More Evidence of Statins’ Negative Side Effects: Fatigue and Loss of Energy

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The New York Times had an article yesterday stating the results of a randomized trial that found evidence statins cause loss of energy in people who take them. 

The people taking statins in the expirement found that their LDL levels (the “bad’ cholesterol) decreased.  However, their energy levels also correspondingly decreased. The study also showed that this was more apparent in women than men. 

In my previous post about statins, I described how my mother suffered from pain and lack of energy while she was on simvastatin (a type of statin).  

The reason for this is that statins suppress the synthesis of a very important enzyme called CoQ10 (co-enzyme q 10).  This element is very important in the production of enerrgy in the mitochondria.  Without getting too sciency, CoQ10 is abundant in young people (lots of energy) and decreases as one gets older (less energy).  Taking statins  depletes the production of CoQ10 thus super-accelerating aging effects and associated symptom like pain and fatigue.  

I’m glad to see a major platform like the NYTimes reporting such trials.  At the very least people can have enough information to question their primary care physician when they prescribe statins.

The Devil’s Pills: Statins and their horrible side effects

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A bit of an exaggeration, calling statins the devil’s pills, no?  Actually, that was what my mother considered them for the seven years she was on simvastatin Zucor, taking 10 mg of those hated pills diligently and daily, because that is what her doctor ordered.

Taking those pills impacted her physical and mental health to a degree we never though possible…I wrote about it here.

Over the span of those seven years, she suffered pain in her legs and hands.  At times it got so bad she couldn’t get up from the sofa without help, or she couldn’t go up the stairs without using both hands and feet.  We would badger her to exercise and she would complain of pain in her legs…we all dismissed her complaints as her just being mom, to our eternal shame.  Her nights were often fitfully spent cause the pain in her legs and the tingling in her hands wouldn’t allow her to sleep.

And then early last year, she started to lose her memory despite being only in her 50s and being descended from long-lived lines, on both sides, that have absolutely no history of Alzheimer’s at all.

Her condition, plus my growing realization of the strong links between diet and rampant Western diseases, gave me the double motivation to look more into her scary symptoms.

This is what I discovered.

– Statins are the best selling medicines in all of human history, selling over $28 billion in sales in 2006.  Huge profits for the pharmaceutical industry.

– The director of the Canadian government run Therapeutics Initiatives which measures and figures out how different drugs work, put out a well researched study that indicated statins only work on men who have had actual heart attacks.  It does not work on men over 65, men under 65 who haven’t had heart attacks and all populations of women.

This quote taken from Businessweek, which did a surprisingly stellar job reporting on the dubious benefits of statins in a 2008 report, illustrates why the myth of statins being a super wonder drug was pushed on us.

The drug business is, after all, a business. Companies are supposed to boost sales and returns to shareholders. The problem they face, though, is that many drugs are most effective in relatively small subgroups of sufferers. With statins, these are the patients who already have heart disease. But that’s not a blockbuster market. So companies have every incentive to market their drugs as being essential for wider groups of people, for whom the benefits are, by definition, smaller

And the absolute capture of the noble practice of medicine by the pharmaceutical industry is illustrated by this quote from the same article…

Drugmakers…make sure that the researchers and doctors who extol the benefits of medications are well compensated. “It’s almost impossible to find someone who believes strongly in statins who does not get a lot of money from industry,” says Dr. Rodney A. Hayward, professor of internal medicine at the University of Michigan Medical School

The combination of huge marketing budgets for statins and the capture of the medical profession by pharmaceutical industry gave statins the aura of a wonder-dug and contributed to its status as the best selling drug in all of human history.

But thanks to the Internet, the truth began to seep out from all sources: doctors with integrity, patients, all of them talking about the scary under-reported side effects of this supposed wonder-drug and the highly overstated so-called benefits.

Severe side effects like elevated blood sugar, muscular degeneration, and cognitive dysfunction.  My mother suffered from these side effects, except for the first one as her diabetes pre-existed her cholesterol medication.

