A Belated Farewell ... For Now

As a soul adventurer of sorts, I have a great many interests that occupy my time.  New interests come and consume my time and focus.  Old ones go on the back-burner, but sometimes return to the fore-front.  The blog you are reading is a bit of a relic of my past interest and passion -- health and nutrition.  It was a very important time for me, as I learned a lot about how a sound body cultivates a sound mind.  However, as these things go for a mental drifter like myself, once I learned the lessons I needed to learn, I integrated them into my life and moved on to other things.  Hence the extreme lack of updates on this here blog.

That is not to say that health is no longer important to me.  Rather, I mean to say that I am not actively pursuing the study of it aside from my own personal tinkering in the kitchen and ever-evolving eating patterns.  It is something I enjoy doing, but it is not something I am inspired to write about anymore or dwell on too much.  That may make some of you feel sad: "Darn.  I really enjoyed this guy's crazy perspectives and wild experiments in health."  It may make some of you feel relieved: "Finally he's stopped his kooky health adventures!  I thought he was going to die of Salmonella poisoning for sure!"

Either way, I have always appreciated the support from my readers.  Your comments, donations, and e-mails still reach me and are always well-received.  So keep them coming.

Where do we go from here?  Well, the blog will stay right where it is.  It is here as both a service to other health explorers who can benefit from the information as well as my own personal historical account that I can look back on fondly.  If I should embark on another significant experimental health venture which I feel the world could benefit from knowing about, you can be sure this blog will be the venue for it.  In the meantime, my hope is that it continues to inspire people to question diet gurus and mainstream nutrition and instead seek answers for themselves, paying attention to the wisdom of the body while utilizing the intuition of the spirit.  That is ultimately the only "right" way to approach health improvement -- as your own journey which only you have the answers for.  The pieces of your body's puzzle are out there for you to fit together.

Wow.  I got pretty deep on you there, didn't I?  That was heavy stuff.  Really, what I want to say is: Keep on keeping on, and may all of your lives be blessed with optimal health, self-knowledge, and tasty food.

Until Next Time,
Ryan Koch

The Long Awaited Palate Expansion Update, 5/21/2012

I often receive e-mails from folks asking how my Homeoblock experience is going, and rather than continuing to respond to individual queries, I finally decided to get off my butt (metaphorically) and create an update post. So here it is.

It's been many months since my foray into the world of palate expansion.  After finding an affordable option for my palatal expander of choice, the Homeoblock, I diligently used the device as instructed -- one quarter turn each week, if possible.  A few months later, I had created almost a 1/16 inch gap in the device.  Pretty impressive movement!

I visited Dr. Darlington in Flagstaff for a check-up, and he was surprised how much I had expanded my palate. Actually, "surprised" isn't the right word.  He actually seemed a little concerned.  As I was among the first of his patients to request the Homeoblock, his experience had been limited and there was cause in his mind to slow down the expansion.  In fact, he told me I might want to back off some.

I found this unexpected, as I had not experienced any uncomfortable symptoms, and the Homeoblock seemed to be doing the trick.  But Dr. Darlington explained that the device appeared to be kind of slipping and not fitting as well, so in the long run it would not have the desired effect.  He went on to say that it might actually tip the teeth instead of expanding the palate if I continued applying the quarter turns daily.  So I left his office that day with instructions to reverse the quarter-turns until the device fit again and then apply very small 1/8 turns or less for a few months.

As instructed, I backed off the expansion of the Homeoblock to where it fit better.  Still, it seemed to me like it wasn't optimal, as I could easily slip off the device with my tongue, where it's only supposed to come off with a firm double-handed loosening.  I decided to just let it be and use it like a retainer until I saw Dr. Darlington again.  Perhaps I would even have to get an entirely new Homeoblock created.

My last appointment was almost a year ago now. (Wow, that's a long time without an update ...)

So now I use my Homeoblock like a retainer and it keeps my teeth from relapsing to pre-expansion position.  I notice that I can now go days without putting the device in and only feel a slight pressure upon reinsertion.  That indicates to me that my palate is holding the teeth in place quite well.  I do intend to visit Dr. Darlington again in the near future, and I will give an update if that happens.

Well, the story ends there for now.  I have been focusing on many other things in the meantime, including explorations in outdoor education work, music production, building community, and researching politics.  That's my nature -- I have a great many interests, and often some take precedence over others, as there is only so much time in the world.  But I do want to refocus my efforts on blogging and integrate some of the interesting things I am up to.  Until then, I wish everybody out there happy expansions!

