Sunday, January 31, 2016

Return to Reality

Dear Readers - Just a quick post to explain my silence lately. As Robert Service said in the Cremation of Sam McGee: "The Northern Lights have seen queer sights..."

Well, this Winter was no different, and I felt a lot like Sam McGee, just before Christmas.


Christmas Cholecystectomy


On December 18th shortly after eating lunch, I started to get heartburn. This same thing has happened to me once or twice year and always resolved itself in a few hours. I've never known the cause of this heartburn, but attributed it to gastritis of some type. It never occurred after a particular meal, just randomly.

A couple of blogging "doctors" I confided in assured me that I was suffering the effects of SIBO or GERD, most likely caused by my high fiber diet, especially the potato starch.  The problem was, this random heartburn started well before I knew anything about "fiber" or RS, in fact, coincided directly with adopting the low carb Primal Blueprint and persisted through the Perfect Health Diet and high fiber/RS diets.

Anyway, on the morning of December 19th, the pain had still not let up, and was becoming unbearable. My wife drove me to the ER where I was quickly diagnosed with pancreatitis. An ultrasound showed a gallbladder full of stones and I was admitted to the hospital. After two days of antibiotics, the pain and fever were under control and they removed my gallbladder (cholecystectomy) using laparoscopic surgery. Apparently, I had been producing gallstones for years that easily passed with only minor discomfort, this time, however, a stone became lodged in the pancreatic duct and became life-threatening, hence the emergency surgery.

Happy Holidays...waiting for the knife!


Life without a gallbladder does not seem so bad. It turns out that having high cholesterol and losing lots of weight are both triggers for gallstone formation, additionally, both my parents had their gallbladders removed, so heredity may play a part. No matter. What's done is done. I eat a fairly low-fat diet so I'm not too worried about the future. The gallbladder does seem to be one of the easiest organs to live without, especially when you do not eat a SAD diet. We'll see.

I was released from the hospital the day after surgery and was back to work one week post-surgery. Within two weeks I was feeling perfectly normal and at three weeks doing light exercises, and at four weeks, my normal routine of push-ups, pull-ups, squats, and walking 2-3 miles a day. As for the antibiotics, I bought some cheap probiotics on Amazon and took them at about 3 times the recommended dose along with potato starch, oat bran, fermented foods like sauerkraut and yogurt, and lots of high fiber foods.  Except for a couple days of really bad constipation right after the surgery, my digestion did not seem to miss a beat.

My First Peer-Reviewed Paper Published!


While this may not win a Nobel Prize, unless there is a category for boring, I was excited to have it published.

Life begins at forty – hybridomas: ageing technology holds promise for future drug discoveries

It was quite an experience submitting and then defending the paper throughout the peer review process. The folks at the Generics and Biosimilars Initiative (GaBI) Journal were very thorough and professional, and I will admit it was quite frustrating at times.

Have a read, I wrote it in a way that even those unfamiliar with hybridomas and monoclonal antibodies might gain some insight into the production of new drugs. Have you seen those commercials on TV: "Ask your doctor about adalimumab (Humira)?" This is what the paper is about. I show some cheaper, more efficient ways of making these drugs. Currently, they use 40 year-old technology. If a drug ends in "mab" it is a franken-drug made from cloned human/animal body parts. Big Pharma Drug Companies will hate this paper because it means that new, small drug companies can make these same drugs at a fraction of the cost.

Cabo San Lucas Vacation


The last two weeks, my wife and I have been in Cabo, Mexico on vacation. We had a blast and enjoyed some great weather--a welcome respite from the harsh Winter in Alaska. Home now and mourning for the sun as out tans fade. 

We stayed at the Grand Solmar Resort, easily the best vacation spot I've ever been to. The people are friendly, the climate is perfect, and dollar goes a long way. If any of you would like to check it out, Richard Nikoley has a vacation rental business and owns several rooms at the Grand Solmar, available for rent on Vacation Rentals by Owner.  Tell him Tim sent you. 

Here are a couple pictures from our trip:

My First "Hemingway Moment"
 
Great food...


...and drinks


The Resort

Hanging with the locals...

..picking up chicks!

