Crps full body and head /face /mouth
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Hello all. I have crps 18 months. It started in my left ankle after a sprain. Within a few months I was diabogosies and worked hard to get off crutches. To this day I still don’t use them. 12 months into it things starting going wrong. It spread to all limbs neck back hips.... I am not sure if nerve blocks was to blame but all treatment was stopped. I am chemically sensitive to medication. Medical marijuana is not available in the country I live. I use cbd oil. It’s ok.
Now it’s gone into my face gums mouth. This is a new challenge for which I am not coping so well with. My pain last week hit a 10 when a dentist tried to make an impression of my teeth for night guard. It was not s good day I never had pain like this in my life.
Eating is difficult this week. Above all this I am positive person and wonder was all the medical intervention and chemicals from meds making me worse.
Any advice would be grateful appreciated. I have 3 young kids one is a toddler. So as you can imagine daily life is impacted severely.
Thank you
0 likes, 38 replies
sabrina51474 brenda_savvy
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Hello Brenda,
I am in the same boat. I can't imagine how hard this is for you with several young ones at home to care for; I'm also a mother of 3 but my kids are all grown up and living independently, not in need of daily, if not hourly, goods/services/hugs from mom.
Latest research says, direct treatment of the pain with things like opioid medications and lidocaine patches, etc., is not optimum for many patients, especially if your process is centralized (and for those of us who have the full-body version of this stinkin' thing, that's kind of like we're the poster-children for central sensitization). Anyhow, see if you can't find a specialist in your part of the world who is up to date on the fact that treating for the autoimmune and inflammatory components of this condition is the way to get symptoms under better control. If not already done, check out the videos on YouTube of Dr. Pradeep Chopra from Brown University, and Dr. Jay Joshi, a pain doc/anesthesiologist from northern Illinois. Both are very up to date. Unfortunately there are a lot of medical professionals that are NOT up to date on the science behind CRPS; there's a lot of misinformation out there, even among professionals who are at least locally well-known for treating CRPS. The science has changed so much in just the last 10 years that if a medical practitioner hasn't kept up with the advances, there's a lot they may THINK they know, that they don't. And ultimately, you are the one paying the price for that lack of knowledge.
I'm a former biologist, current registered nurse, and I worked with injured workers as a case manager prior to getting CRPS myself. I saw several cases of CRPS, one a brand-new diagnosis (that was 20140 and several injured workers that had just not recovered from their injuries, and so the insurance company wanted me to find out why (And the unspoken assumption was these folks were either outright faking their pain so they didn't have to return to work, or they were crazy. Or both). Turns out it was neither; they were undiagnosed cases of CRPS. I had one doctor tell me that this patient didn't have CRPS; she had RSD. Hmmmm. I had another doctor tell me our patient didn't have CRPS in her arm to the shoulder, as evidenced by the fact that he'd given her a nerve block and it didn't help her. And everyone knows (he said) that CRPS is a condition of malfunctioning sympathetic nerves, so a sympathetic nerve block should work... And if it doesn't work, that means it's definitely not a case of CRPS. That's probably what the medical texts said back when this middle-aged physician was in medical school, because it's been a good 20 years ago that reports in the literature began disproving the "sympathetic nervous system only" theory.
Ketamine infusions have really helped me alot. Low-dose Naltrexone daily has been a big help, as has the ketogenic diet; all these treatments, at the end of the day, reduce pain by reducing systemic inflammation.