Why such severe side-effects?

It’s cause the brain needs cholesterol to function optimally and statins inhibit the cholesterol synthesis, affecting an organ that uses 25% of the cholesterol produced in our bodies.   Our brain needs cholesterol and when its deprived, it starts to undergo cognitive dysfunction like memory loss.  Statins also inhibits the synthesis of an enzyme, CoQ10, which is found in mitochondria (the power-house of the cell) and its depletion in people who undergo statin treatment is a major reason of muscle pain.

The reason for the existence of cholesterol medication is because of the assumption that high fat/high cholesterol diets lead to cardio-vascular disease as per the lipid hypothesis touted and made famous by Ancel Keys.

Statins mainly worked on populations who had heart attacks as a means of reducing inflammatory properties.  Essentially, the main benefit of statins is that they are anti-inflammatory.

Guess what else is anti-inflammatory but without adverse effects?  A diet free of inflammation-causing foods like grains, sugar,  industrial oils and anything processed.

Finally, earlier this year the FDA managed to loosen the grip of the pharmaceutical industry on its throat and actually added warnings to statin labels about risks for memory loss and elevated blood sugar.  And all this for a drug that the majority of recipients DON’T have to take!!!

The FDA was a little gentle on the pharmas by stating that stopping taking the statins reverses dangerous side effects like memory loss.  It often does but read the comments sections of articles to do with statins and early-onset Alzheimer’s and you’ll see how the damage done by these drugs are sometimes too extensive for a complete reversal to occur.

In follow up posts I’ll address how we managed to completely reverse my mother’s early-onset memory loss and set her on the path to good health.

Canada’s Food Guide: Then and Now

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Compare and contrast Canada’s Food Guides at 1944 (it was called Food Rules then) and 1992

1944

1992

The biggest difference is that the 1992 version visually demonstrated that the base, or largest component, of a nutritionally balanced meal should be based on “Grain Products”.

Whereas the 1944 version listed the necessary foods without placing undue importance on grains.

The 1944 version also emphasized eating toast with butter! And of the importance of eating eggs and liver several times a week.

Note the recommendation to take fish oil for children and expectant mothers.  I recall people over 60 talking about taking cod liver oil as children.  Not only was it important for developing strong bones but it’s considered excellent brain food as well.  Quite crucial  for people who don’t live in sunny countries.

You don’t see a fear of fat in the 1944 version.  And that was because this guide was developed before Ancel Keys came out with his “lipid hypothesis” that linked heart diseases to high cholesterol brought on by saturated fat.  His famous study “Seven countries” was found to be cherry-picked to support his data, i.e Ancel Keys deliberately rejected data from countries that did not support his hypothesis.  Later on, when researchers reproduced the study from all 22 countries (not just the 7 Keys focused on) they found there was no correlation between saturated fat and heart disease.   The low-fat hysteria that many are starting to blame for the current obesity crisis was predicated on bad science.

The United States was the foremost leader in all sorts of scientific endeavours that it wasn’t a surprised its neighbour to the north got influenced by its nutritional policies.  Canada also suffers from an obesity crisis although less so than the US.  One of four people here is obese whereas in the States its one in three.

Eating according the 1944 food guide would do a lot to help with satiety and ensure people are eating nutrient dense foods.

So What Do I Eat on Paleo?

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I’ve had so many family and friends raise this question to me that I had to create a post that will answer their questions in one go.  I have a feeling this will be the most emailed article to my circle…

First of all, eating a paleolithic diet means eating whole, unprocessed foods.  You can be low or high carb, depending on your goals.  Of course, cutting out processed foods means you’re cutting out so many flour and sugar based products so by default you will be eating less carbs than on a Standard American (or Canadian) Diet.

