born (congenital) and those for which I inherited a genetic predisposition with expression influenced by lifestyle and environmental factors.
I have inherited a genetic predisposition for type II diabetes. I know that lifestyle factors, including physical activity and diet, can influence the expression of this genetic predisposition. This knowledge comes from the classroom at Hawthorn University and from life experiences.
In the early 1990s, the skin on my neck became much darker than the skin on my face. My primary care physician gave me explanations that were not logical. She claimed, for example, that the skin on my neck had always been darker or that the darker skin on my neck was the result of exposure to the sun.
I was born into a generation of women taught to treat their neck as part of their face. I knew my own neck. I also knew that neither my face nor my neck had been over exposed to sunlight since the late 1970s. I have lupus. I am photosensitive. I have permanent scars on my face to remind me of what happens when my skin is exposed to UV from sunlight. As a result, I learned to apply a 30 SPF moisturizer to my face every morning.
My insurance coverage was through an HMO. I had to write this physician a memorandum to get a referral to a dermatologist. Since my memo was included in my file, the dermatologist was ready for me as soon as she entered the room. She told me that the darkening of the skin on my neck was called acanthosis negricans and described it as a precursor to diabetes. I made some lifestyle changes and my neck returned to it’s normal color.
For the past nine years, I have been working with a primary care physician who orders bloodwork the week before an office visit. An important part of the office visit involves going over the results line by line. It is difficult to be in denial when you and your trusted physician are looking at the lab results and at each other. That is why, over the past few years, I have had the opportunity to see my fasting blood glucose levels slowly rising.
After the failure of my hip flexors took me out of the pool and the undiagnosed cyst growing in my lumbar spine took away my ability to walk, my fasting blood sugar level started increasing more rapidly.
Patient education: Diabetes mellitus type 2: Overview (Beyond the Basics) https://www.uptodate.com/contents/diabetes-mellitus-type-2-overview-beyond-the-basics?view=print#H4
When my fasting glucose level approached and then moved into the “impaired fasting glucose” stage, my primary care physician and I talked about dietary changes. I was already following a nutrient dense whole foods lifestyle so there were no sodas, processed, or sugar laden manufactured food like substances to remove. He suggested giving up beans. That was a difficult thing for a “beans and rice woman” like me to do. But I complied. Unfortunately, my blood sugar level continued to indicate that I was insulin resistant and at risk for diabetes.
After my spine surgery in December of 2017, I decided to try the Autoimmune Protocol (AIP). I started the AIP in January 2018. My approach to the AIP was to focus on the wide array of vegetables that were included rather than on those that needed to be eliminated. In March of 2018 my fasting blood glucose level and A1c were both within the normal range, just barely. But, just barely was enough for me to know that something about the AIP was having a positive impact on my health
|Glucose, serum, fasting||114||108||115||109||97*|
|*Indicates results within the “normal” range.|
This motivates me to keep working with the AIP. I am also learning more about dietary lifestyles that overlap with the AIP. In the Plant Paradox, for example, Dr. Steven Gundry recommends removing from the diet many of the same foods that are eliminated in the AIP. Dr. Gundry recommends foregoing conventional dairy, many grains, legumes, and nightshades. His first emphasis is on the toxic impact lectins.
Dr. Gundry’s second emphasis has become promoting his proprietary prebiotics blend. This video which introduces some of the main ideas from the book is a long commercial for this product. I recommend watching the video and visiting his website and reading his blogs. I offer one caveat. If you click on the link at the end of the video and provide your email address, you will become the target of aggressive marketing. I think that I can get the prebiotics that I need without spending so much money.
Dr. Steven Gundry: Cut Your Cravings
I believe that this process is about taking responsibility for what I put in my mouth. If I choose to eat foods that do not impair my body’s ability to produce and respond to insulin the genetic predisposition to develop type II diabetes will not be expressed. I don’t think this is going to be easy. Given what I know about my anatomical and biochemical individuality, however, I think managing diabetes would be even more difficult. So, I intend to try.
If you are interested in these topics continue to follow me. If you want to know if I am successful in continuing to make dietary choices that do not lead to diabetes, then continue to follow me. If you are interested in finding the dietary lifestyle that works best for you, contact me. I can help you with that.
I understand enough about epigenetics, to know that just because you have a gene does not mean that it must be expressed. I know enough about nutritional genomics to know that what you eat can influence your health. If you are still reproducing, then what you eat can influence the health of your descendants across future generations. Let’s take responsibility for our food choices.
