3/6/2015 - And So It Begins

My father and his father both died of heart attacks at 43. It’s not the thing you bring up on a first date, but ultimately, it’s my reason for writing this blog. I’m a few weeks from turning 37, and as much as I have a hard time believing that I’m not still fresh out of high school, I’ve heard from numerous reliable sources that calendars rarely lie.

The knowledge of my family’s history of heart disease has always lurked in my mental periphery, and I’ve often joked about being the Danny DeVito twin who inherited all the worst genes from both of my parents’ respective family trees, but I never put a lot of stock into the idea that my lifestyle choices would one day catch up with me. (And for the record, I still hope they won’t.)

***

Almost ten years ago, for a variety of reasons, some physical, some ethical, I decided to go vegetarian. Determined to do it right, I first saw a nutritionist. Now, a little back-back story is needed here. I’ve had high, sometimes dangerously high, cholesterol since middle school. Early on my pediatrician steered me toward a “fat free” diet, still heavy in animal products, still heavy in processed “fat free” (ie. high sugar, low fiber, pure chemical shit) snacks.

I did this for the better part of my middle, high school and college years, with some considerable digressions, yet I still had borderline high cholesterol and off-the-charts triglycerides. But at least I was trying, right?

Some exceedingly bad dietary behaviors sneaked their way in in college. For instance, I would often buy a large loaf of Italian bread and a couple pounds of cold cuts, then make half of the loaf of bread into one enormous sandwich stacked with meat and cheese, slathered with mayo, and maybe a little iceberg lettuce and some onions to ensure that it was a balanced meal. Not surprisingly, I was up in weight, up in cholesterol, down in overall health.

But that was nothing compared to the all-out culinary debauchery of my post-collegiate years. I would, without compunction or shred of decency, order an obscenely large meatball calzone, devour the whole horrifyingly massive thing in one sitting, and then chase it with a couple slices of Sicilian pizza. 

***

Jumping ahead a few years to my late 20s: As I said, spurred on by my studies and modest commitment to Buddhism (along with my vow to stop killing or intentionally harming sentient beings, yes, even annoying ones like mosquitoes) as well as the promise that I might drop some pounds so I would look less like a Hotei Buddha and more like a Shakyamuni Buddha, I finally decided to go vegetarian. At this point I was up in the mid-to-high 240 lb range, so a change was certainly warranted.

Initially all seemed fine. At the behest of my nutritionist I was keeping a daily log with every calorie, gram of fat, saturated fat, cholesterol, carb, fiber, net carb, and protein that I put in my mouth. And initially I lost some weight and my numbers improved a bit. Yay.

However, I had fallen for the common American misconception that we need MORE PROTEIN! Never enough! If you’re not making your kidneys scream for mercy from the strain you must be protein deficient! And so I was loading up on sliced cheese, cottage cheese, yogurt, eggs, lots of animal-derived protein sources heavy in saturated fat and cholesterol.

Low and behold, my liver numbers started going wonky. The AST and ALT were consistently high. My doctor at the time gave me his reassuring opinion that “I don’t think you have hepatitis and I don’t think you have cancer, so come back in another month and we’ll test your blood again.” And it went on like this, month after month, the numbers steadily rising and the answer staying the same.

It also didn’t help that my average meal portion was still in the range more suited to a land mammal a few times my size. There was a particular Taqueria (which is no longer in business, I say with a mixture of nostalgia and gratitude) where they would build a burrito of the customer's design. The people working there were more than liberal with the toppings. In fact, they often had to use two overlapped tortillas to keep them from rupturing the oozing, writhing mass of black beans, rice, sour cream, shredded cheese, lettuce, tomatoes, olives, hot peppers, cooked peppers, and a suspiciously Velveeta-esque goop that they called "espinaca con queso", but which I happened to know was some chemicalized concoction that came in frozen in a giant plastic bag that was reheated by soaking the whole thing in a vat of warm water. Yum…  Anyhow, the burrito would often weigh upwards of two or three pounds! And of course, in about ten minutes it would be gone, along with a bag of tortilla chips and another container of the espinaca con queso which had virtually no espinaca to speak of, (and probably nothing that could legally be called queso either).