Check out this Paleo Food Pyramid from Fitbomb:

I’ve sent Diana Hsieh’s (ModerPaleo.com) link re Paleo Principles to several family and friends and think it’s worthwile to quote below.  The last couple of points relate to her Objectivist (Ayn Randian) point of view so I chose not to include them as not to confuse my readers.  Otherwise, I agree with the rest of her principles and think she lists them quite well.

  1. Eat real foods, prepared well. Prepare your own food as much as you can. Beware the junk ubiquitous in convenience and restaurant foods. [+/-]
  2. Don’t eat wheat, corn, rice, or other grains. If you choose to eat some grains, eat them sparingly and prepare them to minimize toxins, such as by sprouting and soaking. Wheat seems to be the worst of all the grains, while rice seems to be the most benign. Whole grains are not better than refined grains. [+/-]
  3. Don’t eat sweets: avoid sugar, corn syrup, agave nectar, honey, maple syrup, and artificial sweeteners. If you must have some sweetener for a dish, you might try a bit of stevia. With time, your tastes will adjust: ordinary sweets will taste cloying, but formerly bland vegetables will seem delightfully sweet. [+/-]
  4. Don’t eat modern oils derived from grains and seeds — such as canola oil, corn oil, or soy oil. Make your own mayonnaise and salad dressing. Don’t eat fried foods in restaurants: rancid vegetable oils are standard for frying. Avoid all hydrogenated fats; they contain damaging artificial transfats. Instead, use liberal amounts of animal fats — like butter, ghee, lard, and tallow — as well as unrefined coconut oil and olive oil. (Reserve your bacon grease: it’s delicious rendered lard!) Do not fear saturated fat: it’s healthy, including for your heart. [+/-]
  5. Don’t eat soy. Some fermented soy might be okay, if tolerated. However, all soy is goitrogenic and contains estrogen-mimicking hormones. [+/-]
  6. Don’t eat beans and other legumes. If you choose to eat some legumes, eat them sparingly and prepare them to minimize toxins, such as by soaking them. [+/-]
  7. Watch your ratio of omega-6 to omega-3 polyunsaturated fats, as well as your total omega-6 intake. Most people eat far too much omega-6, both absolutely and relatively. Today, the average ratio of omega-6 to omega-3 in Western diets is 17:1, but the ideal ratio looks to be between 2:1 and 1:4. To achieve that you’ll need to limit omega-6 intake by eliminating modern vegetable oils and eating high-omega-6 nuts sparingly. You’ll likely need to supplement with high omega-3 fish oil too. [+/-]
  8. Eat plenty of high-quality meat, preferably from pastured animals. Grass-fed meats have a better ratio of omega-6 to omega-3 polyunsaturated fats than grain-fed meats. Avoid meats treated with antibiotics and hormones, if feasible: the animals are likely treated better, and they taste better. Enjoy plenty of red meat. Try uncured bacon and other breakfast meats. They might not be any healthier, but they taste so much better! [+/-]
  9. Eat eggs, preferably from pastured chickens. Eggs enriched with omega-3s are a good option too. Prefer nutrient-dense egg yolks to nutrient-poor egg whites. [+/-]
  10. Eat fish and shellfish periodically, preferably caught wild rather than farm-raised. [+/-]
  11. For workouts, ditch the standard “cardio” sessions. Try short, high-intensity workouts instead: you should be able to kick your own ass in ten minutes or less. Try weight training, sprinting, and barefoot running. For more structured programs, try CrossFit or Body by Science. Also, move around a lot. Ladies, don’t be afraid to weightlift: you will not turn into Ahnold overnight. [+/-]
  12. Eat vegetables, but don’t think of them as the holy of holies. They are particularly good when slathered in good fats. Beware the goitrogenic effects of some vegetables, particularly when eaten raw. [+/-]
  13. Eat fruit sparingly. Fruits are often high in sugars, particularly fructose: tropical fruits are the worst; berries are the best. Fructose is particularly hard on the liver. [+/-]
  14. If tolerated well, eat some high-fat dairy, preferably raw and/or fermented. Avoid low-fat dairy like the plague. You might need to limit dairy if you’re trying to lose weight. It can be helpful for building mass, however. [+/-]