- In the past several posts, I have written about how I strive to be well given the challenging health conditions with which I born (congenital) and those which developed as the result of a genetic predisposition. I have written about scoliosis and the pain from the leg length discrepancy it produces. I have written about the congenital stenosis and spondylolisthesis in my lumbar spine which have, in conjunction with degenerative processes and a cyst, damaged the nerves that enervate the muscles of my shorter and smaller leg. I have written about the autoimmune diseases with which I live: lupus, Hashimoto’s, Sjogren’s Syndrome, etc. ↑
- I knew this before my DNA was analyzed. According to members of my extended family, Type II diabetes, or “the sugar,” runs in our blood. Both of my parents were diagnosed with type II diabetes. I get emotional when I think of the family members that I have lost because of the complications of this disease. The cases in my family also seem to be following the national pattern in which people are experiencing the onset of the disease and its more serious complications earlier in life.I am familiar with the statistics, national trends, and the debates over causes because I have facilitated graduate level seminars on the sociology of food and nutrition offered through the sociology department at VCU. ↑
- Most of my clients still get their blood drawn at the time of their office visit. Some still only get a phone call after a result is outside of the expected range. Some now have access to their lab results through “patient portals.” I assist these clients with accessing all the portals in which their health data are stored. I help them become comfortable with the way the data are presented. You do not need a medical degree to recognize a result that is changing over time in undesirable ways. Many specialists will only send a report to the primary care physician. Having access to a patient portal allows one to share the information with every member of the health care team. ↑
- Impaired fasting glucose is defined as a fasting blood sugar level between 100 and 125 mg/dL (5.6 to 6.9 mmol/L). ↑
- The process of reducing lectins in tomatoes took me back home to Alabama and watching my aunts go through the process of canning tomatoes. I will be trying to make a reduced lectin tomato sauce and seeing what happens when I include it in my diet. https://youtu.be/Qq0QXdql7Po ↑
I love to walk, even when it hurts. And when it hurts, I am going to say that it hurts. It is simply an empirical observation. It is not always possible for me to walk the outside paths that I prefer. Then I exercise inside. I am developing a long term and somewhat intimate relationship with a stationary bike. That relationship has been influenced by the body mechanics of cornerbacks.
My recent interest in cornerbacks came from a YouTube channel which presents comic exaggerations of those who play various football positions.
Watch “CORNER BACKS BE LIKE..” on YouTube
Eventually it “clicked in” that I found the backpedaling of cornerbacks so fascinating because of what it demonstrated about the working relationship between the muscles that act on the posterior aspect of the thigh and those that act on the anterior aspect. I switched to viewing videos of great cornerbacks and then to younger ones being trained to back pedal
Watch “Football Tips (Defensive Back): How To Back Pedal” on YouTube
For two decades physical therapists have noted that my hamstrings are over developed in relationship to my quadriceps. The imbalance is usually in the other direction. None of the programs that physical therapists designed for me solved my imbalance issue and some even lead to injuries.
I believe that the problem starts with the scoliosis and leg length discrepancy combined with a really “wonky” pelvis. I also think that the structural defects in my lumbar spine and the damage they have caused to nerves play an important role in what is going on in my legs. The nerve damage which has atrophied the adductors in my right thigh, also plays a role in the weakness of my quads. Of course, knee replacement surgeries have played a role. When surgeons take you apart you may find yourself in “Humpty Dumpty” land and never properly put together again.
I have now been to physical therapy so many times that I know what I need to be doing at this stage of my rehabilitation. I am not minimizing the importance of those who have earned the title Doctor of Physical Therapy. I am saying that the last time I started what was supposed to be an eight-day program they kicked me out after day three. They simply told me that since I already knew the program, I should work it on my own. That is what I am doing now.
I think it “rocks” that I can approximate the stance required from a backpedaling cornerback. It is like the ¼ squat that was on the list of exercises given to me by my home care physical therapist a few days after my last surgery. Check out the ¼`squat and compare it to the initial back pedal stance of cornerbacks.
Watch “1/4 Squats to Regain Knee Strength After an Injury” on YouTube https://youtu.be/bhv871C66wI
We started those ¼ squats with me holding onto the kitchen counter. I put in the work and I got stronger. It is now a standard part of my morning workout with no chair or counter top required. Yes, I include ¼ squats and other movements during my morning walk.
