Tag Archives: Fatty liver

Bad news and good news

A little health update:

  • in a check-up with Gerard, my nutritionist, two months ago my bodyfat had crept back up to nearly 19% :no:
  • I’ve been travelling a bit in the last few weeks, including a trip to the USA, but I worked on my diet and went back to eating Ful for breakfast instead of porridge, tried to keep starches out of most meals, upped my vegetable intake :yes:
  • I haven’t been exercising much over that time :no:
  • I had a check-up last week and my bodyfat was a bit over 18% :yes:
  • Gerard let me know he’s leaving the practice to become a schoolteacher – apparently that’s fun! :-(( :no:
  • this morning I got my own Tanita bodyfat scale so I can monitor my bodyfat daily or weekly if I want to :yes:
  • Niche and I are kicking up our workout consistency this week and I’m planning to fit in more high intensity cardio. :yes:

So, on balance, things are good :-))

Fatty Liver update III

Over the last two weeks, I’ve had a second round of blood tests and a follow-up ultrasound exam of my upper abdominal cavity.

The visible progress has all been good. Gerard (my naturopath-nutritionist) has been watching my bodyfat measure on his scale drop from my original 22% three months ago down to 15% and my waistline shows the difference, so he and Nick (my psychotherapist-GP) agreed that it was time to get a second round of tests.

Last week, Nick and I sat down to review the results. The liver numbers on the blood report were all in the middle of the normal range, way down from their elevated levels that sparked this whole project off. The golden moment, though, was the ultrasound report. Nick had request that the sonographer compare this exam with the film from the previous exam. Here’s the conclusion:

The findings previously of fatty infiltration of the liver have resolved.

So, in a very technical sense, I’m well.

Gerard and I spoke last week about adapting my diet out of “crisis mode”. We all understand that if I go back to the way I was living for the last few years I will wind up in the same spot or worse in a few years, so we talked about how to keep the current plan sustainable: another serve of wholegrains a day, lots of variety , sticking with regular exercise and finding fun ways to get it. The usual.

I think one of the many things I’ve got out of this is that to frame my former way of eating and exercising (or not) as “abuse”, now that I’ve adopted a new set of behaviours I’ve got all the indicators to show that I’m “normal”, but my aim is to weave them into a sustainable lifestyle that is recognisably “healthy”.

Wish me luck!

Three coffee habits

Leaving aside whether it’s useful or sensible to give up coffee, I thought it might be interesting to post some thoughts about how to give up. Perhaps these thoughts might apply to other kinds of habit-forming substances. Your mileage may vary.

I’ve given up coffee several times, for several reasons. I’m not suggesting you do and if you do, I’m not suggesting you do it forever. You may have some short term reason for doing so, or you might want to do it for the long-term. My suggestions about getting off, because I’ve gone on and off, I don’t have much to offer about long-term strategies other than – if you end up with a habit again, just do all this again.

The main thing I want to point out is that most coffee habits actually have three distinct aspects woven together: addiction, psychological habit and social habit.

Addiction is a physical dependency. Your brain builds a dependency on having caffeine fed to it regularly, when you stop it goes into caffeine withdrawal causing headaches (and possibly other side-effects). I once went from about 7-8 espressos a day to none overnight – I’ve described the effect as “wearing the iron crown” for three days. Imagine a big crown cast from pig iron with spikes that dig into your head. As I recall it was also three days in which everyone hated me and I hated everyone: I really don’t recommend it.

Because addiction is a physical dependency based on chemical needs, I’d recommend treating it chemically – just make sure that you wean yourself off caffeine over a few days. You can do this by cutting down cups, slowly substituting decaf for caffeinated coffee or using caffeine pills (much like you’d use nicotine gum or lozenges when quitting smoking).

But, you’re also likely to have a psychological habit of drinking coffee – maybe you associate coffee as a reward drink, a drink marking a mid-point in the afternoon, a drink you have when you wake up. You have an individual pattern of associations between various times and actions and drinking coffee.

An approach to giving up that deals purely with the chemical addiction, but not with the habitual behaviour patterns is less likely to work. I’d recommend finding substitute behaviours – maybe other drinks to fill the gap: tea, decaf, herbal drinks – or in the case of rewards things like dark chocolate. However in the world of rewards you tend to drift to booze, candy and cigarettes and really, coffee’s the lesser of many evils, but if you can find a healthy substitute reward that works for you, go for it.

The final aspect is the social habit. You probably “go for coffee” with friends. I have always had a cup of coffee with my beloved as a way to start the day, coffee often comes after a shared meal and so on. In many cases, we hang out with other coffee drinkers whose social persona includes “coffee drinker” as a self-identifier, as does one’s own. This aspect is not about your personal habit, or your chemical dependency, it’s about social pressure.