  15. Eat nuts, if you like, but beware the omega-6 load in some nuts. Grouped and ranked from least to most omega-6 content, we find: (good) macadamias; (okay) cashews, hazelnuts, almonds, and pistachios; (worse) pecans, brazil nuts, and pinenuts; and (terrible) walnuts. Nuts may require soaking and drying to eliminate toxins. Remember that peanuts are legumes, not nuts. Avoid rancid nuts. You might need to limit nuts if you’re trying to lose weight. [+/-]
  16. If tolerated well, eat some tubers like sweet potatoes. Some people seem to tolerate modest quantities of white potatoes, but others don’t. Sweet potatoes are an excellent source of carbohydrates for athletes. Try limiting or avoiding tubers if you’re trying to lose weight. [+/-]
  17. Fermented and cultured foods — like yogurt, kefir, and homemade sauerkraut — are beneficial for your gut bacteria. Enjoy them! [+/-]
  18. Be adventurous: don’t neglect organ meats and bone marrow. Make homemade stock made from leftover bones. [+/-]
  19. Supplement with vitamin D, based on your blood levels. Consider the following supplements as well: cod liver oil and butter oil; iodine and selenium; magnesium and potassium; vitamin K2; fish oil. Try to get as much good nutrition from real foods as you can, but recognize that depleted soils impact the nutritional values of the foods available to us. [+/-]
  20. Some people require a few weeks to adjust to eating a paleo diet. It’s not uncommon to feel a bit lethargic or foggy while the body transitions to using fat rather than carbohydrates as its major source of fuel. You can choose to dive in whole hog — or you can gradually adjust your diet over a few weeks. [+/-]
  21. If you wish to lose (fat) weight, lower your carbohydrate intake to about 50 grams per day or less. Limit tubers, fruit, dairy, and nuts. Be sure to lose that weight gently: eat only when you’re hungry, but don’t deprive yourself. If you’re looking to gain mass, try eating more high-fat dairy and tubers like sweet potatoes. [+/-]
  22. Sleep plenty and sleep well. Take time off time to recover from workouts. Don’t abuse your body by failing to give it the rest it requires. [+/-]
  23. Pay attention to your body; experiment to find what foods work best for you. If you have health problems like autoimmune disease, test foods by a process of elimination. Try completely removing potentially problematic foods — like gluten, dairy, nuts, eggs, and nightshades — from your diet for a month or so, to see if you feel better without them. Whatever others say, eat what works for you. Ultimately, you should “look, feel, and perform” better than ever. [+/-]
  24. Reject the meaningless concepts of “moderation” and “balance” as applied to diet. Instead, identify your range of healthy foods, then eat a wide variety of those foods. Try new foods, as your tastes will change over time. People will consume different macronutrient ratios on a paleo diet, depending on their bodily needs, health goals, and lifestyle. You will need find the right range for you. [+/-]
  25. Skip meals periodically, particularly when good food isn’t available. Try intermittent fasting. Feed yourself well, but vary how much you eat. [+/-]
  26. If you choose to eat non-paleo foods on occasion, don’t flagellate yourself as an abject failure and bury yourself in a gallon of ice cream. Instead, acknowledge any “cheats” as such — and recognize that you’ll likely pay a price for them. Sometimes, those cheats remind us of the reasons to eat paleo. Don’t make a habit of such “cheats” by scheduling “cheat meals” or “cheat days.” Just do them on occasion, when fitting. [+/-]
  27. Beware sources of toxins, such as the BPA lining all canned goods and bromine in hot tubs. Non-stick pans can be a problem too: consider using stainless steel or cast iron cookware instead. If you want really clean water, use a reverse-osmosis or distiller system. [+/-]
  28. Don’t put oils on your skin that you wouldn’t put in your mouth. Coconut oil is a wonderful moisturizer. For soap, use a simple soap, or none at all. You might try “no-poo” for your hair instead of shampoo — or nothing but a water rinse. For toothpaste, try brushing with baking soda or just water. Many people report much improved dental health on a paleo diet, particularly when taking cod liver oil and butter oil. [+/-]
  29. Pets like eating paleo too! Consider switching your cats and dogs to grain-free pet food — or better yet, a homemade raw prey model diet. [+/-]