The back pedal is more of a challenge. However, I do add a few back pedals and shuffles to my morning walk. Defensive back exercises improve not only muscle strength but also balance and agility. My hamstrings are still doing most of the work. That is why on the bike, I backpedal and dream of being a great defensive back. I DO NOT TRY TO TURN AND ACCELERATE. I am imaginative, not totally insane.
In my fantasy life, I am a Mike Singletary quality middle linebacker. That is why I sometimes take down offensive people without a second thought. You offend me, I sack you. It is just that simple. Bye. I am fighting for my life. I don’t have the energy to deal with shade and snarkiness politely. Comeback when you are ready to be on my team, to offer me support and encouragement.
If the removal of the cyst allows the damaged nerves to regenerate, then my quads might start doing some of the work required to walk. I am responsible for the effort. The outcome is beyond my control.
GirlTrek.org is helping me to be inspired by “the baddest freedom fighter our country has ever seen.” I am only on step one. It is a step that requires honesty, openness, and directness. I am up to that part of the task. Inspired by Miss Harriet Tubman, I am saving my own life first.
- My first undergraduate anatomy and physiology professor was a kinesiologist for the Chicago Bears. His approach to teaching this introductory course was to put 10 questions on the blackboard during the first class of the quarter and inform several hundred students that half of them would be on the midterm and the other half would be on the final exam. We were expected to learn the answers to those questions from the textbook and from the laboratory in which we dissected cadavers. Then he lectured on the what the Bears had done wrong in a game, with a strong focus on the quarterback. This delighted the students who were also required to take a kinesiology course with him. It gave them a leg up on those students who took intro with other professors. The physical education majors and pre-med students in the class were very competitive and always looking for a leg up. After all these years, I still can’t think of basic anatomical mechanics without thinking about football players. ↑
- I am not providing a list because then someone will want to argue about their rankings and that is not the goal of this post. ↑
- I AM NOT FLAKING OUT ON PAYING CLIENTS. While I work on saving my own life, I will continue to provide consultation services to paying clients. ↑
THE HASHIMOTO’S EXPERIENCE
I was born with a genetic predisposition for thyroid disease. I knew this before I saw reports generated by analyses of my DNA. Both my father’s mother and my own mother had thyroid disease. My paternal grandmother’s goiter is clearly visible in the picture below. I saw my mother’s goiter with my own eyes but have no pictures from that period of her life.
As a child I hypothesized that their goiters were the result of insufficient levels of iodine. (Yes, I was that child. I spent my early childhood in a segregated community in the U.S. South without routine access to physicians. My maternal grandmother was a healer. She allowed me to follow her around until I started asking inappropriate questions about sexual and reproductive issues. I paid attention. I think this is where I was introduced to the value of traditional knowledge and self-care. The more I learn from modern medical science, the more I know that my grandmother was a brilliant woman, even though she thought my curiosity about reproduction required an exorcism.)
My own experiences, as I spent decades coping with undiagnosed and misdiagnosed thyroid disease, do not support the “lack of sufficient iodine” hypothesis. Those were very difficult years characterized by a wide array of painful and energy draining symptoms. My thyroid disease was not diagnosed until the gland stopped functioning, knocked out by a medication prescribed for a condition that I do not have.
Hypothyroidism (underactive thyroid) https://www.mayoclinic.org/diseases-conditions/hypothyroidism/symptoms-causes/syc-20350284
Many people with lupus have stories about the horrors they experienced before being diagnosed correctly. My initial lupus diagnosis came quickly. My horror stories revolve around years of undiagnosed and misdiagnosed Hashimoto’s Autoimmune Thyroiditis. I lost my left knee to Hashimoto’s at age 40. But the most nightmarish part of the experience was being misdiagnosed with bipolar disorder when the changes in my energy levels and moods were in fact caused by the Hashimoto’s.
Is it Mental Illness or Hashimoto’s Disease – https://www.holtorfmed.com/mental-illness-hashimotos-disease/.
These experiences also highlighted my genetically based hypersensitivity to antidepressants. Several years ago, decades after I knew better, I succumbed to pressure from a pain management physician to try Duloxetine as a treatment for neuropathic pain. I expected to experience a brief period of hypomania which would convince my physician that it was not a good idea for me to take the drug.
