Managed, ... to beat drug resistence!

 

By Malini Shankar

Digital Discourse Foundation

In the post Pandemic era that we are living in, COVID 19 survivors are facing the bleak prospect of aftereffects of steroids. These can include developing endocrine disorders like Diabetes Miletus, hypertension, cholesterol, chronic insomnia, debilitating mood swings and consequent mental health issues, weight gain, thickens blood, creates drug resistance, arthritis and rheumatism, hair loss, skin lesions, internal irritation, chronic itching, food allergies, loss of bladder and bowel control, and so on. That is why I write this in time for World Health Day 2023.

If this scares the daylights out of you, take heart that each individual responds in a unique way… it could also well turn out that the exact opposite of what’s listed above might turn true… for example it could well be low blood sugars, or low blood pressure / hypotension etc can take grip in a person. It depends on a person’s body constitution.

Now let me share my personal battle against steroids. In my case I had built strong resistance to COVID 19 itself so eventually when I got COVID 19 in July 2022 I was isolated at home without administration of any medicine. I have suffered from chronic after effects of steroids for a different reason.

I was not yet eight years old when during school holidays I fell backwards during playtime on 23.04.1977, crashed my head against the parked car door handle at the skull base, suffered a massive head injury and brain concussion, lapsed into Coma, suffered a near death experience (including out of body experience, brain trauma and its psychological consequences like PTSD, tunnel vision), photographic memory, and suffered hemi-paralysis on my left side… leaving me mobility impaired even today, 46 years later. 

Growing up with a dysfunctional left hand and unresponsive left leg, I am proud and happy to share that I still managed to overcome the disability with infinite support from my parents who got me the relevant post traumatic treatments and an infinite education; School principal and teaching staff, too provided me a platform for inclusive education making me a confident individual… and my school classmates, they were and are the darling angels who gave me a heartfelt smile during these years of traumatised childhood.  

Oh! But the steroids… they kill you alive I tell you. Since there was no effective medicine against fluid formation in the brain post trauma back in 1977, I was administered a good 49 shots of 50 – 100 ml of Efkorlin injections or steroids over a period of seven days to 10 days. Immediately after the Golden Hour I / my body received hourly shots of Efkorlin for 24 hours. This was tapered to one a day after the 7^th day till the 10^th day I think, if I recall right.

These steroids played havoc on my body and soul.  Immediate effect was no swelling in the brain alright. But PTSD started showing barely a month later. Simultaneously the paralysis started showing drastic improvement: within four weeks I started walking ungaitly in the physio therapy department.  I lost one year in school, and to be nice to me, the school principal, an eminent educationist told me I was younger age in comparison to my classmates so it helps to repeat a year.

The emotional hee-haw one faces after administration of steroids discounts the PTSD factor completely. The mental and emotional strain itself creates stress induced disorders… atleast in me it triggered stress induced diabetes some 27 years later. I do not understand why the medical professionals are unable to quantify this. But much worse is the impact of the steroids on the body.

In my case the blood thickened almost immediately but I lived without a trace of diabetes or cholesterol for a good 27 years after the brain trauma. In one instance of unprecedented stress in 2004 I was diagnosed with Diabetes with random blood sugar reading revealing 256. Immediately I was put on Glyciphage 1 Mg as I was at that point living in the USA. About 8 weeks later on returning to India, fasting blood sugar was 114 and PPBS was 121. 

Yet because I was overweight at around 82 kilos (/180.4 pounds) for a height of 5’7” (/ 170 centimetres) the doctors advised me to continue this medication. I had a healthy lifestyle with 90 minutes walking and 45 minutes aerobics everyday and I was regularly doing breathing exercises so I could effectively mitigate the diabetic twin:- Hypertension for a good decade and more. 

This was thanks to a very healthy diet and healthy lifestyle that included aerobics, yoga (that I restarted in 2011), walking, cycling and Pranayama six days a week. Yet my weight was not coming down. The body shaming I have been subjected to, during my growing up years still haunts me, past 50. I felt I was resembling the Rhinoceros.

In 2015 I developed hypertension and was put on medication for hypertension.... this again because of stress.