Fecal Transplants: Ben's Story

Continuing my adventures in understanding the long hollow tube that is the human GI tract, I've been in correspondence with a blog reader, Ben D., for the past month or so regarding fecal transplants and our similarities in intestinal dysfunction.  We are definitely gut brothers from other mothers, as his symptoms match up incredibly well with my own.  When he told me he would be trying the human probiotic home infusion protocol a few weeks ago, I was very curious to follow his progress.  Ben was wonderfully light-hearted and humorous about the whole thing while providing very useful information regarding his 10-day transplant experience.  Here is his intestinal saga in his own words.  Thanks, Ben!

What's up gutsers? I am coming to the end of 10 days of fecal transplant therapy carried out at home with my doctor's blessing and prescriptions.

I am posting here because I want to answer any questions people have about the procedure, especially if they are considering doing it themselves. So far it has improved my symptoms quite a bit, but has not been a total cure. I think it is going to turn out to have been a very valuable tool in the treatment, and eventual cure of my condition.

Below is a short version of the whole story of my illness. Check it out before asking questions... the answer may be in there.

My name is Ben. I'm 25 and I've been dealing with Post-Infectious IBS-C since January 2010. It started on a trip to India with some diarrhea and then I became constipated for the next two months of the trip. I tried the usual fiber + probiotics and I think they just made things worse. Since nothing was moving, I think they just gathered in my small intestine and gave me a case of SIBO because I ended up with terrible bloating on top of the C.

I had stool and blood tests done, as well as a colonoscopy, while traveling and they all found nothing. The Indian doc diagnosed the P-I IBS-C and gave me Lactulose, a daily laxative. I took that for a while and it helped the constipation, but made the bloating much worse. I eventually got another case of diarrhea, took some antibiotics for the diarrhea, and all the symptoms went away. About a week after the antibiotics, some symptoms returned in a very mild form, but didn't bother me much.

Then in January of this year (strangely enough around the same date that the first flare began in India), after 8 or so months of relative health, the constipation came back. Again I tried more fiber in my diet and probiotics and again this produced the backed-up, SIBO-esque bloating. I had stool and blood tests and an ultrasound that found nothing. I then tried 3 rounds of various antibiotics, because they seemed to help back when I was traveling. None worked this time, so I started working with alternative treatments: Oregano oil, raw garlic, cloves, Wormwood, Black Walnut hulls, Aloe Vera, acupuncture, Chinese herbs, etc. I've also been on the Specific Carbohydrate diet since early April. Some of the alternative treatments helped, and the SC Diet keeps the bloating from being too crazy, but nothing was really moving me in the direction of a cure. I also saw a holistic doctor who had me do a stool test with Diagnos-techs. It found a very light amount of Candida, moderate pathogenic Strep, occult blood, and low SIgA.

I got a recommendation for a tropical medicine doctor in New York (Dr. Kevin Cahill). I saw him and he inspected a scraping of my colonic mucous that revealed an infection with Entamoeba Histolytica. I was relieved to finally have a more clear diagnosis. He gave me Paromomycin, an anti-amoeba drug, and Doxycycline, an antibiotic. I took them, was retested by him, and came up negative for the amoebas. He told me it may take a couple months to heal and feel well again, but after abouta month and a half I only felt worse.

At that point I began to assume that the amoebas and all the antibiotics I had taken had caused some other damage to my whole flora that needed to be addressed. My holistic doctor had mentioned fecal transplant as a possibility and so I began to look for donors. Without intending to actually ask her to donate, I mentioned the procedure to a good friend's girlfriend and her eyes immediately lit up. "Do you want me to shit for you, Ben?!," she excitedly asked.

She told me she was very comfortable gut-wise and went 2-3 times a day consistently, which sounded great to me considering I was dealing with constipation. I started the low-fiber diet part of Borody's protocol right away and got her a stool test kit. Her test came back clear, and after 3 weeks of the low-fiber, I started taking Vancomycin, as recommended by Borody, as well as Nitazoxanide, an anti-protozoal just in case any of the amoebas were left.

The antibiotics made me feel horrendous. They added to the general feeling of unwellness that I had been experiencing for months, made me more constipated, and worsened the depression that this whole experience had created.

