I wrote about my kidney disease in June when my internist referred me to a nephrologist for what I nebulously referred to as "kidney issues". I've since learned that my diagnosis is for chronic kidney disease. Blood tests continue to monitor this.
The immediate comeuppance of this, that I wrote about in June, was the need for a low potassium diet. Normal daily potassium intake for a healthy person is around 4g. I needed to cut that in half, at least. That presented two significant obstacles. First, there is potassium in almost everything we eat. Second, there are relatively higher levels of potassium in most of the highly ubiquitous foods that virtually define the American diet, like white potatoes, milk, beans, most green leafy vegetables, many root vegetables, bananas, nuts, whole grains, tomatoes, etc.
In June, I foresaw a future dramatically altered:
A lot of Italian, Mexican and basic American food is out the window on a low potassium diet. I see a lot more Asian food in my future, but even there it can get weird. I suppose substitutions are possible. I'm going to try making an apple salsa tomorrow.
The apple salsa was perfectly awful, by the way; I was pretty much wrong about everything else, too. Come out into the tall grass for the rest of the story.
A week after the June post another blood test confirmed that I was still retaining excess potassium. That whole week I had obsessively researched what the internet had to offer to support folks on low potassium diets. I was sure that I had assiduously avoided all higher potassium food choices with little regard for my previous preferences and tastes, for that whole week, in hopes of a better result, but nothing improved. The nephrologist encouraged me to continue to seek better dietary potassium control. For another week I continued experimenting with this alien diet as I searched for apps, references, recipes and other help on the internet. But the best that I found was only marginally useful at best.
At that point, I figured out a big part of my problem: I didn't know how much potassium I was actually eating. I had been on the lookout all along for apps and websites that supported keeping food diaries. The problem was that none of them allowed for tracking potassium. Calories, fat and carbohydrates were the staples, with some support here and there for protein and cholesterol, and even for net carbs. But potassium? Fuhgeddaboudit.
So, I did what any nerd would do. I opened a spreadsheet. I would start tracking the ingredients of every meal, every snack, every day, day by day, until I was satisfied I was in control of this thing. If I ate so many ounces of this or a half cup of that or a tablespoon of the other, I would simply write it down, breakfast, lunch, etc. Since I was going to do that much, I might just as well track calories, too, that most basic measure of any diet. Also, I am Type II diabetic, so when I'm looking up that other info, I might just as well take a note of carbohydrates. There are internet sites where all of this can be referenced. I began doing this the second week of July. I also entered my weight on the morning of the first day and once a week since then; I added columns for pre-meal and 2 hour post-meal blood sugar test results. I set a daily goal of 2000 mg of potassium, 2000 calories and 150 g of carbohydrates. I figured that if I was going to such unprecedented, for me, and compulsive lengths over my diet, for the first time in my life, really, I might as well see if I can lose some weight while I am at it.
The results have been startling, far beyond my initial hopes. During the first five weeks of this experiment, I have had average daily dietary intake of: Potassium: 1438; Calories: 1805; Carbohydrates: 144. I have lost 12 pounds. I have enjoyed a month of the lowest and best controlled blood sugar since I was first diagnosed with Type II diabetes over 10 years ago.
This has not come with the dire food pleasure deficit I envisaged when I first wrote in June. By doing most of my own cooking and shopping and eating carefully in restaurants, during those five weeks I enjoyed meals like Ribeye steak on July 18, BBQ baby back ribs on July 27, chicken with tarragon in cream sauce on July 30, Mexican Restaurant enchiladas and cocktails on August 1, etc. I have bacon and eggs or bacon and sausage at least twice a week. I eat fried chicken. I've eaten pizza three or four times, sometimes even with tomato sauce. I've had ice cream twice. I also eat a lot more fresh fruits and vegetables, spending most of my time, during most shopping trips, in the produce department.
I know this diet is high in fat as percentage of caloric intake, even though I don't record or control for it. I figure that sorts itself out if I control for total calories and, since I am controlling for carbs, the calories have to come from somewhere. Anyway, every EKG and heart test I've ever had has been perfect. A medical person last week, when taking my pulse, told me I had the heart rate of an athlete. I have the body of an athlete, too, a sumo wrestler.
Anyway, the spreadsheet has evolved into more than just a record. It is a planning tool. Precise information about what I have eaten in the past now informs my judgments about what I plan to eat next. Also, being a guy, the sheer rectilinear starkness of the numbers on the ledger evokes a self-competition response and somehow inexplicably motivates me to improve my performance.
Yesterday I rode my bike, previously untouched for years. What other wonders await remains to be seen.
I tip my hat to Major Kong for his insights about weight control in his recent excellent diary. I find I am pretty much doing everything on his list and endorse everything he says. But my potassium problem is a wrinkle that demands more steps, and the kind of record keeping I do might be helpful to anyone with the time for it who isn't helped enough by following Major Kong's advice. Anyone not satisfied with what their diet is doing to them should try one of the online sites or apps and try keeping a food diary. It couldn't hurt.
May the blessings of happy, healthy, pleasurable eating be upon you all.