Side Effect

“This is a very important problem, with some patients gaining sixty to one hundred pounds. Its mechanism is unknown but may involve increased appetite and/or effects on leptin, a hormone important for fat metabolism. Most disturbing are data suggesting that weight gain and the efficacy of the drug may be related, that is, you may have a choice of being fat and non-psychotic or thin and psychotic.” -Torrey, E. Fuller. Surviving Schizophrenia. 1983. Pg 217.

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I am a very lucky person who only fully understood and experienced “side effect” after I turned thirty. I am both humbled by and mindful of what modern medication can do.

One of the major adverse side effects of second generation antipsychotic Olanzapine (brand name: Zyprexa) is weight gain. When I started taking Zyprexa for schizophrenia, no one told me about the possible problem of gaining weight. My body adopted to the medication the same way most people did. My body changed how it reacted to food.

The first thing that changed was how hungry I felt when I was eating. I never felt craving before this. But now I did. Having growing up never had to resist food and always had been a stick, I did what I always did. I ate whenever I was hungry. Now, my stomach felt like an endless hole. No matter how much food I put into it during a meal, I could always eat more. I did not feel food the same way. I loved trying new restaurants with friends. I kept eating and gaining weight. I gained 30 plus pounds and went up from size 0/2 to 8/10 in a few months. I finally was worried. Something changed. But it was not me, was it? 

During my thirties, there was a few times when I was off my medication. As soon as I was off Zyprexa, my weight dropped. I would lose 15 to 20 pounds in a couple of weeks. I would no longer feel so hungry. I realized and validated that my medication was changing how my body dealt with food. Taking medication to cure a problem traded another (relatively minor, true that is!) problem.

As much as I loved eating, I had to start watching how and what I ate. The side effect was now a reality and I had to learn a new eating habit even though I felt like my old self, that I had not changed. But my life did change because of schizophrenia and I was no longer a skinny Asian stick who did not need to think about the action of eating. Ironically, in the last decade, I spent more time managing my weight than schizophrenic symptoms. (Knock on wood, my schizophrenia is controlled by Zyprexa and I am very thankful for that!) My cousin gave me a wireless scale as a gift in 2012 and I have been tracking my weight daily since then. I learned that if I ate three “normal” meals, normal as in pre-schizophrenia days, I would gain half of a pound a day. It never failed to do that. So I had and have to consistently work on this daily!

On the bright side, it seems that now my stomach has gained back some sensation in the last couple of years and I do feel a bit more when I eat. Perhaps, my body is readjusting to the medication and bouncing back a bit after a decade!

For the most part, I am still very much a foodie. And to quote my dad, “you are lucky you can eat!” Indeed, I am!

Managing side effects from medications is a serious focus for anyone who is managing a chronical disease and taking medication. We know that life is a balancing act and full of learnings and tradeoffs. It’s not easy but we have to keep at it.

Behind every person and body, there may be a story! We can all be more understanding and not judge someone too quickly.

Great Seafood Restaurants in Boston

My personal recent favorites are, from left to right, Pammy’s, Waypoint, and Select Oyster Bar. First, the food was excellent. I have been to these places multiple times so they are not a one-meal wonder. Second, the places are cozy with character. I enjoyed being there. For the man who was on a blind date with me and wonders where we should meet next, well, here is a big hint! For other men out there looking for a nice post-first-date spot, check these out and don’t forget to make a reservation for your special someone!

More about these dishes that I love:

  1. Citrus Grilled Prawns, nori fattoush, herb salad, pickled pepper aioli · $17
  2. Spanish Octopus, roasted tomatillo, chimichurri, blistered snap peas, cilantro · $21

Taiwanese Night Markets

One of my favorite places in this world is the Taiwanese night markets. They have the smallest “restaurants” I have ever experienced. Each “restaurant” takes up no more than a small square of space, typically out in the open, on the street, one next to another tightly packed. There is usually a table with whatever is needed to either display or cook the food. Usually one person is behind the table. Some have sitting areas and some don’t. The food, everything, is authentic, tasty, and cheap. My favorite dishes are oyster pancake, tofu and peanuts dessert soup, minced pork on rice, and stinky tofu. Many locals can stroll and eat the night away. It’s similar to bar-hopping except this is stand-hopping. On this special day with my cousin Chao, we made it to five. How many stops do you think you can stomach?

Strawberry Shortcake

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From: Japonaise Bakery

Right in front of the St. Mary T stop on the Green C line is this muted-colored bakery. It’s a hidden treasure, easy to miss, even though it’s located on Beacon Street. The staff is always courteous, helpful, and soft speaking.

When I am there, I am reminded of my childhood in Taipei. Some Taiwanese pastries and cakes are heavily influenced by the Japanese and similar.

My favorite is the Japanese style strawberry shortcake. Typical of Japanese desserts I know of, the shortcake is flavored lightly and not sweet. The taste of the sliced strawberry is mixed with layers of delicate sponge cake and whipped cream frosting on top.  I find it very tasty!

Of course, there are many other pastries to try. I am still working my way through. Don’t expect fancy. No wifi or plugs. Somewhat pricy!

As it is, I love this little unassuming gem that brings Japan to Brookline.

Liquid Diet

I opened my mouth during my annual health check-up and ended up with an order to get a colonoscopy. I received detailed instruction to prepare my colon. I went to CVS and was given a 4-liter intimidating large bottle with white powders inside. The day before the procedure, I was to clean out my inside through a liquid diet.

My master plan was to stay home and surf the web while drinking pink lemonade, sparkling water, chicken broth and the lemon flavored prep solution.

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Grass-fed cheeseburger and fries from The Kirkland Tap and Trotter

I love food. I eat any time I am hungry. Now it felt like food and I were on a relationship break. I missed food, but I couldn’t have any of it. I thought about sushi, burgers and fries, pasta, bread. I thought of numerous proper meals that I had in the past. I craved food.

I continued to drink the lemon flavored prep solution at the specified times and intervals. I can do this. A few more hours. Drink. Nap. Drink. Think about having a burger. Visit the bathroom. Drink. Knit. Drink. Fries. Drink. Visit the bathroom again. Nap some more. Drink. Drink. Finally, bottom up!

The procedure seemed easier than putting food out of my mind. After the procedure, I ordered a brunch burger and fries. I swallowed it, tasting every bite. The liquid diet brought a new feeling of tremendous gratitude of being able to eat. Just eat.

Food, I am glad we are together again after a very brief separation! Love you!