Instead, the side effects were devastating. Not only did I experience a very unpleasant period of hypomania. I also experienced lightheadedness and a loss of balance. It was during this process that I fell and traumatically injured my brain. Even though I went to urgent care the day after my fall, it was more than a month before my traumatic brain injury was diagnosed.
Traumatic Brain Injury – https://www.mayoclinic.org/diseases-conditions/traumatic-brain-injury/symptoms-causes/syc-20378557
Then I tried stopping the medication. The effects of Duloxetine withdrawal sent me into a life altering downward spiral. The “brain zaps” hit me hard. I reached out on Facebook. Instead of offering me help, most of my friends and relatives ignored me. A few made fun of me. (BUNDLE UP CHILDREN: SOME OF US LIVE IN A COLD, COLD WORLD).
Cymbalta Side Effects – https://www.drugwatch.com/cymbalta/side-effects/
The physician who had prescribed the medication told me that what I claimed to be experiencing was impossible. He lashed out at me by telling me that I needed a psychiatrist. Since I am always open to that possibility, I called the psychiatrist who had been with me through the process of establishing that what appeared to be a mood disorder was in fact an autoimmune disorder of the endocrine system.
My former psychiatrist returned my call even though he was retired and was in the process of closing his office. His response was empowering.
“Ann, you do not need a new psychiatrist. You need a new pain management physician. You are an intelligent woman. No good physician is going to ignore what you have to say about your own medical history.”
I decided to tough the withdrawal out on my own. After talking to my daughter, who works in a microbiology laboratory, I bought myself a set of Norpro Mini Stainless-Steel Measuring Spoons – http://amzn.to/2MN7x2E and some Micro Scoops – https://amzn.to/2IgVFCV. While dealing with a traumatic brain injury, the side effects of Duloxetine, and Duloxetine withdrawal symptoms, I used these tools to titrate off the drug by gradually removing beads from the capsules.
One of the things that I learned from this experience is to never take drugs prescribed by a physician who has not thoroughly studied and accepted my medical history. This experience has also played an important role in the philosophy that I bring to my work as a health educator. I believe that people should know as much of their family health history as possible. They should be able to present that history in ways that health care professionals must respect. And they should be able to provide themselves with appropriate self-care. Maybe they need to consult with someone who has a graduate degree in health and nutrition education and some first-hand experience.
MY GOALS AS A HEALTH EDUCATOR
To assist people with claiming their own health history.
To assist people with understanding the value of appropriate self-care.
STILL CARING FOR MYSELF
My health history dictates that each morning, as soon as I climb out of bed, I take my thyroid hormone replacements. The failure to take them has such severe repercussions that I have put a great deal of effort into building this habit. I require a replacement for T3 as well as the standard prescription for T4. And of course, I have my favorite books.
GRATITUDE AND COMMITMENT TO TRUTH
I still have pain and fatigue. I visit an ophthalmologist for routine hydroxychloroquine toxicity screenings. That is why my cataracts were diagnosed prior to surgery and why I was recently lectured on the need to provide better care for my dry eyes. Sjogren’s adds to the pain and fatigue and to steps in the daily routine of self-care.
However, given that I was born with several skeletal defects and that my genetic propensity for autoimmune diseases was triggered in 1956, I am grateful to still be alive, upright, and moving under my own power. This has been a life long war. I survive by confronting the issues realistically. I will not be bullied into a conspiracy of silence and denial. I will not be seduced in telling lies. I will speak my own truth.
If you think that every mention of pain is indicative of powerlessness, failure, and negativity, I could probably help you too.
Back pain as the result of a leg length discrepancy due to scoliosis and lumbar spinal stenosis forced my father to change his life during his mid to late 30s. Prior to that time, he had been an outstanding athlete both on the basketball court and with baseball bat. I inherited the painful structural defects in my spine directly from my father. I have known this since I was diagnosed with scoliosis as a high school student.
If you have a good eye for structural anomalies you can see our curved spines and leg length discrepancies in this 1957 photo taken at the bullfights in Nogales, Sonora Mexico.
What I did not learn until later in life is that early intervention could have dramatically reduced the negative impact of these genetic gifts on my overall health status. I want young people who find that they too have inherited these defects to understand the importance of intervening in the degenerative processes as early as possible. They may need to become proactive self-advocates long before physicians are concerned. Young people may need to remember that conventional medicine is designed to treat illness and dysfunction. They will require a more preventive approach to achieve wellness.