Keep asking the hard questions, and being your own detective. You WILL find what works for you, despite the ignorance out there and the occasional high hopes that you have found THE thing that's going to make all the difference and result in the Big Cure. I keep looking for this too, but in the meantime, I have, over the last 2 years, found several little things that each give 10-20% relief, and that adds up to the point where (unless it's super cold outside, or the weather/barometric pressure is changing really fast!) I have about 6 hours in which I function at about 50% my former speed and energy levels. But by working smart instead of hard, I still get Stuff done. Wishing you the best on your journey!!
lisavila sabrina51474
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Wow Sabrina, thank you so much for taking the time to share this information. I have read a LOT about CRPS but you summarized this condition like no other medical professional. I will look up the ketogenic diet. I also did a 5 day inpatient ketamine infusions but it really didn't help me. Question for you: should I try ketamine again even if it didn't work the first time? Pain management doc says that if didn't work the first time then there's no point trying again. But I've talked to some people who said it could work subsequently. Your thoughts?
brenda_savvy sabrina51474
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brenda_savvy lisavila
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sabrina51474 lisavila
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Hi lisavila,
I may be somewhat biased because Ketamine IV's work well for me, though it's certainly the case that some of my treatments were more pleasant than others... Even when the dose per hour was the same. My last 4 treatments were infused at 60mg Ketamine per hour, for 4 hours. Prior to that, Dr. Joshi started me on 40mg per hour, and then the next treatment was 50 mg/hour, also 4 hours (That's standard protocol for his surgicenter).
This is probably the long way around of saying: Everybody's different, and so the dose and the protocol that work for one person may not be optimal, or even effective at all, for the next person. Dr. J. says it's a lot like a first date: You don't know that much about the person until you've spent some one-on-one time observing them. I disagree with your doctor who said if it didn't help the first time, that Ketamine won't help ever; what was the dose?? For how long did you get it? What other meds were you on at the time? Too many variables to make that determination after only one infusion, I think. Incidentally, I'm red-headed, and whereas Dr. J. has patients that essentially can barely speak or move on 60 mg Ketamine per hour, I can reposition myself and do math, chatty as all get-out, asking questions, singing to myself, and just generally being a pest. Yet if anything, it works as well or better for me than for other patients. I've read about people who actually need 120mg/hr or more to begin to dissociate, to help your brain "reboot", which is the therapeutic goal of Ketamine in the first place. So once again, too many variables to say for sure that it would never work for you. If I was on one of those 5-day infusion protocols as a hospital inpatient, and they were running the IV at 10-30 mg/hr., I imagine I wouldn't feel much, if anything; it would be a lot like they were just running straight Ringer's lactate. Ketamine doesn't hang around in your system for that long, so what you start infusing doesn't really accumulate in your bloodstream hour by hour as much as most analgesic drugs do.
There can be a lot of reasons for this huge variance in protocol: One of the main ones is that there is really no gold standard for how to do Ketamine infusions. You typically see in the literature that a good way to start treatment is to take the patient's weight in kilos, and infuse 0.5mg/kg. But there are providers out there who give more or less than that, for an hour or two only, or on the other end of the spectrum, they do very low dose but for 5 days at a time, or shorter infusions for 3-10 days in a row, or you name it.
My first, 40 mg per hour infusion (I was 77kg, so that's just about 0.5mg/kg) was pretty mild, and hilarious: I was so highly suggestible that the mostly-below-ground surgicenter reminded me of a rabbit warren, and suddenly, the medical staffers all had bunny ears and noses, even though they were walking around in blue scrubs and talking while they worked away. I couldn't stop giggling to myself, to the point that I made my own face ache from smiling. I did get pretty substantial relief from that first infusion, but only for days when it came to the pain, and about 3-4 weeks for the digestive, motor, sleep and cognitive issues. I still only get relief for weeks, not months, even at the higher dose, but function is SO improved, that the 4 hours per month that I spend getting the infusion over at "Rabbit Central"