Reverting Back to the Ancestral Diet: An Inuit Case Study

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In my last post I mentioned how traditionally, humans evolved on a grain-free, Paleolithic diet consisting of plants (vegetables and plants) and meat.

The Globe and Mail had an interesting article a couple of weeks ago outlining the journal of an Inuit man whose obesity and associated health risks led him to adopt the diet of his ancestors, before the Westerners arrived with their flour and sugar.

I found this quote quite telling:

Ever since colonization, my people went from being a fit, athletic race of people to the most sickly and lame. The most obese. The highest diabetes rate… We went from eating our natural food to a diet completely different from 100 years ago.”

More than a third of Canadian aboriginals are obese, and about a fifth told the 2011 First Nations Regional Health Survey they had diabetes, according to its preliminary results.

He researched the diet of his ancestors but there wasn’t a consensus on what that was…so he created his own.  From reading Taubes and other sources, I do know that the Inuit of the far north subsistied on a diet of seal fat and fish for at least 6 months of the year, and they were considered very healthy before adopting European diet.

A fascinating case is of Canadian adventurer Vilhjalmur Steffansson, who explored the Arctic and whose 10 year experiment with an all meat (and animal fat) diet with the Inuit make him a figure of interest in Paleo circles.  He and another man reproduced the all meat (including organs and bones) diet in a laboratory setting for the Journal of the American Medical Association, closely monitored by observers, and the result was perfect health for both men.

Back to the article.

Mr Ducharme states that one point, his new ancestrally-intuited diet started to take a toll on his disposition – he was constantly hungry, moody, and emotional.

I’ll bet it was because he wasn’t incorporating fats into his diet, due to operating under the “fat is bad” for your paradigm.  He mentions eating very lean game meat like elk and buffalo and lots of nuts and fruits and veggies, with wild rice and natural sugars.  He probably would be a lot more satiated by adding some fats.

I’m glad to see awareness of the horrible state of health of traditional hunter-gatherer societies and actual attempts to adopt ancestral diets in an effort to reverse illness and achieve good health.  Mr Ducharme is in the process of producing a documentary on his journey and it will hopefully help others in his community.

 

Why Paleo?

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Human beings have been in existence in homo spaiens form for over 2 million years.  For 250,000 of those years we evolved into our current homo sapiens form.  During this very long era, human beings were hunter-gatherers, hunting animals and their fat for meat and gathering roots and vegetables.

Around 10,000 years ago, grains were discovered and the era of agriculture, the Neolithic era, started.  Grains were a source of cheap energy and could last a long time enabling storage and transporation (and hence the spread of civilization) and they could be grown in mass quantities enabling the proliferation of populations.

Think about it…as human being, we have only begun eating grains for about 4% of our existence.  We didn’t evolve on that stuff but we did evolve on meat and plants.
Anthropologists can tell at a glance if the remains of a skeletal bones are from the Neolithic (agricultural) or Paleothic (hunter-gatherer) era.  The Neolithic remains tend to be shorter, with less bone density and cavity-filled teeth.

Grains are filled with anti-nutrients (like lectin, phytates and gluten) which prevent the absoprtion of nutrients to the body.  For more information, click on this great explanation from Mark.