All of which is to say that even though I was vegetarian, I was still basically a junk-food vegetarian. And my body was responding in kind.

***

We’ll fast forward now to the first Vegetarian Expo in Saratoga, NY. At this point I’d been vegetarian for two years, but felt like I was somehow copping out. Like I was on the right path but that I should be following it further. Like I knew I could and should be doing more. I’d heard about veganism, but also heard rumors about how extreme and unhealthy it was. Like, don’t they just live off of wheatgrass, salad, and martyrdom? And seriously, where the hell do they get their protein?  Besides, everybody knows somebody who went vegan and got terribly sick and/or cancer and/or died.  

So ethically I was feeling more compelled to going whole hog-less, so to speak, having only recently been exposed to footage of the great abomination that is factory farming, and the inhumane, rather absurd world of even the “ethical, family-owned, local farm” dairy industry. But still… I shouldn’t have to DIE for my fledgling morals, should I?

That day I attended a talk by Dr. Caldwell Esselstyn*, a respected cardiac surgeon and long-time vegan, that literally changed everything. He described how a vegan, whole-foods, plant-based diet was optimum for making you not only heart attack proof, but for even reversing heart disease once it had begun. Veganism is, he continued, the healthiest diet for all of us. No way! It’s healthy and ethical? I decided immediately that I had to go vegan. I bought his book, asked him some questions, and stepped out of the Saratoga Convention Center that day on my path to a healthier whole-foods lifestyle, feeling like a huge weight had been metaphorically (and soon to be literally) lifted from my shoulders. 

The transformation was strikingly quick. In total over the next six months or so of veganism I lost over 60 pounds, had more energy, improved complexion, and more importantly, after ditching the dairy, my liver levels were back to normal within the first two months! It turns out I was giving myself cirrhosis of the liver from fatty foods! And for the record, my AST and ALT levels have been perfectly normal ever since.

My cholesterol too was down to a record level in the low 120s (down from the 200s in my earlier dietary iterations). And even more stunning, my triglycerides which had formerly been up in the high 700s, came down to a record low of 23. Yes, 23.

***

I’ve always hated exercise. I am a firm believer that exercise kills. This was my partly tongue-in-cheek mantra for most of my life. Seriously, though, didn’t Bob Marley die from toe cancer from kicking a soccer ball or something?  I did, however, at this point begin walking around the block a few days a week. Surprisingly, it didn’t send me to an immediate grave, and it probably did speed up the numerous benefits.

At first I stuck very strictly to Esselstyn’s regimen; no added fats, all whole grains, no processed foods, moderate exercise… But slowly the little temptations (and old familiar laziness) eased their way in. I don’t actually have a heart problem, and vegan food is still a hell of a lot healthier than what most of the rest of the country eats, so I can totally have seconds of this vegan turtle cheesecake laced with homemade caramel and pecans and coated with a chocolate-coconut ganache. Besides, I walked all the way down the hall to the fridge, and then back to the computer chair; that had to have burned off at least half the calories, and this morning I traversed a whole flight of stairs to get a chocolate chip cookie from the freezer, which left me with no choice but to climb the damn things again to get back to my computer chair… Screw it. I earned a bag of Kettle Maple Bacon potato chips.

***

Cutting to the chase, in the past few months, (or maybe the last year or two, I have no concept of time,) when I do make the effort to mount the treadmill and put in an agonizing half hour of inclined walking, I’ve found that I’ve experienced a bit of chest and back pain, and that the exercise-induced asthma I’ve been suffering from my entire life (and that has also helped confirm my earlier hypothesis that exercise kills) has been getting worse. So last week I finally worked up the nerve to ask my doctor if we could check my heart. To that end he ordered a Blood Lipid Panel, and sent me for a Coronary Calcium CT Scan which can actually see the plaque inside your arteries. I expected the worst, but hoped for my not-so-perfect vegan diet to be in some way protective.

For the past few years I’ve been riding a roller coaster of food-related guilt. I’ll fall significantly backward on my whole-foods goal, only to feel terrible and turn a corner for a month or two, soon to be tempted away yet again. One of my biggest vices is bread. Twice a week I would buy a beautiful loaf from the farmers market (made often of horrible bleached white flour) and proceed to annihilate the entire loaf in well short of 48 hours, often slathered with obscene amounts of Earth Balance.