On the first day of infusions, I noticed an almost immediate loss of that depression and malaise. It could have been simply the hope involved in trying a new treatment, but it felt like there was a more physical, medical connection. It made me even more sure of the brain-gut connection and the ability of our flora to effect our emotions. I remained constipated for a couple days, but on the morning of the third day, I woke up to an immediate, easy, giant, solid BM. Those easy morning BMs have continued, except for one more bad day on day 5. Tomorrow will be the last infusion and then time will tell how well the new bacteria will colonize my gut.

The bloating after meals remains so I think it is a related but separate issue. Like I said before, it didn't start until a week or so into the constipation flares, after I had eaten lots of fibrous foods and taken probiotics in trying to move things along. If it does not fade with time, I'm definitely going to get tested for SIBO, and then treat that somehow, possibly following up with more transplants to keep things moving well.

Fecal Transplants: The Turd Twister & A Historical Account

I have been voraciously exploring the world of human gut bacteria, fecal transplants, and the like as of late, and I wanted to update all you readers with some information that I've found particularly invaluable.  Well, okay the first bit of info isn't invaluable, per se, but it is pretty funny.  My awesome aunt, a frequent reader of this blog, recently sent me something she dug up as she was preparing for an estate sale.  I don't know if anybody else out there has heard of this.  It's called a "Turd Twister."  I thought it would make a great gag gift, especially for a potential fecal transplant donor.  There are many wonderful shapes that can be produced and presented with this device!  Anyway, the version I received is kind of old school and uses hard cardboard, but for more serious turd twisters, you might want to check out the website for a modern and far more comfortable-looking model.

Next, I wanted to reiterate a point I made in the comments of a previous post in order to further bolster the merits of the "sh*tshake" method.  Here is a comment from "Mike K" on the Freakanomics radio show website:

Forty years ago, we treated antibiotic resistant bacteria in the colon by giving the patient a dose of antibiotic sensitive E. coli in a malted milkshake. The sensitive bacteria would replace the resistant bacteria in a day or so. Our theory, or that of my professor who devised the treatment, was that “wild” or sensitive bacteria are better adapted to the normal colon environment. Antibiotic resistant bacteria can only take over when the sensitive bacteria are killed off by antibiotics, as when a patient has been treated for an infection like diverticulitis. When the antibiotics are stopped, the normal sensitive bacteria will quickly oust the resistant ones which are less adapted for life in a normal colon. All that is necessary is to provide a dose of the normal wild bacteria.

In the County Hospital, we used the same method although we did not have the nicety of cultured sensitive bacteria. We would take a fecal sample from a healthy patient coming in for hernia surgery, for example, and give it to the patient in a milkshake.

Needless to say that none of the patients were ever told the extra ingredient of the milk shake. 

This marks the second time I have heard of a fecal transplant used in such a manner.  The first time was from a retired nurse who basically said the same thing.  What surprised me in both cases is that the amount of "donation" required was minimal enough for the patients to not even realize they were drinking a poo concoction.  Also, one might think that the milk would cause a serious acid dump in the stomach and kill the beneficial bacteria, but this didn't seem to happen.  Must be a strength in numbers thing.  Anyway, this just goes to show that the essence of the fecal transplant's magic is actually pretty simple, and it certainly doesn't require some of the exorbitant costs and methods of implementation that are associated with it.

Next up, I have a very juicy post to share about an adventurous blog reader, Ben, and his recent foray into the fascinating world of home fecal transplants.  
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My Intestinal Saga, Part 10: Final Thoughts (cont'd.)

Okay, let's add some more notes to parts 5 through 9 of of the saga.

Part 5, Monastyrsky and Kwasniewski: The most important lesson I learned from this time period was that the heaviness in my body was directly related to being constipated 24/7, and that there were ways to restore my intestinal motility.  I highly recommend Monastyrsky's book, Fiber Menace, to anybody interested in the ins and outs (pun intended) of digestion and how to maintain a smoothly functioning GI tract, as this is what ultimately opened my eyes.  This book has a combination of the author's deep experience and thorough research, which makes it a very powerful read.  His recommendations are solid and very helpful to most modern people struggling with GI problems.


Part 6, It's All Digestive My Dear Watson: Damn, I wish I could eat all the fat I wanted without having gut issues.  Maybe someday I'll be able to if I ever resolve things completely.  Until then, I have to actually keep fat consumption at moderate to low levels because I get the same symptoms as I described in this post: the bad breath, the muscle tension, the bloating, the insomnia.  All of these things I believe are related to the slow motility of my intestines.  And I discovered this by thoroughly observing my body's response to eating food.  This is a fine art, and it requires an understanding of just how food travels through the body.