 So that's where I've been this Winter, in case you were wondering. There's another Potato Hack post set to be posted tomorrow and classes for the Spring Semester start up as well. Three more classes to go until I'm done with my master's degree in biotechnology. By the time this semester is over, it will nearly be summer. This has been quite a Winter.

Take care,
Tim
      




58 comments:

  1. Tim, sorry to hear that just before Christmas you have to have an emergency operation snd have your bladder removed. thank God, everything turned out very well, no complications, so that you could enjoy a warm and sunny holiday in Mexico with your lovely wife.

    You had announced that you would be holding a blog stop so that you could concentrate on your masters degree. But I'm glad to see that you will be picking things up again very soon. Have missed the exchanges with you and other responders.

    Jo tB

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    1. Thanks! As far as surgeries, GB removal seems to be one of the easiest and least complicated. I heard they even take them out as a matter of course with weight loss (gastric bypass) surgery now because so many people develop stones afterwards.

      It was great to get through it all with no complications, it's scary when they make you sign the release forms after reading a laundry list of possible complications. As much as I hate the American medical system, and think it is designed to keep people medicated and only half-healthy, I am quite impressed by the emergency medical system we have in place.

      I think people need to try to take care of themselves as best they can with food and exercise, and only rely on doctors for life-threatening conditions. Once you get in the clutches of Big Medicine, it's tough to get out.

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  2. Tim, I'm very pleased your back and more importantly ok!

    I look forward to future blog posts, no other blog bests this one!

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    1. Thanks. I have at least a monthly post planned all summer, but so much good research that goes unnoticed, so probably more as I have time. The class I'm taking this semester is a 6 credit "capstone" class on drug development and looks like a lot of work. Summer term should be easier.

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  3. Glad to hear your problem was resolved and you're back on track!

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    1. Thanks. Except for 4 tiny scars, I'd never know I had my GB removed. I shudder to think what the result would have been if this happened while I was in Mexico.

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    2. Rob, bests is good too. Very British.

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  4. Replies
    1. And delicious! I brought 40 pounds of meat home, now reading that marlin are one of the worst for mercury. Maybe I will limit it to once or twice a month. It tastes like very tender beef. No fishy taste at all, even when eaten raw or very rare.

      Here's a question: When one has a diverse, healthy gut biome, how much of a danger is the mercury from fish?

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    2. Mercury in fish and gut microbiome have nothing in common excpet organic mercury has an antibacterial effect if the dose is high enough. I doubt there's any studies about the impact of organic mercury compounds on the gut microbiome. But mercury is antibacterial. That's why they used it for syphilis back in the old days. Or was that gonorrhea? Or both... sheesh.

      Just eat the damn fish and have done with it. Don't keep it in the freezer too long.

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    3. Just had a piece of lightly seared tuna and made ceviche for later.

      What I was getting at with gut biome is the mercury chelating ability of some bacteria: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426676/

      "A number of environmental microorganisms have long been known for their ability to bind metals, but less well appreciated are human gastrointestinal bacteria. Species such as Lactobacillus, present in the human mouth, gut, and vagina and in fermented foods, have the ability to bind and detoxify some of these substances. This review examines the current understanding of detoxication mechanisms of lactobacilli and how, in the future, humans and animals might benefit from these organisms in remediating environmental contamination of food.

      The ability of lactobacilli to bind and sequester metals depends on the strain's resistance mechanisms. In coping with arsenic and mercury, the main method of resistance is through active expulsion of toxic metals from the cytosol. This has been shown by the presence of mer and ars operons in Lactobacillus and other gut-associated species (76, 116) which encode efflux transporters. Bacteria which have the ability to export metals out of their cell reduce damage to the organism by lowering the cellular concentration. However, such a mechanism is not ideal for detoxification of the gastrointestinal tract, as it results in the cycling of metals. Possibly the ideal species for detoxification are those which lack the genes encoding metal transporters and thus only bind and sequester heavy metals."

      So, with a gut filled with friendly bacteria, maybe they take care of all the mercury and other toxins for us.

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    4. That mummified iceman, Otzi, was an arsenic eater. A popular thing to do because it causes peripheral vasodilation and in a cold climate helps a person feel warm. His gut microbiome was probably okay. Big Pharma wasn't around yet in those days. ;)

      Mostly warnings about fish that may contain mercury is for women who may get pregnant. Or are pregnant. Since there isn't much chance of that happening to you (although given your penchant for doing odd things, who knows), I don't think, given you are not meganoshing on these sorts of fish on a chronic basis, you don't really have much to worry about (unless you want to get all neurotic on us.) Invite the friends over for a barbecue. Time to show off all them big fishies you landed.