With the advent of mass industrialization of food (specifically the processing of grains and sugar canes into flour and sugar) in the last 150 years plus the subsidies the agricultural industries receive in the past 50 years plus the misguided government nutritional policies that push the idea of processed carbs as the bedrock of a healthy diet in the last 30 years, and you have populations that suffer every sort of ailment unseen in the past…Allergies, dental decay, acne and bad skin, neurological disorders, obesity, cancer, Alzhiemer’s, every kind of chronic illness, etc…

Weston A Price’s “Nutrition And Physical Degeneration” (freely available for reading via project gutenberg) had a central hypothesis that Western diseases from dental decay to cancer, were rarely present in developing societies.  His research of isolated and hunter-gatherer tribes across the world (it took him 10 years to complete his very comprehensive study) led him to extrapolate that abandoning traditional diets and adopting the Western diet (flour and sugar based) introduced diseases of the West into societies that never before had experienced them before.

Taking the Red Pill: Or Reading Taubes’ “What if it’s all been a Big Fat Lie?”

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The chronic diseases riddling my relatives, plus my mother’s physical and mental deterioration, in addition to mine and other people’s struggle with keeping fit, and overlaid with the knowledge that our elders back in the old country were fitter, lived longer and had better quality lives than their descendants in the West, all combined to make me receptive to unconventional information and a different truth.

Which is when I serendipitously stumbled across Gary Taubes’ seminal New York Times article “What If It All Has Been a Big Fat Lie

Gary Taubes, a well respected science writer, with science and engineering degrees from Stanford and Harvard, wrote about how the low-fat dietary dogma that has been pushed by the medical and scientific establishment for the past 30 years has proved to be a dismal failure.   A quotes from the article:

These researchers point out that there are plenty of reasons to suggest that the low-fat-is-good-health hypothesis has now effectively failed the test of time. In particular, that we are in the midst of an obesity epidemic that started around the early 1980’s, and that this was coincident with the rise of the low-fat dogma. (Type 2 diabetes, the most common form of the disease, also rose significantly through this period.) They say that low-fat weight-loss diets have proved in clinical trials and real life to be dismal failures, and that on top of it all, the percentage of fat in the American diet has been decreasing for two decades. Our cholesterol levels have been declining, and we have been smoking less, and yet the incidence of heart disease has not declined as would be expected. ”That is very disconcerting,” Willett says. ”It suggests that something else bad is happening.”

He states an alternative hypothesis that a small but growing number of researchers are working on to explain the obesity epidemic in light of decreasing fat consumption in the US.  Mianly, that carbohydrates affects insulin and blood sugar which in turn affect fat, hunger and metabolism.

If the alternative hypothesis is right — still a big ”if” — then it strongly suggests that the ongoing epidemic of obesity in America and elsewhere is not, as we are constantly told, due simply to a collective lack of will power and a failure to exercise…. But because the public health authorities told us unwittingly, but with the best of intentions, to eat precisely those foods that would make us fat, and we did. We ate more fat-free carbohydrates, which, in turn, made us hungrier and then heavier

Taubes gives overviews of different studies, lots of them either ignored or unfunded when they contravened conventional wisdom about the dangers of fat, which show that diabetes, the obesity epidemic, heart disease and other diseases of civilization are caused by a high intake of refined carbohydrates in the form of grains and sugar.

I cannot overstate just how much this article served as my version of the glitch in the Matrix.  I was hungry for more so I proceeded to devour his lauded book “Good Calories, Bad Calories” where he expands the thesis presented in the NY Times article, comprehensively going into the epidemiology and history of nutritional science, explaining how we got to this state of affairs and presenting anthropological evidence of societies that thrived, with very low disease rates, before adopting the western diet, heavy on grains and sugar.

GutsandBlackStuff gives a great chapter by chapter summary of the book, for those of you too lazy to read it.

Reading Taubes led me to reading Weston A Price’s fascinating book “Nutrition and Physical Degeneration: A Comparison of Primitive and Modern Diets and Their Effects”, the Drs. Eades’ “Protein Power”, Rob Wolff’s “The Paleo Solution” and Mark Sisson’s “Primal Blueprint”.   All of them agreeing on a central point, with some some differences, i.e. that a diet of unprocessed foods, which naturally means a higher-protein, higher-fat, but lower-carb diet than one recommended by the conventional scientific, medical and nutritional establishment, is one that is best for optimal health and weight as it the kind of diet our ancestors ate and that we evolved on.

