Elie Jarrouge, MD - How I got here
I used to be proud of my good health and athletic tendency growing up. Fast foreward many years, while busy with medical training, I wasn't paying attention to my own health. Weight slowly creeped up and within 8 years, I had gained 30 pounds and my waist grew 4 inches. My blood pressure started to run high, I was starting to become pre-diabetic, and my energy level plummeted. I developed text book Metabolic syndrome and I was only 28 years old. I thought I knew the answer. I just had to eat less and move more. Great! I did it… Except nothing changed. One day at age 30, I was putting pants on and my back gave out. I was in excruciating pain for a week, slept on hard floor and it took me 3 weeks to walk straight again. I didn't think much of it at the time, except bad luck. Then, for the following year, my lower back kept giving out every 2-3 months, debilitating me, and in between episodes, I suffered with chronic lower back pain. Structurally there was nothing wrong with my spine. I just could not understand it. Every attempt to exercise inevitably led to another flare up.
As a hospitalist since 2013, I treat patients admitted to the hospital for a myriad of conditions. It was high acuity and fast paced. When I first started, I saw patients show up very ill, treat them and see them improve dramatically. I thought I was fixing problems. Life was good, right? I couldn't be more wrong. Over time, I realized that it was all band-aid. Many of my patients kept getting readmitted with the same problems and deteriorated slowly overtime. I wasn't fixing anything. I just managed their diseases. It dawned on me that I couldn't even help myself heal!
I dismissed any dietary advice from friends, ignoring the fact that I didn't get any nutrition education in medical school. I thought it was easy for them to say since they were fit. Then one day, after my 5th or 6th severe back strain episode, it became clear that I had to do something different. Feeling desperate, I didn't see a reason to resist lifestyle changes any longer. I started reading about nutrition starting with the Whole 30 program, which is basically paleo with focus on the psychology of food. A month later I was down 15 lbs. I repeated it a couple of months later and I was down another 5 lbs. In between, I kept a semi clean diet and felt amazing. My back pain was 80% better, my energy was up and my waist size dropped 4 inches. I started working out and felt stronger. I was so excited about my progress that I went down the rabbit hole of nutrition and health. I read many books, listened to endless podcasts and eventually I decided to take my journey up a notch and dived into the ketogenic diet in January 2018. I did it for 3 months straight. I dropped another 10 lbs (30 lbs total), lost another inch off my waist and never felt better in my life. My back was 100% better. Since then, I continue to tweak how and what I eat and added intermittent fasting. I haven't had a flare up of my back pain in over 2 years. My high blood pressure resolved, I am no longer pre-diabetic and my weight is down to where I was when I was 17 years old.
Once I saw the benefits, I could not ignore it. Practicing conventional medicine alone felt wrong. Prescribing medications to treat symptoms and never fixing the problem felt like betrayal to my patients. For the past 3 years, I took advantage of the time I get with my patients in the hospital to teach them about the root cause of their conditions and how medicine alone wasn't going to make them healthier. For those who listened and were willing to make a change, they took notes and promised to implement changes. Seeing the look of hope on their faces that their diabetes or liver disease or obesity don't have to be progressive until they die, made it all worth it. They felt empowered that there is something they can do about it, but also they felt angry that nobody talks to them about nutrition and when they do, it's the same flawed message that they have to eat less and move more. Those encounters however, left me wondering if my patients will actually act and stick to change long enough to see the benefit. I know that I struggled at first and it took a tremendous amount of effort and repeat attempts. I knew they need someone to guide them, coach them, monitor their progress and also get them off their medications. Who's going to do it? Their PCP? They barely have 15 minutes with their doctors and most doctors are still dismissive of lifestyle interventions. I knew I had to be their coach. So here I am.