      Hope the crazy cat survived your absence.

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    5. I've never worried at all about mercury, even the stuff sadistic dentists stuff inside our heads, lol. It was just that as I googled for ways to prepare marlin, all I could find was warnings about mercury.

      One thing that I did not realize, the mercury in these big fish is naturally occurring. I had thought it was man-made pollution from mining or industry. Maybe that's just the way Green Peace spins it.

      The cat is fine...a bit whiny when we got home, but he did not destroy the house.

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    6. I let you write it. The stuff about naturally ocurring mercury. When I tell people this, they don't believe me. People have been brainwashed to believe that anything in the ocean that is 'not good' is there because of human activity. It certainly is not.

      This is also why Albacore tuna contains mercury but Yellowfin and Skipjack do not. Different ecosystems occupied by these species of fish.

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    7. Hi Interesting you bring up mercury. Because I'd not been making as much progress as I would have liked (i.e. not 100%), I researched heavy metal toxicity. I had my amalgams replaced around a year ago. I have just completed my 8th round of Andy Cutlers chelation protocol.

      Experiences? Certainly not a linear progression of improvements. Skin shows mass improvements with consistently no flakiness. Dark patches under eyes (always had regardless of sleep), look lighter and flatter. Thinking seems crystal clear at times.

      Negatives. Fatigue hit hard until I supported adrenals. Yeast symptoms (mainly itching anus) flared and every so often when on round (TMI alert!) I have like a major clear out. And when I say major - I mean major - can go to toilet 4-5 times in fairly short period of time and each time I think where did ALL that come from!

      It feels like I'm doing right (maybe just hoping!) - certainly going to stick with for quite a while yet. Will retest my hair later in year to see if things improved. 1st showed little mercury (though can hide in organs), relatively high aluminium and poor levels of nearly all essential elements except sodium and potassium.

      Thought I'd share in case anyone found it interesting.

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    8. Tim, just take some extra selenium along with those marlin mercury meals. http://www.takemarlinoffthemenu.org/Mercury_in_Marlin

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  5. If anyone ever earned a vacation I'd say you did. Congratulations on the paper!

    Thanks for linking that poem. :-)

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  6. Welcome back! I've missed the discussion and stimulation here too. Congrats on the article as well. You are smart *and* explain things well, which is rare. I'm sure it will be the first of many.

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  7. Yikes! What a winter! So sorry for all your troubles but so very glad to learn that so are doing so well now.

    And a timely reminder that there can be so many causes of indigestion. The husband has been having some recently and my recommendations seem to have resolved it, but your experience just highlights how serious "a little heartburn" could be.

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    1. Just to freak everybody out, my Dad had indigestion that was caused by an aortic aneurysm. It was his only symptom. By the time he was diagnosed, it had already begun leaking.

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    2. I knew the explanations of GERD and SIBO were BS, but these seem to be the "go-to" diagnoses. It also points out that when something is wrong, try the easy fixes first and then get your butt to a doctor if it does not resolve.

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    3. Yeah but you were 'touch and go' for a while there.

      I know. Those of us who are not neurotic about our health wait things out until it becomes obvious waiting is counterproductive. Just glad you got your sorry behind to emerg before it was too late.

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    4. I feel sorry for the "average" patient, SAD diet, poor immune system and health, not fit. If nothing else, this little experience taught me why it's important to keep yourself as healthy as possible. We never know when something will go awry. Even a traffic accident or whatever. The better shape one is in, the better they will recover.

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    5. True true. Our adaptive reserve goes down as we get older. Especially the car accident business....

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    6. Tim, so glad everything's okay now!

      I have had gallbladder pain a few times in the past year due to weight loss, and I know there's nothing like it. Indescribable. A couple times I almost made it to the "time limit" I set myself for pain decrease before taking myself to the ER (always happened at night). I got an ultrasound that showed stones but didn't say how bad. At the end of the last attack I decided that if I ever got *another* attack I would go to the ER as soon as it started. That was six months ago, and hardly a peep out of the old gb since. Knock wood.