is SO worth it... Not just for me but for my family, who were watching me walk around in the pre-Ketamine days, sort of like something out of "Night of the Living Dead". My last infusion was the same dose as the previous 3 had been, but for some reason, the experience was muted; less colorful, more flat. But it worked just as well on my symptoms, so I don't really care. Nobody promised me a party, after all 
That being said, in the literature there are a bunch of references to the fact that just like with Neurontin, or Naltrexone, etc., a certain subset of CRPS patients respond well to very well, but some are just kind of like "Meh". Used to be, there wasn't much of a way to determine ahead of time who was who, but more and more, they are discovering that CRPS is a lot like "cough": It's not one straight-up condition, but instead a sort of spectrum of related conditions that just all converge in terms of the signs and symptoms, or mostly so. Some cases of CRPS are clearly triggered by trauma, but some cases may not be. Many CRPS sufferers have a loss of small nerve fibers on skin biopsy testing, but some don't. Some of the ones that do, have length-dependent small fiber loss, but a few have non-length dependent small fiber nerve loss instead; and this latter one, NLDSFN, is what I have. Instead of appearing over many months, it went from my left knee to toes only, but then after knee surgery, it was literally all over my body inside of another 8 weeks. And I mean it was up my nose, in my mouth and ears, and we won't even talk about my "swimsuit" areas. Sheesh! Turns out, it may have to do with exactly how and how fast the symptoms get into your central nervous system, and exactly what they do/where they go when they get there. Almost everybody has insomnia and anxiety to a greater or lesser degree. I temporarily lost about 20 IQ points on exam about a month after my surgery, when my CRPS was spreading weekly if not daily (mainly because my short-term memory had gone up in flames, as it turns out), but about a year later, I got most of my points back., and I just developed ways to work around my deficits as time went by. Anyhow, Ketamine treats not so much the CRPS, but the central sensitization. That's why it works on stuff like PTSD and fibromyalgia, too: All these conditions have a central nervous system component that keeps amplifying your pain. Ketamine helps to normalize your central nervous system again. But you know that from your reading
Sorry...My sleep has been sort of spotty this week; I really need to get another Ketamine infusion soon
. Just wanted to remember to add: Regarding the Naltrexone... The doctor who basically took a flyer by letting me trial Naltrexone said that he had only had one other patient who tried it and she/he were not impressed by the results. You are no doubt aware that Naltrexone comes in 50mg tablets. This same doc on follow-up was astonished to hear that instead of taking the whole 50mg tablet daily, I had just looked up the protocol from Dr. Pradeep Chopra at Brown University for this drug: Dr. Chopra says to go low and slow, so I dissolved the tablet in 100ml distilled water, and used a little syringe or baby med dropper to dose 1.25mg to start. I took it in the AM, when I got up, because I had read plenty about it giving some patients really wild dreams, and I wasn't getting much sleep anyhow, and so wasn't looking to add any fuel to that particular fire.
Anyhow... When you consider that people with drug and alcohol dependency issues take the whole 50 mg tablet at a time, I was amazed to find that for the first week, I couldn't increase my teeny-tiny dose at all, not even by a tenth of a milligram, without extreme dizziness and moderate nausea (And my adult daughter who takes it for menstrual irregularities experienced the exact same thing!) and constipation resulting. I thought at the time that I was in fact, crazy. Since then, I have read that a lot of other patients have pretty much some version of this same thing with Naltrexone. It took me, no lie, almost a calendar year to work up to my current dose of 4.5 mg daily. I can still, if I'm having a bit of digestive upset due to most recent Ketamine IV on the wane, take 1-2 tenths of a mg extra Naltrexone if I have to travel in the car a long way, or sit in a doctor's waiting room, etc., and know for a near-certainty that I won't have to make a mad dash for the bathroom to have diarrhea. Just that little tiny bit extra Naltrexone does the trick. Go figure! Makes me wonder if my doc's other patient who trialed Naltrexone didn't just swallow the whole 50mg tab at once, resulting in not very nice side effects for her, and so no good symptom relief overall.
