AndyJ's Body Enhancement Thread

I tried for 3.6 miles on the treadmill yesterday, but bailed at 1.2. My hips were killing me. I went back this morning and made it with no problem. Hopefully they’ll improve like my knees.

Walking or running?

Walking. 2.2mph according to the readout on the treadmill. I can normally do 2.5mph, but after bailing out yesterday I dropped the speed down a bit. Since mid-February I’ve been adding .1 mile per week.

I’ve never been able to properly run, even as a small child. The best I could do was a sort of high-speed lurching, even before child-onset arthritis became a problem in my early teens. Following up on suggestions in the squat thread in the fitness subforum, the main problem seems to be "dorsiflexion", which may also be why I tend to wreck shoes quickly, walking on my toes. My feet only bend up a few degrees at the ankle, no matter how much weight is on them. That’s probably why I’ve had to re-clock or modify the shifter and rear brake levers on every motorcycle I’ve ever owned in order to be able to operate them.

It looks like I need some specialty "squat shoes" and "walking shoes", with heels. Buying shoes is already a miserable experience; no local store has anything suitable, which means I’ll have to order them online, and then deal with the hassle of returns until I find something that fits properly.

You should look into the Knees Over Toes Guy. That’s his Schtick. I’ve probably mentioned him before but he runs a thing called ATG Online Coaching . Personally, I bought that for a month to download all his videos. Good investment. You can probably get 90% of it by searching youtube for ‘Knees Over Toes Guy’ or ‘Ben Patrick’.

Also it might be worth investing in massage. There are a couple of things that prevent movement: tight muscles and tight tendons. Decent massage can help with the muscles and Ben Patrick’s stuff tackles muscales and tendons.

Nice job.

Also a massage gun, like a Theragun. I struggle with hamstring and adductor tightness, as well as trap tightness, and a few minutes with the gun can open things up amazingly. Makes mobility easier and resolves my tight hamstring-induced low back pain right away.

The theragun is really expensive. Lot’s of chinese knock offs though. Interesting. I might have to try one.

Thanks, I’ll check it out.

Follow-up visit with the nephrologist yesterday. Got to see the doc himself this time, not his PA. It became apparent that he still didn’t have the previous lab work to refer to, nor had the urologist who referred me sent the labs I asked them to forward. Another win for Electronic Medical Records, yay! I saw an EPIC login on the doc’s laptop; it’s one of the larger EMR software companies.

Back in ancient times, the referring doc would fax or email that sort of thing to a consulting physician, but now that doesn’t seem to happen. Perhaps the urologist is on a different system, or (more likely) failed to forward the records twice now.

I had to be in the area again today, (it’s 35 miles away) so I dropped off a printed copy of my lab spreadsheet, with all my labs going back to 2016. He was out of the office, so I left it at the desk. Hopefully he will look at it; 3 out of 4 doctors look at patient-provided data like a vampire looks at a cross.

At the visit yesterday he did show some familiarity with ketogenic diets, which was good. He said the C-RP and creatinine was off, but felt scheduling regular follow-up visits was all that was required. Sure, as long as insurance pays for it. He took blood and urine samples and a couple of boxes of a drug called Farxiga, which he felt would help prevent kidney problems. According to him, it will cause frequent urination, and also dump sugar, which would be good for maintaining weight loss. If I don’t report any problems he’ll write a prescription.

Downside: the sugar dump greatly increases the risk of UTIs. Occasionally pissing barbed wire is how I got to his office, through my GP and a referral to a urologist who referred me to the nephrologist. And the referral-go-round goes round and round…

I haven’t had a chance to read up on Farxiga yet. Unless I see something miraculous, I’m inclined to not take them. Absent other information, I suspect I’m seeing another case of "treat the lab report" instead of "treat the patient".

Gym Buddy had discovered a new walking trail. After our workout we drove to it. It even had signs, "Canoe Trail" and "Walking Trail." We parked at the trailhead. The trail was mowed grass instead of paved or dirt. We walked all of 20 yards before it dead-ended at a creek.

Oo-kay. Maybe Parks & Recreation blew the budget on the signs, but it was a bit underwhelming.

The nephrology office called this morning; they want me to come back next week to give a urine sample to see how I’m doing on Farxiga.