      Anecdotally, apple cider vinegar is supposed to help dissolve gallstones or prevent them from forming. Experientially, it stops "indigestion" in its tracks. For anyone that might help.

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    7. Amy, how would apple cider vinegar dissolve gallstones?

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    8. Gab, I dunno. That's why I said "anecdotally". This is one of those natural health topics that is long on anecdote and short on scientific proof. I've seen it speculated that it has to do with the malic acid in ACV, but I've also read that ACV has too little malic acid to possibly affect gallstones at tolerable doses. So who knows.

      I tried it because that's what I do when I'm having a problem and I find a potential solution that seems as benign as ACV. I've been hearing about ACV miracles for years, anyway, so I figured WTH. I started off by taking it daily, and then only symptomatically or prophylactically (if I eat too much). Perhaps coincidentally, I haven't had a gb attack since I started taking it, and to my surprise, it really does seem to work for garden-variety "indigestion" (which is how incipient gb attacks seem to start out).

      Go figure. :-)

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  8. Hey buddy, thanks for the spiff.

    Tim & Jackie rented from me last year, along with friends and they ended up buying in, they liked it so much.

    It's literally one of the most impressive resorts in the world. Last I checked it was in Conde Nast top 20 Mexico and top 100 Planet Earth.

    Anyway, it's special. Thanks again Tim. Fortunately, you don't have to wait too long for lots of sun in your neck of the woods.

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  9. I too have gallbladder issues from losing weight rapidly. Luckily I've had no pancreatitis and keep the pain in check with herbs. I've heard that some people who've had their gallbladder removed need to take lipase products e.g. Lypo Gold by Enzymedica

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    1. I think most people who have digestive problems after GB removal are those who insist on eating SAD diet. So far my digestion seems as good as before, but being cautious and watching to see. It sucks to have an organ removed, I wish I had it back, but those stones are deadly.

      Have you had your stones confirmed by ultrasound? If they are still small (ie. sludge) you may want to try Ursodiol (by prescription) or Rowachol, available over the counter: http://amzn.to/1WXCsrK . Also Milk Thistle is a great herb for liver ailments.

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    2. Anonymous, look into taurine. I believe it helps with bile production and viscosity. Some supplementation might help prevent stones from forming. Also, check out lecithin, which emulsifies bile.

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    3. Acu-Greg: Lecithin and bile emulsification: references?

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    4. Gabriella, I don't know if the lecithin and bile emulsification is well-studied or not. I doubt it. There are some functional medicine and naturopathic physicians using it, however. Even WebMD mentions it: http://www.webmd.com/digestive-disorders/understanding-gallstones-prevention

      This article on Alternative Medicine Review mentions a couple of studies on page 5. http://www.altmedrev.com/publications/14/3/258.pdf

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  10. Glad you're back, Tim! How are the honeybees?

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    1. Looks like they have not survived the winter. I just ordered new bees to be delivered in April. I think it would be hard to overwinter bees here without keeping them in a warmed building and feeding lots of sugar. Still, bees need to make periodic cleansing flights through the winter, no way we ever get warm enough for that.

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    2. If you add Rick Williams on Facebook, he is also in the north (prairies). He overwinters in 2 deeps, with 1 medium for honey stores. He covers them with R30 worth of insulation, top and sides. I saw video; midwinter, deep freeze, his brood nest was as warm as a house, 21C!

      You have the comb built last year; that will save time with your new package. Price of packages has gone up AGAIN, $220/package now in my area.

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    3. Russian bees overwinter just fine; and bees here in the soggy rainforest sometimes have to wait 9 months without a cleansing flight. They can manage. Do you know what the cause of your dead-out was? Did they run out of stores? Did they have stores, but couldn't reach them? Did they dwindle away to nothing because of varroa?

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    4. These were Improved Russian Stock bees, known to overwinter here. I think it was a combination of me not knowing exactly how to arrange the supers for winter and the fact it was a first year hive.

      I'm excited to put new bees on the wax, pollen, and honey stores instead of empty frames. I think next year will be a different story for survival, but not holding my breath. Interesting that they could go 9 months w/o a cleansing flight. There appeared to be no verroa mites at all.

      5 pound packages with 1 queen are $170 delivered for 2016 here. Nice to think bee season is just around the corner! Days getting noticeably longer.