And re: Ketogenic diet. Yes, and yes to the thread about glucose metabolism abnormalities causing all kinds of extra problems with pain and function. The ketogenic diet helps to normalize these metabolic glitches and reduce body and central nervous system inflammation at the same time. My only caveat: This diet was developed in the 1920's by a pediatric neurologist who was trying to find something-anything at all- to help his epileptic patients have decent quality of life if the medications of the day didn't work for them... And the ketogenic diet was the result. Now, back almost 100 years ago, eggs, meat, butter and sour cream, etc., all came from animals that were allowed to graze on natural pasture grasses. I suspect the modern version of the ketogenic diet isn't quite as beneficial as that original version was. That's likely because conventionally-produced animal products aren't as high in Omega-3 fatty acids; they have more Omega-6 fatty acids proportionately. Unfortunately, the tipping of the scale in favor of more 6's and fewer 3's in our modern diet produces more inflammation and depression, and maybe atherosclerosis as well as some cancers and even some forms of dementia. This is under study on a lot of fronts, but just saying. I will keep eating my pasture-fed butter and cream, and organic coconut oil. I eat ALOT of fat; if I skip a day of this, boy do I feel it by about the 36-hour mark!! Talk about burning pain!
Good for you for being inquisitive! CRPS patients sure as heck need to be well informed, because you run into the craziest opinions out there in the world, even among some of the medical folks who see CRPS patients, for sure.
Best of luck finding what works for you, and keep me posted!
sabrina51474 brenda_savvy
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With CRPS, anything and everything is possible, right??
jess73631 brenda_savvy
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This may sound a bit silly but I think you should do a 'medical trial' for a few days....and cut out all carbohydrates (except for a few vegetable ones) for a few days and see if you feel any relief!. You may be a diabetic without even knowing about it. And high glucose in the bloodstream can damage not only nerve endings, but also the neurons in the brain (where the sensation of pain is felt). A doctor may do a Hb1ac blood test and you may be below the 42 (which is the cut-of point in UK scales), so you will be told you are not diabetic....but I have never understood how you are 'not diabetic' if your blood glucose is 41....but the next day your blood glucose is 42.....so you ARE diabetic!! The damage that is occuring during the years that the blood glucose is rising and falling can cause all sorts of damage, the sort of damage that all diabetics are at risk from. I am not a doctor,,,but my 'theory' is that it is damage done to the brain neurons by glycation (caused by blood glucose) which gives us the distorted 'sensation' of pain....when there is no cause that can be found for it. Remove anything that causes blood sugar rises for a week or so and see if it helps. I bought a glucose meter and testing strips and tested before and after meals so that I know what foods raise the BG the most (usual suspects; wheat and all grains, sugar,pasta, cereal ...but also fruits and veggies!!) . Read some of the Diabetic forums and websites to get a better idea of the damage that high BG can cause.
brenda_savvy jess73631
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I will try anything from tomorrow I will do my best to follow this and log it all ! I want my life back. I cannot live a “sick “ life anymore.
jess73631 brenda_savvy
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Well, if you suffer from PCOS then that further backs up that you could have a blood sugar issue, as that is a conditions which correlates with diabetes. William Davies book Wheat Belly is a book you should invest in....and has tons of information on the damage done by high blood sugars. I cut out grains approx a year ago, but still continues to eat lot's of vegetables and fruits..well, they are 'healthy' aren't they? It turns out , no they are NOT if you happen to be diabetic or pre-diabetic! Another person you should research (he has many videos on YouTube where he explains things very clearly) is Richard Bernstein (he is 86 yrs old and been Diabetic all his life). He was the first person to use a 'home' glucose meter decades ago. The damage that high blood sugar causes affects every cell in the body, and can cause many many symptoms that you may think are unrelated (PCOS, depression, anxiety, neuropathy, blurred vision, fatigue, fertility problems, joint/muscle pain etc). If you can afford a meter it would be a good investment, but if not just cut out all carbs and see how you feel after a week or so. I hope you will let us know if you try this 'experiment' and let us know if any improvement. I am doing this experiment for the last couple of weeks and seeing good improvement...but being very very strict.
brenda_savvy jess73631
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sabrina51474 jess73631
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Yessss!!!! So true; errors in glucose metabolism lead to increased system and neurogenic inflammation, and hence to errors in protein synthesis, and even mitochondrial replication/division errors!!