As I approach my 72nd birthday, I am grateful to have recovered some of my ability to walk. My morning walk is my favorite part of the day. I only measure the length of my walk in terms of physiological effect and time elapsed. I walk until I have worked up a good sweat and elevated my heart rate. Right now, it tends to be 40 minutes from the time I leave my dwelling until I return. My goal is to increase the amount of time that I can walk once my heart rate has been elevated.
I want to find the wall of my endurance and push through it until my brain rewards the effort with a “rush.” I know from experience that my brain manufactures the best “feel good” chemicals in the world and that is the pain relief that I am chasing. I know I have achieved that state when my internal sound track plays James Brown’s “I feel Good.” The purpose of my rehabilitation program is to change the frequency and intensity of the pain signals that my body sends to my brain AND how my brain interprets those symptoms.
Ready to Roll
I tend to sleep “ready roll” for walking. I roll out of my bed, wash my face, brush my teeth, take my thyroid hormones, grab my stuff and go. My “stuff” includes the right stick, the right shoes, the right music player, and the right mindset.
I have a few sticks and trekking poles (in addition to several pairs of crutches and a few canes). I love what I call my “big stick.” It is beautiful and functional but not quite right for my current physical status and needs. These days I only go for aerobic walks in my neighborhood. Therefore, I have opted to use a lighter stick for help with balance, cadence, and to incorporate upper body movement into my walking routine. The wolf carving on the straight lighter stick is symbolic of lupus and serves as my reminder to behave in ways that keep the beast calm
Keeping the beast calm while using a footlift to compensate for the difference in the length of my legs, requires walking shoes with specific characteristics. I look for lace up shoes with a removable insole, extra depth, and a wide toe box. The Merrell shoes on the left have served me well and I am getting ready to put a new pair into the lineup.
The laces that come with new shoes are too long for this Lupangeezer. I often replace those laces with a brand that locks. Sometimes I simply lock the original laces, cut or burn them, and tie the ends into knots. On other occasions, I resort to the original curly no tie type of lace. The only thing that I do not do is trip on my shoe laces.
All Shoes Need a Lift
One of the most important things about wearing the footlift to reduce the shear on my right sacroiliac joint is that the footlift must be in place every time that I stand up. I cannot walk barefooted, and a lift must be inserted in every pair of shoes that I wear. This pair of Rocket Dog Stokers are my favorite house shoes. They are not great walkers, but they have the required removable insole. The wide toe box and elastic and Velcro closure keep me relatively comfortable indoors with the challenging concrete subfloor.
The music that I prefer for aerobic activities is already loaded onto the waterproof mp3 player that I use in the pool. I clip it on, push play, and I have four hours of music that I love, music that inspires me to move. I thought about adding an appropriate playlist to my phone but after a lengthy discussion with ALEXA about song choices, I realized that turning the phone off and adding it to the contents of my fanny pack was the best option.
I am more than a tad obsessed with the concept of walking. Since I started working on DNA genealogy and family history, I am fascinated by the fact that some of my ancestors walked from the coastal plains of eastern seaboard of the United States to the Mississippi Territory and beyond: the slavery trail of tears – https://www.smithsonianmag.com/history/slavery-trail-of-tears-180956968/.
This connection to walking motivated me to join GirlTrek.org http://www.girltrek.org/.
It feels as though the founders of this movement have read my heart, mind, and soul. So, even though I am stranded in my neighborhood and walking alone, I walk in communion with a group of like minded women. Harriet’s Handbook has become one of my most important tools. It provides inspiration. It adds the accountability that a person walking alone really needs. And it rewards the achievement of goals. I am documenting my first official Warrior Week.
Sometimes my thoughts retreat into a more distant past, such as the development of bipedalism in early humans. Sometimes it starts flipping pages in anatomy texts trying to figure out what else I can do to compensate for the skeletal defects with which I was born. “Here there be dragons.”
Sometimes, I don’t need more information or more thought. I just need to walk far enough, long enough, and fast enough that my brain can handle no thought more complex than “I FEEL GOOD.”
- One day a new comer to the therapeutic pool at Sheltering Arms watched me go into a session really dragging (think “Nobody Knows the Trouble I’ve Seen”) and come out singing “Papa’s Got a Brand-New Bag.” She asked if the exercise had changed my pain level that drastically. I answered her honestly. “The pain has not changed. My brain just doesn’t care as much about it.” I am still moving my body through the pain to change the way my brain feels about it. ↑