What I read explained why the elder generation back home in the old country in lived longer and healthier lives than their children in the West.  It explained why my mother and others, despite diligently following doctors and dietitians advice to eat low-fat, whole-grain “heart” healthy food, were losing the battle against the bulge, losing the battle against diabetes with rising A1C1 and losing the battle against rising triglycerides and LDL, year over year. Finally, it explained why mostly everyone I know who did the conventional low-fat diet, plus exercised diligently, failed miserably at either losing or keeping off the weight.

I had taken the red pill.

I Don’t Remember: Onset of Short-Term Memory Loss

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In every person’s life there comes a moment where they realize the fragility and mortality of their parents.  Mine came in March of 2011 when I had a conversation with my mother that shook me to my core.

First, a bit of background.  My gorgeous, warm, sharp mother had diabetes for almost a decade and high cholesterol for 7 years.  It was managed via metformin for diabetes and statins for the cholesterol.  She also struggled with her weight for decades.

She also suffered from pains in her legs for years and to our shame we (her family and her doctor who should have known better) dismissed her complaints as the result of being overweight and not exercising.

Coming from a culture that does not believe in taking pills, my mother disliked taking her metform but truly loathed taking the statins.  She took them because her doctor prescribed it and she, like so many, has an unwavering respect for doctors.  However, she protested in her way by refusing to take increased dosages of each medication, especially the statins which she instinctually distrusted.

She also recalled how when she was first diagnosed with high cholesterol by her family doctor and a specialist, the nurse and her pharmacist privately disagreed with the diagnosis, confiding that the numbers were not bad and that she could control her cholesterol levels via diet.  Faced with conflicting advice, she decided to go with the doctors’ diagnosis and recommendation cause again…good ole respect for doctors.

Year after year, her bad cholesterol rose.  Year after year, her A1C1 diabates number rose.  She took to heart everything her doctor recommended, including eating a low-fat, whole-grain “heart” healthy diet and to no avail.  All the indicators rose.  Her blood pressure even rose to the border

Physically, she was finding it difficult to climb the stairs.  She often would use her hands and feet to go up the steps cause using her legs only proved too painful.  If she sat down, it was a struggle to get up.  She always begged for foot and leg massages to alleviate the pain in her limbs.  Her diet, rich in heart-healthy whole grains like oats and whole wheat bread, left her hungry.  Whenever she ate injera, which is a flat, pancake like bread common to Eritrea and Ethiopia, she would suffer greatly from GERD, to the point of going to the emergency room.  And her doctor was recommending an increase in metformin and statin dosages which she adamantly refused to do.

One day in March of 2011, while her and I were having a conversation, she mentioned that she was having issues with her memory.  While working, she would have to look at the clock a million times cause she couldn’t recall the time.  At church, after mass, she had several embarrassing moments where she would greet people and then 10 minutes later greet them again as if meeting them for the first time.

A tinge of ice entered my heart when she told me all this but for her sake, I kept calm and re-assured her she was just having a senior moment.  Of course, privately I didn’t believe what I was saying.  Senior moment,  my butt.  My mother was in her mid-50s.  She is too young to start having short-term memory loss.

A week later, I had a three way conversation with my mother and her brother in the US.  It was a 2 hour long, enjoyable, funny and  raccuous talk, in only the way my  mother and her brother can be.

Three days later, my mother called me for some small matter and then lamented that she hadn’t talked to her brother in months.

I felt a sharp pain in my heart.  With great hesitation, I reminded my mother that her, my uncle and myself had a very long conversation only a couple of days ago.  There was a long pause while I waited for my mother to respond.

“I don’t remember”, she said.