Depending on how big a part coffee drinking plays in the group’s culture, this part can be easy or very, very hard. If it’s just a basic social habit to have a cup of coffee with friends, it’s fairly easy to substitute green tea or a herbal tea for your usual cup of coffee without much problem.

But if you hang out with people whose usual drink is a single shot of espresso, who know what a ristretto is and who laugh out loud when a friend orders a “decaf skim latte”, you may have some issues.

You’ve really got three options in my view:

  1. show up a little late and order a decaf so that no-one can hear
  2. order whatever you want and soldier through the derision
  3. find new friends and stop hanging out with the coffee pushers

My approach this time through has been aimed at minimising pain and taking it easy.

  • I bought a really nice-tasting, organic, Fair Trade decaf coffee for our espresso machine
  • I started substituting decaf espressos in place of my usual, without changing frequency
  • after a couple of days, I tried only drinking decaf until I started to feel a headache or some withdrawal symptoms and then add a “medicinal dose” of caffeinated espresso
  • over a week or so, those incidents naturally started to space out
  • I started to substitute green tea and herbals in place of some of the decafs

… and that’s pretty much it. Now once or twice a week I have a cup of caffeinated coffee if I feel like it, and I rarely do. I start the day with a decaf with Anthony because we like to make coffee for each other. If my friends raise their eyebrows when I order decaf (and they mostly don’t) I laugh.

That’s my thoughts. Your mileage may, of course, vary. I hope some of that’s been of some value.

Title problems

I’ve just been doing some maintenance on the blog (hello Disqus comments!) as I sat here with my decaf espresso and pondered the current irony of my blog title.

The fatty liver issue has meant that I need to restrict my intake of caffeinated coffee (green tea is OK). So, while I have still “just had coffee”, it’s now the decaf stuff. Nice, fair-trade, organic decaf, but decaf nevertheless.

Fatty Liver Update

Just visited the nutritionist. So far, so good. I’ve stuck to the diet and exercise for two weeks, no major slip-ups. I’ve lost 3 kilos or so, but some of that is muscle – we think because I’ve been skipping some protein. So more protein and some weight training.

In any case, the bodyfat percentage is down. In a couple of months, we’ll test my blood again and see if my liver’s recovering.

Fatty Liver Lifestyle

In May this year I turned 42. I figured a prudent step might be to go see a physician and get a medical check-up just to see if anything was amiss. I’ve spent so much time in the last ten years trying to cajole my late mother into seeing a doctor, it seemed a bit hypocritical not to.

I found the kind of General Practitioner I’ve always fantasised about: Dr Nick Bassal. Nick started the Wholistic Medical Centre a couple of decades ago to provide integrated health management. There’s four medical doctors and a whole crew of naturopaths, osteos, nutritionists, masseurs, acupuncturists and so on. I like using alternative therapies, but I’ve always wanted a GP who could refer me to what was the right one to use. Now I’ve got one.

The check-up involved mostly blood tests, which showed skewed liver numbers. We followed up with an ultrasound which showed I have a “fatty liver“: my spreading girth (or “central adiposity” as the medicos like to euphemistically phrase it) is accompanied by visceral fat around my organs and fatty pockets inside my liver. Early signs of Metabolic Syndrome, says Dr Nick. The liver condition will get worse if I don’t change my lifestyle – pockets of fat in my liver gradually squeeze healthy liver cells rendering my liver less functional. Diabetes, cardio-vascular disease, cancer.

Well. That’s why you get a check-up I guess.

So, off to see Gerard the naturopathically-qualified nutritionist to talk about my diet. I saunter in holding a food log from the previous month anticipating a relaxed chat about ways I could improve my diet. Gerard has other ideas.

He hands me a booklet called “Whole Life Vitality” which firmly lays down the law on (previously loved) foods which are forbidden and (previously ignored) foods which are now mandatory. And 60 mins of exercise per day. Every day.

No potatoes of any kind. No white rice. No sweets or chocolate. I count my blessings that he crosses out the “no coffee” part, but seriously, is life worth living without potatoes?

I take a deep breath. It’s not that bad. I’ve done crazier diets and this one’s for serious (as my beloved sister likes to say). I need to work out how to keep this up basically forever or at least until my live gets less fatty.

This is my fourth day. It takes a lot more forethought and planning about my diet than I’m used to. My usual approach is to just do what ever I’m doing until roused by hunger pangs, survey the immediate environment and scavenge food. This approach will no longer work.

I’m kind of in shock about it all. It all seems a bit big. I’ll try to check back in when I’m the swing of things, if that ever happens.

Wish me luck!

Edit: all posts about my fatty liver lifestyle are here: Fatty liver