I finally went to the main web page at AstraZeneca and read about it. Interestingly, it tells how it’s for "Chronic Kidney Disease", but it doesn’t say *what kind* of disease. All of them, apparently. And there’s a warning "Do not take FARXIGA if you are allergic to dapagliflozin or any of the ingredients in FARXIGA." Okay, but I haven’t been able to find a list of those ingredients.

Essentially, Farxiga looks like a diabetes control drug. I don’t have diabetes.

Among the listed side effects:

Actual information about the drug is buried in PDFs. "FARXIGA Full Prescribing Information.pdf" says:

My blood sugar moved up from mid-90s to mid-teens on keto; that’s normal, and still okay. I had a full cardiac checkup last year, no problems. So the only possible thing would be "eGFR".

Further in the document, I find:

I never got the labs I asked for from my first visit, on 12/04/23. [slacking on follow-ups…] The last eGFR test I have results for was 10/03/23, from the urologist. That was 50. "Normal" is >59. I also have results from 07/20/21 (88) and 06/03/21 (92), a proteus UTI infection and follow-up after treatment. That was before I went on keto.

Okay, off to look up eGFR. According to the National Kidney Foundation web site, eGFR is :

My GP freaked about my creatinine and C-Reactive Protein numbers after I went on keto; I took a couple of weeks off, re-tested, and everything looked fine. He was still unhappy about it, so he checks it every time I’m having blood work done.

Cystatin C was a new one to me. The Wikipedia page (yeah, whatever) says:

Did he test for Cystatin C? I guess I’ll have to make another hour-plus trip to their office and get copies of the labs. [makes phone call] Looks like I’ll be driving down there *again*, third time this week. [sigh]

They’re supposed to have both labs plus the visit notes ready to pick up. I called the urologist’s office and they’ll have printouts of the last labs he did waiting for me; I have to pass near his office to get to the nephrologist.

Given some common side effects are the very problems I got on the referral-go-round to avoid, and my last eGFR number was above the drug manufacturer’s limit, and that eGFR is based on creatinine, which is out of range due to keto, I’m even less thrilled about taking Farxiga than I was before.

Getting your docs all squared away sounds very convenient.not.
Knowing what the hell is going on from one doc to the next gets to be pain in the ass but you seem to have it handled well.

You mention keto, I started that direction in Jan to clean up my diet but I’m not tracking any macros. Not that I needed it but I’ve lost 10# which wasn’t something I was trying to do. I did have my lipids checked and while in the past my numbers have been really good, this time my LDL and Cholesterol came back very high. Not unusual from what I’ve been reading and I don’t have any other markers out of whack so hopefully not going down the wrong track.

Keep up the workouts, even if it ends in a short walk, you won’t regret it.

If you trend more to "carnivore" than "keto" you can dispense with all the macro hassle.

What I’ve found is, if I stay under 60-75g of carbs I keep the benefits of reduced allergies and arthritis symptoms, but I don’t lose any weight. If I stay below 10 carbs I almost completely eliminate the allergy and arthritis symptoms and lose weight rapidly. I’m still about 70 pounds from where I want to be, but I bumped the carbs up a bit when I got more into the exercise stuff, and because after losing over 100 pounds rapidly, my skin didn’t fit me very well any more. It has shrunk enough that it’s time to knock off that last 70 pounds, though.

eGFR 10/04: 50, 12/04: 36, 03/18: 51

creatinine 10/04: 1.50, 12/04: 2.01, 03/18 1.51

There’s no separate Cystatin C test listed, so that would be rolled into eGFR.

The lab sheets from the nephrologist are laid out a lot different from the ones I’m used to. It looks like there are two creatinine tests, one for blood, one for urine, but the numbers for the urine version are 10x for the blood version. I need to study up on that. At least they give the full names for each test instead of the three or four letter abbreviations the endo’s lab uses. Maybe they’re saving toner?

The blood donations appear to be working; platelets and red blood cell counts are "below normal range" instead of above, so when I see the endo next month she hopefully won’t freak out.

Now to update my lab spreadsheet… it’s a whole lot easier to just run along rows and columns instead of flipping through pages of different report styles.

3.8 miles on the treadmill yesterday. And then I slept for fourteen hours.