update May 21 '20
I have been on a weight plateau for the previous four or five weeks. Still eating low carb (like, zero), high fat & protein diet, trying to do a One Meal Every Other Day but found some difficulties. When water fasting, I have found that I get very hungry the first day. When breaking the fast the next day, I may have eaten too much. This week, I am doing a 5-day water fast and am down to 260 lbs for the first time in 5 years on the fourth day. It is very important to drink a lot of water.
Tomorrow, I go to my PHP and will ask for a wider range of blood tests than they ever gave me before. They have never tested my triglycerides or given a CAC score or fasting insulin levels or glucose tolerance, yet I am prescribed Atorvistatin and Metformin. There is no baseline---yet. I will ask for specific tests for inflammation markers and anything that will give information on my liver health (fatty liver). Also a coronary artery calcium (CAC) test. DW had one yesterday (at my demand) and she had a score of 10, which isn't zero, but much less than the trigger level of 100. It cost us $100, well-spent.
I have learned yesterday that Medicare authorizes only 3 doctor visits a year and only 20 minutes a visit. A detailed report must be made. More than 20 minutes or non-standard subjects require special explanation. If not acceptable to the reviewers, the doctor (and the hospital) will not be paid/"reimbursed" by Medicare insurers. Having read my last report (for the 40 minute visit), I realize that I have to be very careful how I manage my visits or my PHP/hospital/Medicare will be uncooperative. The ketogenic diet is contrary to the textbook. I have also learned that LDL is pretty much useless (also contrary). HDL and triglycerides are much more important. By the way, coffee of any kind can elevate triglycerides, so I am sticking to decaf green tea.
I plan to investigate the studies that say that baby aspirin is good and that everybody must take statins. If I find the conclusions less than convincing, I do not plan to share that with my PHP.
So, maintaining a ketogenic diet has not been hard for me. One-day Intermittent Fasting has been difficult, but 5-day or more is a breeze. Go figure.