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    5. Fortunately, I think it is too cold in your area for the wax moths to get in and destroy the wax.

      What symptoms did you notice? Were there a small amount of bees, or a large amount? Had they dwindled? My hive is dwindling, but I don't see any varroa either. I was told by my bee source, that that is the result of not medicating them with formic and oxalic acid. But without signs of varroa present, something else must be going on. I'm going to try "Caspian Solution" if the bees go below a certain amount, I've already made a heavily insulated "rescue hive" to put them in. I really think heavy insulation could help. Michael Bush says it didn't make much difference for him, but I don't know how heavily he insulated before giving up. R30 is an incredible amount of insulation.

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  11. "The problem was, this random heartburn started well before I knew anything about "fiber" or RS, in fact, coincided directly with adopting the low carb Primal Blueprint"

    Regardless of family predisposition, weren't you also on some drugs and medication around this time that would contribute to, or speed up the gallstones development?

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    1. Yep. I was taking Gemfibrozil for high triglycerides back in my SAD, unhealthy days:

      "Because gemfibrozil is chemically, pharmacologically, and clinically similar to clofibrate, some adverse effects of clofibrate such as an increased incidence of cholesterol gallstones, cholecystitis requiring surgery, postcholecystectomy complications, malignancy, and pancreatitis may also apply to gemfibrozil and the usual precautions associated with clofibrate therapy should be observed."

      http://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+7735

      Yes, I was firmly in the clutches of modern medicine. My crappy diet and lifestyle caused my triglycerides to go out of control, they medicated me with a drug that lowers trigs, but can cause gallstones. Nice.

      Funny, when I quit eating SAD and started eating real, whole foods my triglycerides normalized in a couple months. That was back in 2010 or so, and about the time I first started having the gallstone symptoms.

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  12. Is it possible the raw potato starch contributed to the gallstones?

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    1. If so, probably the first case in history of a prebiotic fiber being the cause of gallstones. But, no, I think not. I was having the symptoms of gallstones long before I experimented with RPS.

      My progression from initial symptoms to emergency surgery followed a text-book path. Initially, they are asymptomatic, sometimes for years. Then cause minor discomfort as the stones get bigger, and finally they become more mobile and cause blocked ducts at which point there is no option other than surgery.

      As soon as a doctor sees gallstones, they recommend "elective" surgery to remove the gallbladder. If caught soon enough, there are drugs that can dissolve the stones, but once they block the pancreatic duct, surgery is the only real solution.

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    2. It's so damn disappointing that a VLC Paleo Diet doesn't melt gallstones, since it literarily cures everything else known to man, and throws off rainbow farts from flying unicorns too, as excess, wasted magic.

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    3. "If so, probably the first case in history of a prebiotic fiber being the cause of gallstones".

      Tim, it looks like beans can promote gallstones.

      http://www.ncbi.nlm.nih.gov/pubmed/2783676

      Last year I was really upset when I tracked down my gallbladder pain to eating beans. Great and easy fiber, butyrate production, etc, but a big problem for my deformed gallbladder:(

      I love your blog. Be well.

      Esha

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    4. But the beans are only promoting gallstones in this small set of Pima Indians. This group, and a few other indigenous American/Chilean Indian groups are genetically prone to gallstone formation.

      I'd be very surprised if we can find a paper saying that beans are a risk factor for anyone else. In fact, here's one that seems to show the opposite: http://www.ncbi.nlm.nih.gov/pubmed/2262261

      "As legume intake was recently shown to increase biliary cholesterol saturation, it may be a risk factor for gallstone disease. Data from a case-control study in The Netherlands were analysed to confirm this hypothesis. A negative association was found between legume intake (including green beans) and gallstone risk. This appeared not to be explained by diminished legume intake in gallstone cases under the influence of gastrointestinal symptoms. We hypothesize that components from legume pulses (seeds) and pods may have opposite effects on the risk of gallstone development."

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    5. But the beans are only promoting gallstones in this small set of Pima Indians.

      Well… not only in Pima Indians, in me too)) On high bean diet I lived in pain, sometimes acute, day after day after day. On Russian sites they always mention legumes-gallstones connection and in fact my gastroenterologist was against beans (I was fool enough to ignore her advice because of butyrate and gut bugs and so on). In English it’s harder to find this information for some reason.