I have found through talking with others that the one place many folks get tripped up in evaluating their own bodies' digestive capacity is not knowing their symptoms connect with very specific parts of the GI tract.  For example, I have heard many people complain about "feeling full" after a meal, and they'll often say that their "stomach is full."  Yet, when I see where their hands go to describe this fullness, I realize it is not their stomach that is full at all -- it is actually their lower abdomen that is bloated and uncomfortable.  The stomach, of course, is just below the sternum a little to the left -- not around the belly button.  So this "fullness" is most likely coming from the last part of the small intestines.  This region is probably bloated from some kind of dysfunction and is putting pressure on the GI tract above it, including the stomach -- which gives the sensation of having eaten too much.  Knowing about little things like this can help a person really narrow down and target their specific digestive ailments.


Part 7, The Holy Grail of Probiotics ... Part 8, A Fecal Transplant Story ... Part 9, The Long Journey of Mister Poop: I'm covering all of these parts together because they fall under the same general category: taking someone else's poo and putting it in my body to restore intestinal flora.  There are many things that I would do differently now if I did the procedure again -- possibly antibiotics before the implant; better donor selection; make a more palatable concoction and pinch my nose (!) while drinking.  I'll outline my plan in more detail in an upcoming blog post.  For now, I will say that I have not ruled out this procedure and still have great hope for its use in the near future.

I believe very deeply that this is the ultimate tool in regaining digestive health and it deserves far more attention and research than it is currently getting.  However, word is definitely getting out, and I'm encouraged by some of the latest coverage of the treatment.  Here's a list of very recent and active links that I've found regarding fecal transplants:

Freakanomics Radio: The Power of Poop -- A good primer for potential donors on the merits of the procedure.  And it's entertaining.
Fecal Transplant - I Took the Plunge! -- On the "Healing Well" forum.  Exhaustive 5-part resource on individual experiences and questions regarding the treatment.
Home Fecal Transplants -- A group of people attempting transplants.  Some are beginning to consider doing an oral transplant similar to the one I did.

How Are Things Now?  

I am currently fairly stable in my gut as long as I follow certain rules that seem to work for me:

1) Low fiber diet: in addition to meat, butter, cheese, etc., I eat white rice or peeled potatoes for my starches and occasional bowls of homemade ice cream (with unrefined sugar).

2) No gluten: this without a doubt keeps my GI tract stable and happy.

3) Magnesium supplementation: prevents hard stools better than anything else I've tried.

4) Pancreatic enzymes: these appear to aid the digestion of foods in my stomach, particularly starches.

5) Moderate to low protein and fat: if I don't gorge on meat and fat (as much as I want to), things remain stable.

6) Two meals a day: this gives my digestive tract time to rest and be free of symptoms, and it appears to allow me to sleep through most of the night without intestinal disturbances.

7) Chewing fennel seeds: three or four times a day I'll grab a pinch of fennel seeds and chew them like gum.  I extract as much of the beneficial oils as possible before spitting out the fiber (when there is no taste left).  Really helps with expelling trapped gas and relaxing the gut.

When following these guidelines consistently, I find that my bloating is very minimal, my muscles have very little tension, and my mind is clear and focused.  Overall, I just have more energy.

This Is (Not) the End, My Friend

Well, here we are at the finish of my intestinal saga -- at least for now.  There will certainly be more updates in the future as I continue to discover more and more about my condition.  I still have a great amount of curiosity in exploring the mystery that is my GI tract, and only time will tell what kinds of crazy treatments I might stumble upon.  One thing all of you out there in blogger land can be sure of is this: you will hear about it.  Thanks for reading -- and happy digesting!
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My Intestinal Saga, Part 10: Final Thoughts

For this final installment of "My Intestinal Saga," I wanted to add a few notes and resources to each of the previous parts before I close with an assessment of where I am now, as well as ideas I have to further improve -- or possibly completely resolve  -- my digestive problems.  I would appreciate any input from others, as well.  Please leave a comment if you think you might have more insight into all this gut stuff.  Here we go again down the long, hollow tube!

Part 1, Dabbling in Parasites:  Here I delve into my childhood health issues a bit, which included headaches and TMJ (tempromadibular joint) disorder.  My best guess as to why these things were happening is the same reason that I experienced them in a more mild form as I grew older: digestive tension/pain.  There is a direct correlation for me.  I believe I had a problem with gluten as a young child, and this created a poor digestive environment and subsequent pain in the GI tract that referred pain and tension to my neck and jaw.  Here is a quote from a great blog post explaining this phenomenon:

In a nutshell, referred pain happens when nerve fibers from regions of high sensory input (such as the skin) and nerve fibers from regions of normally low sensory input (such as the internal organs) happen to converge on the same levels of the spinal cord. 