And to make matters worse, for the past few months, hoping that all the pro-coconut propaganda I’ve been reading has some merit, I’ve been eating fresh coconut meat three times a day, along with snacking every couple of hours on nuts or scoops of peanut butter from the fridge, and often eating a huge bowl of popcorn cooked in coconut oil as a late afternoon snack… (Not to mention my even worse habit of plowing through almost a whole bag of spicy chips of one variety or another in a sitting.)

So when I had my tests done this week, I was really really really hoping that my daily kale smoothies (with peanut butter and fruit) had sufficiently preventative benefits to compensate for my other digressions.

Not so much. 

My total cholesterol had risen to 185, not bad for the national average I suppose, but terrible for me. My triglycerides were up to 153, my HDL was down to 40, and my LDL was up to 114.

This was understandably discouraging, but the results from my CT Scan were far more distressing. I had a score of 250, on a scale where 0 means you have no arterial plaque, and 400 means you have extensive plaque (and possibly a heart attack or stroke in your near future). 250 is a moderate amount of plaque, and much higher than they would expect to see in a 36 year old.

It is my hope and suspicion that the plaque was accumulated primarily in my pre-vegan years, and that I'm just now finding out about it, but unfortunately there's no way to determine how old it actually is. 

That was my wake-up call. We all need one sometimes.

Thankfully, I’m not in a fearful death spiral. I’m not wondering “Why me?” (I know full well why me!). I’m not feeling like a victim of my genetics. (There is some reason to think that my body might collect plaque at a more accelerated rate than someone else’s might, but I'm inclined to think it was really just the result of bad dietary and lifestyle choices.)

Instead, I am empowered. I have the tools of diet and exercise to reverse this. And I plan to. I’m thankful that it was caught relatively early, and that I’ve had the exposure to some proven antidotes. And I’m hopeful that I can manage this myself without needing to resort to statins or baby aspirin. I’m going to see a cardiologist in the next few weeks, but I have no interest in starting any meds at this point.

That is why I decided to write this blog. To chart my journey from the beginning in hopes of inspiring others, and to warn other vegans that just because you’re not eating animals, it doesn’t mean you have carte blanche to consume everything else you want with impunity. Every bite we take can bite us back.

***

I’ve pulled Dr. Esselstyn’s book off the shelf and am going to follow his very strict recommendations of a diet consisting of no added oils, no processed foods, no coconut, few actual nuts, but tons of fresh fruits, veggies, legumes, seeds and whole grains. I’m sticking to my daily kale smoothies (though revised with more veggies and no nut products), and will probably be having them for breakfast and lunch most days, replacing my usual lunch of oats, organic cereal, fruit and a couple cups of vanilla almond milk. I know it still sounds rather healthy, but the only days I would ever lose weight were the days that I skipped this decadent treat. (I might still indulge in a version of it occasionally, just in a much smaller bowl.)

I also plan to exercise on a more regular basis. I have two seasons of Adventure Time DVDs cued up, along with a Netflix account that I can access on the big TV in front of the treadmill. And if all else fails, I’ll play Wii while I walk and double the exercise. Distractions are key.

I am starting this blog weighing 175 pounds. I hope to end it in a couple of years with a lower plaque score, lower cholesterol, and body weight in the 150 pound range which would be an optimum BMI for my height.  

I’m not much of an exhibitionist. I don’t post much on Facebook. I never Tweet. But I feel like this is important enough to get me to add my voice to the blogosphere. Again, I hope to inspire others, as well as to make people aware of what could be going on inside their bodies.

I welcome constructive comments and questions.

Let’s hope we will all end it in a healthier place!

Thanks for reading! 

*It probably goes without saying, but in case it doesn't, I have no affiliation with any of the doctors, the RAVE Diet, or any of the products I currently buy and occasionally gush about. I have nothing to sell or anything to push. Also, I am in no way qualified to give nutritional or medical advice. I'm simply regurgitating things I've read and heard elsewhere. I'm just a guy looking to turn his own health scare into something positive and empowering for others!