      I’m a fan of fiber and microbiome, just a word of caution.

      Esha

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    6. I'm not convinced that beans increase the likelihood of developing gallstones, but this is different from beans being the cause of gallstone pain.

      If there are gallstones present, a food that causes a contraction of the gallbladder will cause pain, usually this is a fatty meal, but also coffee, potatoes, and even physical exertion can cause the contraction that causes pain, or dislodges a stone that can get lodged in a duct.

      It is possible that beans could contribute to gallstone formation if a person has very high cholesterol, then goes on a weightloss diet that uses beans to lower cholesterol. There are some funny interactions that bile undergoes when one loses weight, causing the bile to become supersaturated in the gallbladder and forming stones.

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    7. Probably a good idea to eat at least enough fat/oil once per day to get the gallbladder to squeeze out the bile so it doesn't sit around.

      But with type 2 diabetes there is a dysfunction of the cholecystokinin which is produced in the duodenum in response to fat. Probably why it is diabetics don't always find fatty meals easy to digest and instead tend to eat carbs which make thing worse as far as the diabetes is concerned.

      Over here, in honour of this being the International Year of the Pulses, I'm eating 1 or 2 servings per day. So far, so good. No adverse symptoms (but I also have no gallstones.)

      Recently I've been eating a lot of braised red cabbage and today stir fried savoy cabbage. Now this stuff is craptastic! A bit too much so. Pulses not. at. all. Whatever benefit to the colon with butyrate and mucous formation, pulses on their own don't make for poopy celebrations. That takes cooked vegetables: squash, tomatoes, eggplant, etc.

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  13. I am glad you followed your "gut instinct"and got yourself to the ER. A well deserved vacation!

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  14. Glad your answer came fast and easy! (As far as illness and surgery goes) Mine started much the same way, but gallbladder proved fine, intestines fine, then CT showed the Nutcracker. I spent New Years Eve getting a seldom done surgery with an incision going completely across my abdomen as my trophy! My vagus nerve and adrenals are so much happier now. Just returned to work this week and have a year of taking it easy while my abdominal wall heals.

    Glad you were able to get right back into life, with less digestive complaints to boot! Congrats on being published!

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    1. OMG...I think you have me beat! Good luck with the recovery, eat lots of fiber!

      "Nutcracker syndrome refers to the compression of the left renal vein between the aorta and the superior mesenteric artery, which results in elevated left renal vein pressure and possible collateral vein development. Clinically, Nutcracker syndrome is characterized by intermittent hematuria with or without left flank or abdominal pain. The syndrome occurs in relatively thin patients and adolescents who often have an otherwise healthy medical history.[1] The true prevalence of Nutcracker syndrome remains unknown.

      Nutcracker syndrome can have several clinical manifestations. The most common presentation is hematuria. Hematuria from the left ureteral orifice on cystoscopic examination in the absence of any detectable abnormality of the urinary tract should raise suspicion for Nutcracker syndrome.[2] Nutcracker syndrome can also cause mild to moderate proteinuria. Other presentations that are rare include gonadal vein syndrome and varicocele.[1,3,4] Prominent collateral vessels may develop, and the gonadal, ascending lumbar, adrenal, periureteral, and capsular veins are major potential collateral veins that can develop from left renal vein compression or obstruction.[1] "

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    2. I'm sure it's caused by carbohydrates in the diet and a VLC or Keto diet ought fix it right up.

      Too bad she wasn't on it in the first place and this would have never happened.

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    3. Richard, sarc? Sounds 'anatomical' to me.

      How's your toes and stuff? Have you gotten used to 'so so' sensation or are things gradually improving?

      Btw, you owe me more cutey cutey pictures of Scout.

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  15. Tim, Sorry to hear of the gall bladder crisis. Glad you're doing well. You're one of the great gents of the Internet!

    I think mercury danger depends in part on your selenium level as well as the condition of your microbiome and mitochondria. There were times when I was eating a lot of fresh-water fish I caught that are supposed to be high in mercury and didn't worry about it. Never noticed any ill effects. As always, YMMV. Best wishes.

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  16. Well.... perhaps your troubles stem from the internet. Dealing with all the trolls can be *galling* :-)

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