Then in mid 2016 I ate carbs for dinner for a week as we had visitors at home. This shot up the three month average of my blood sugar  and it started showing tell-tale signs… increased visits to the toilet, insomnia etc. 

I made the mistake of going to the Diabetologist fearing insulin administration, fearing loss of kidneys etc. The blessed Diabetologist, a nice gentleman and a good doctor, a family friend put me on Rs. 170 worth of medicines per day. This created drug resistance and immunity from my regimen. Oh my god! Sleep became a mirage. 

Diabetology drugs had an exploding side effect on me: Skin lesions, body itching, pins and needles on the soles of my feet (neuropathy) marbles on the soles of my feet, and after three months blood sugar levels too saturated. 

My skin became as rough as gneiss rock and my lips were as brittle as Lava or charcoal. I was looking haggard and resembled a drug addict. When I complained to the diabetologist about the side effects he threatened me that with HBA1C of 7.4 if I stopped taking these drugs my kidneys would fail within 24 hours. Later it turned out that WHO announced that HBA1C  levels between 7 - 9 were sustainable. I developed immunity towards Diabetology drugs! And here’s the crux.

By January 2020 the drug resistance was so severe that my fasting blood sugar-levels breached 400 and my HBA1C was 13! I gained weight rapidly, touching 94 kilos again. I had to touch myself to check if I was alive, for, going by diabetologists I should by now have faced 2 brain strokes, 2 heart attacks and lost both my kidneys. 

Changing diabetologists worsened things as they were only experimenting with different drugs on my body. I was fed up.  One blessed Diabetologist asked me to get myself admitted to his specialty Diabetes clinic as an in-patient. I found him rude so hung up on him. I was eating oats for dinner and millet porridge for breakfast. Lunch included 1 - 2 phulkas and a measured 30 gms of uncooked raw brown rice (when cooked it was a bowl of rice), with lots of vegetables. Doctors and diabetologists at the premier Karnataka Institute of Endocrinology Research a Government research and referral hospital in Bangalore with advanced treatment for chronic diabetics agreed that I was indeed facing drug resistance and that my healthy lifestyle including yoga, walking, cycling, aerobics, Pranayama and healthy diet was what had kept me alive miraculously… and my kidneys, feet, heart, lungs and brain were thankfully intact. A C-peptide test revealed that my Pancreas was working 100% optimum, which gave me tremendous confidence; and I started researching a great deal.

But I was suffering from chronic Irritable Bowel Syndrome, skin issues, insomnia (I could not fall asleep till 6.30 in the morning one night in December 2019), lack of appetite, and weight gain … I touched 94 kilos by 2019 and I thought I was now resembling beef cattle in the Mid-West. That was what I was made to believe by those who have body shamed me all my life.

I am a photojournalist and filmmaker by profession, so insulin is anathema to me. All of 2020 I suffered … thinking my days are numbered. In early 2021 - as an acquaintance who was suffering from COVID 19 told me about the subscription lunch boxes served by someone known to reverse diabetes - I thought I should give it a try. The nutritionist claimed she had reversed diabetes in her mother who was insulin dependent.

I found a benign tumor in my body too. My already weak nerves on my left side were so affected by all the Diabetology drugs and “combination medicines”, that I could no longer do my beloved yoga. I was advised physio therapy as this was part of “Neuropathy” It affected my weak left hand and leg. Neuropathy meant I could no longer do my walking either. 

For a person who was doing 18 hours of work out a week and 3.5 hours of Pranayama weekly, absenting myself from this regimen was, plain torturous. 

Simultaneously I took a very bold decision. I decided to abandon all the Diabetology drugs and stick to only Glucophage / Glycomet and aimed at coming back to 1 Mg of this tablet per day. I am now resistant to even 1 mg of Glycomet. It creates bubbles on the soles of my feet, and I can barely walk without support. I also get an intolerable burning and tingling of the soles of my feet. So I usually take 1 tablet of 250 mg of Glycomet after one carb based meal a day. 