This is something to keep in mind for folks out there engaged in your own health explorations.  The body can be a tricky bugger sometimes, so it is important to stay open to what the origins of your discomforts truly are.

I also want to expand upon some of the thoughts I had in this post about bloating.  I was completely unaware that the bloating was a simple distention of my belly and not an actual "gut."  This unawareness created body image issues for me, as I thought I was fat and struggled to get rid of the belly.  No matter how hard I worked out, it remained, and it left me feeling frustrated and inadequate.  I imagine there are others out there for whom this may be the case, and I just want to say that bloating is not fat!  Even today, I can see my belly go flat and distend over a matter of hours depending on my mealtimes, types of foods eaten, etc.


Part 2, Lower Back Pain: This is where I discovered the magic of referred pain and what measures I truly needed to take to resolve it.  The tweaking of my back left me debilitated, and at that time I thought it was because I had a "bad back."  This turned out to not be the case, as I found out while working in the wilderness, where my back pain disappeared while eating very little.  It was all digestive, once again.

I want to share a wonderful resource that I came across a few years ago that shed a lot of light on how digestion is connected to much of the pain and discomfort I have felt in my life.  It is a book called, The Digestive Awareness Diet.  Interestingly enough, the author actually says that the reason we suddenly throw out our back or get a tweak in our neck isn't from muscle strain, but digestive tension.  This certainly rang true for me.  Check it out.  It might help you better understand your body.  I know it helped me.

A few more resources about general body awareness that might be useful which I utilized during my "yoga years" are the Feldenkrais Method and the Alexander Technique, both of which got me thinking about posture and what is and isn't the natural, optimal use of the human body -- or "use" for short.  One of the authors even suggested something I had already intuited: observing little kids and indigenous people to understand proper use. One thing to keep in mind, however, is that resolving digestive tension is a big part of regaining our bodies' natural ease.  Utilizing the body awareness techniques in combination with digestive understanding is a potent combination in restoring some of the light and easy feelings we are supposed to have in our bodies.


Part 3, Making Connections: Ahh, the wondrous world of the ileocecal valve (I found this page randomly on Facebook -- I am one of two people that like it so far.  Ha!).  Some natural health practitioners believe this is the root of many of our digestive ailments.  All I know is that it was directly related to my back pain.  The interesting thing is that once I got my posture back on point after doing yoga and the aforementioned body awareness methods, I was able to feel the pain exactly where it was -- my lower right abdomen -- as opposed to thinking it was only my back muscles acting up.  This reinforces the idea that, in order to come to more full understanding of what's happening in the body, an individual must use a multi-faceted approach to health observation.


Part 4, Gurus and Rotten Meat: One interesting occurrence from this period of wild dietary experimentation was a complete malabsorption of fat.  Looking back, I believe this was due to my duodenum just beginning to recover from years of being beat down by the gluten in my diet.  A classic consequence of such a beating is flattened microvilli, which inevitably leads to the poor processing of proteins and fats.  There is also a chance that Giardia played a role in this process.  Whatever the case may be, this problem resolved on its own after several months.

The chest pain I experienced during this time was exclusively due, once again, to digestive stress.  The chest pain was most likely my stomach being unable to resist the huge amounts of acid it was all of the sudden releasing for my high-meat diet.  I'm sure it was in a weakened state from years of malnourishment.  I swore I was having a heart attack.

I also describe a "heavy" feeling in the entirety of my body.  I believe this was a result of very slow intestinal motility and the hard stools I was constantly having.  Another symptom I didn't mention at this time was shallow breathing, presumably from the stiffness of my abdomen.  I have heard accounts from others of a similar phenomenon, and it is something that I still have now and again.

Final thoughts on "My Intestinal Saga" to be continued ...
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Accepting Donations From My Fellow Health Nerds

If you look to the right of my blog, you'll notice that I've set up a donation button for anybody interested in supporting this blog and my health explorations.  I would appreciate any amount you can offer.  I also accept gifts through the mail, such as gluten-free cookies or books that might be of interest to me.  Mostly, I just want cookies.  Donations of healthy poo -- freeze-dried and neatly packaged -- for my next attempt at a fecal transplant will be assessed on a case-by-case basis.  (Kidding!)  Thank you. :-)
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