End of 2018 Reflections
As the year closes, and the Garage is closed until the New Year, it is a great time to reflect on 2018.
It's been eight months since the Garage opened, and already we have witnessed so many health transformations.
Our members are a diverse lot - ranging from 23 to 79 years of age, almost evenly split between men and women. Many have sought our help to restore their health - reversing their diabetes, controlling their blood pressure and decreasing elevated cardiac risk. Others have come to us to regain confidence in their health, lose weight and get in better shape. While some leverage our precision lifestyle medicine tools to optimize their health, fitness and performance
.A few stories stand out...(these members have consented to share their stories - names and initials have been changed to protect privacy)
FJ - a 57 year old man with Type II Diabetes came to us looking for help with using a ketogenic diet to address his diabetes. He had read about the amazing reversals and remissions achieved through a low carb, high fat nutrition strategy. As a retired paramedic and first responder, he also realized that diabetics on high doses of insulin should approach intensive therapeutic nutrition with medical supervision. During our assessment, one of the first things that we did was check his C Peptide levels to ascertain was whether his pancreas was still producing insulin. His levels were low, indicating advanced diabetes with pancreatic fatigue, but they were high enough to encourage us that reversal was still possible. After completing our Comprehensive Lifestyle Medicine Assessment, our approach was actually simpler than recommending the ketogenic diet that FJ had originally sought from us. Instead when we reviewed his behaviors, we decided to take a more graduated approach to his nutrition. As I explained, we should start with the elimination of added sugars, refined carbohydrates, bread, pasta and white rice; add an element of time restricted eating (at least 12 hours without calorie consumption) and moderately increase exercise towards 150 minutes per week, and wherever possible increase activity. Even though these changes were not as aggressive as an immediate adoption of the keto diet, I still recommended that FJ reduce his insulin by 40% to avoid low blood sugars.
The changes were immediate - blood sugars that had been reading in the 15+ mmol/L range dropped down to 5-7 mmol/L. The first few weeks transitioning to this way of eating were tough for FJ but he as he commented: "the support from the Wellness Garage team made this easier". After a few weeks, the cravings that had thwarted other previous attempts to change his eating went away. The changes no longer seemed hard, they were now the new normal.
When FJ started his major symptom was chronic pain - "Old injuries in my elbow, lower back, and hip regions would wake me up at nights and bother me throughout the day." After weeks with his new nutritional habits, his pain disappeared. His diabetes, which had been diagnosed over 25 years ago, and had progressed to the place where he was taking over 200 units of insulin per day with a continuous insulin pump, had dramatically improved.
In 4 months his HbA1C has improved from 11.9% to 6.5%, while his insulin dose dropped to 60 units per day, his cholesterol has improved by 19%; triglycerides by 81% and his TG/HDL - a measure of insulin sensitivity (and likely a predictor of ongoing improvements) has improved by a stunning 85%. Even more encouraging, his C-peptide levels returned to normal, indicating recovery of pancreatic beta islet functionality.
...and he has lost 25 lbs (3 pant sizes smaller!)
All this without calorie counting or strict restrictions - just real food, not too much, coupled with increased activity.
In the next few months, FJ plans to work on increasing his exercise gradually, which should be easier now that his chronic pain has resolved and he has lost some weight.
Almost as dramatic is the story of JW, a 26 year old woman who was referred by her neuro-opthalmologist. JW, a former athlete, had gained over 100 lbs in the past 3 years and was suffering from intense migraine headaches multiple times a week. At her initial consultation, she weighed over 350 lbs and said she felt trapped because of lack of resources. She and her husband were living on a $200/month grocery budget and as a result were eating a lot of refined carbohydrates (especially pasta) as well as fast food. Her initial workup, revealed that JW was now diabetic with mildly elevated blood sugars and HbA1c. With this diagnosis and her circumstances, what she really needed was nutritional coaching at a very practical level to help her eat real, whole food on her $200/month budget. With a bit of ingenuity along with some trial and error, JW learned to make different choices at the grocery store and different meals at home. Her ability to focus, and her drive to get healthy allowed her to make the changes within weeks. Again, her results have been dramatic - 50 lbs weight loss in 6 months, coupled with a reversal of her Type II Diabetes. Her headaches are almost all gone, and she is getting ready to return to work.
ST, a 32 year old police officer with a traumatic brain injury came to the Garage as part of a weight management program. He was suffering from regular headaches, fatigued and irritable. For ST, the nutritional approach was pretty simple - increase his veggies, decrease his refined carbohydrates, help him plan for healthy snacks all while gradually increasing his running (paired with some strength and yoga work). In 4 months he lost 23 lbs, the headaches, fatigue and irritability were greatly improved, and the running was going so well that ST shifted from restoring his health towards optimization by setting a goal of a 2019 marathon.
In reflecting on these changes, ST said: "After the injury I felt like so many things had been taken away from me. Focusing on my health has given me a sense of control back in my life."
The final quick story, I will relate is that of HL a 62 year old marathoner who came to the Garage to see if there was anything he could learn to improve his running performance. His DXA showed a bit more abdominal fat than was expected and the nutritional assessment found a few simple changes that could help. Within months, WL found he had dropped back to his university weight and his running times were his best in 8 years. Simple changes - big results.
In the eight months since the Garage opened we have been privileged to help many on their healthy journeys and the transformational changes that we are seeing are really quite stunning. The improvements in weight, blood pressure, cholesterol, blood sugars and cardiac risk are at levels well beyond what any drug or drug combination could ever realize. What we are witness to is the body's profound resilience and ability to return to health when simple behaviors are changed.
Nothing that we recommend at Wellness Garage is radical - instead it is the application, and stacking of many small habits, that one by one help restore the body's natural homeostasis and optimal health.
All of these amazing results have come from people, taking control of their health, one habit at a time.
The hard work is done by our members, we are their pit crew to support them on their health journey.
As 2018 closes, and I look back at the year, I am very grateful to have participated in so many transformations and look forward to more to come.
If you, or someone you know, is looking to make 2019 the year that you restore or regain confidence in your health - please reach out or tell others about Wellness Garage. We welcome everyone with a free initial consultation where we can discuss how we can help.
Dr. Brendan Byrne