Now I also take 30 ml of Ayurvedic medicine called Amrith Noni D Plus, which has Government of India clearance and is readily available as Across the Counter medication. And I have reduced dairy products drastically. In consultation with the nutritionist I followed the following diet and effectively shed 22 kilos of weight over a total of 24 months:

• 1 Breakfast includes 1 mug of millet soup and 1 cup of coffee without any kind of sweetener or jaggery… 1 Tablespoon of sprouted fenugreek seeds, 1 Tablespoon of dried fruits. I take only half tablet of a 10 mg Hypertension tablet after breakfast…. Any later and it affects my sleep. 5 mg hypertension tablets are not available in india so I have to break the 10 mg tablets into two and consume half tablet. 
• 2.Lunch includes: 1 Phulka or 1 Millet roti, 3 servings of raw vegetable salads, ½ cup of rice / wheat / millet (any cereal), 1 bowl of cooked vegetables (like in a curry), probiotics like kadhi or yoghurt based curies, etc + 1 glass of thinly beaten buttermilk (called majjige in Kannada and chaas in Hindi). 
• 3. Dinner or supper includes a bowl of oats which I eat with either sambar or Rasam; A bowl of seasonal fresh fruit and a small cup of oat milk comprising 2 ounces of the liquid. 

I have still not defeated or reversed Diabetes. But my fasting blood sugar levels have come down to between 200 – 250, by decreasing and discarding almost all tablets! That in essence is the battle against steroids. 

My nutritionist has told me that I should restrict dairy, have one cooked / carb based meal, one only vegetables based meal and one only fruit based meal per day. 1 hour of exercise regimen without fail is a must for all of regardless of any disorder one suffers from.   My neuropathy is now getting better with decrease in tablet regimen! 

This is why I have come to the conclusion that steroids thickened my blood, to breach that I need to eat large amounts of probiotics and native foods we grew up with so that digestion is easier. 

In my case and after understanding the complexities of the impact of steroids I realise I might not have had Diabetes per se. I think it was only a case of stress induced trigger for increase of random blood sugar: by administering diabetic drugs I only ended up building drug resistance. A very strict diet and healthy lifestyle can, I am hoping  help me reverse Diabetes during the course of this year.

An acquaintance of mine who is a COVID 19 survivor also faced uncontrolled diabetes after COVID ...  his blood sugars went beyond 400 and with intermittent fasting he reversed diabetes completely. 

I cannot emphasis and reiterate more the need for a healthy lifestyle for those who have 'suffered' steroids:

1.         No junk food
2.          Healthy home cooked fibrous foods
3.          Active lifestyle with a strict regimen.

·         Fenugreek sprouts helps mitigate the impact of steroids in my experience. Ideal diet to reverse Diabetes is:

• ·  5 fresh / raw vegetables, 
• 5 cooked vegetables, 
• 5 green vegetables, 
• 5 fresh fruits, 
• 5 dried fruits, 
• 5 different sprouts, and about 
• 2 tablespoons of any cereal per day does the trick. Reduce dairy consumption. No need to eliminate dairy altogether. But in my experience A2 milk / milk products are far healthier than dairy products per se. It is not easy for us Indians and foreigners too to give up dairy altogether. But one can definitely avoid things like cheese paneer or cottage cheese, .... things one will be better off without. That amount of milk spared for the calf is far more sustainable and a best practice for Humanity.

A vegetable rich diet has and will help me reduce my tablet further. In my case the drug resistance is so severe because of steroids that the Diabetes tablets simply do not work. From experience I know that my body responds better to a healthy lifestyle rather than tablet regime.  So from next month I will be having one Litre of tomato juice with a bowl of fenugreek sprouts for breakfast, a plate full of 10 vegetables and 5 green vegetables for lunch and oats with fruit for dinner. Hoping to be able to dispense with the remaining 250 mg of Glycomet tablets soon.  Will keep you posted. Watch this space. 

I I would like to end this blog today with a disclaimer that diabetes is very dangerous. One must not ignore it. In my case drug resistance was so severe that it almost maimed me from my routine. I only try to share my learning here and am certainly not preaching to any diabetic that one can afford to give up all medication. Reversing Diabetes needs trained supervision, but am hoping my lessons learnt will be a helpful pointer. 

 Cheers,

Malini 

Photo credit: Poornima Jayarao, Malini Shankar, Creative Commons