Sorry... I'm not just a CRPS patient, but a former biologist as well as an RN.
Not many people, even healthcare professionals, truly understand the import of too much carbohydrate in the diet/too high of fasting glucose levels, too frequent insulin release!
brenda_savvy sabrina51474
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jess73631 sabrina51474
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Oh I am so pleased it could be good advice. I have suffered 3 years of hell with not only the terrible burnings, tingling but lots of other awful symptoms too (to numerous to mention)! I think every nervous system in my body has been affected. I have had to become a medical researcher myself to get any sort of relief! Whenever I asked GPs about blood sugar they actually SHOUTED at me that I 'was not a diabetic'! Because I am not overweight, and fairly slim they just think I could not be diabetic! But my problems started when I gave up smoking my pack a day....and smoking itself has now been shown to not only correlate with diabetis...but also be be causal! In other words smoking can CAUSE diabetes even. I have discovered that every time I had a cigarette my liver would immediately dump insulin into my bloodstream! Each cigarette was like me eating a crispy creme doughnut!! So when I suddenly stopped smoking my whole system was thrown into chaos.....my muscles, within days, turned into deflated balloon and the fatigue was boneshattering. I have lost 3 years of my life, but am hoping that now I know it IS a blood sugar issue (despite what 'medically trained GP's say) I will continue to make improvements. I hope others try it and post their progress on here. We need to help ourselves.
brenda_savvy jess73631
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sabrina51474 brenda_savvy
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Hi Brenda,
I'm happy to share with you what works for me, but keep in mind I've been vegetarian for about 35 years, so my choices may not be your personal go-to's, and that's OK. Everybody's going to be a bit different, not in the least because with CRPS, I'm sure you've noticed that now and again, you can sure try to talk yourself into eating/drinking something because it's good for you, but if it sounds/looks/tastes bad to you, it's not a good idea for your gut at that particular moment in time.
I love, love, love Dr. Joel Fuhrman's "GOMBS", or "Nutritarian" diet. Dr. Fuhrman is an MD who says that your body is not stupid; if you follow a diet that doesn't meet or exceed your body's needs for micronutrients, your body will do everything in its power to trick you into eating more, so its needs will be met, even if that ends up making you fat and tired as a side effect of the strategy to get more nutrients. How right he is!
After much research of the current nutrition and metabolism literature, I basically have evolved into eating a low-carb version of this diet (On the Furhman website; plenty of great recipes there) but with a few modifications that just happen to work well to keep my pain levels and energy levels as optimal as possible.
I don't eat breakfast because solid food early in the day just doesn't work for my gut. Instead, I drink what my son calls a "fat bomb". This is from the book "Bullet-Proof Executive" which is a version of the ketogenic diet, and truthfully, it's still somewhat controversial with nutritionists, but happens to work for me: It's 1/4 cup unrefined coconut oil, 2 tbs. pasture-fed butter, and a bit of stevia for sweetness. I blend it with 8 oz of fresh-brewed organically-grown coffee. I sip it over the course of about 1/2 hour, and I don't need another thing except maybe water or a cup of tea, for the next 4-6 hours. If you need a snack, though, I have found that a high fat, moderate protein, low carb snack is best: A handful of nuts or seeds, a pasture-fed hardboiled egg, a dip with a few raw veggies, etc., works very well as long as I remember to chew my food
Don't want to forget; with this low-carb dietary strategy, you WILL go into ketosis (start burning fat for energy) so your urine will smell more or less like nail polish remover at times, and you will need to drink 8 or more glasses of water per day so as to facilitate the process: Ketosis is not quite as efficient of a metabolic process as your typical glucose metabolism is, so it takes more energy (read: calories; great for those of us who have some extra pounds) but also more water. If you don't drink the water, you may get a headache, or even be a bit dizzy due to dehydration.
I fill up a 64 oz filtered-water pitcher in the morning, and drink out of it all day until it's empty. That's how I make sure I don't space out and forget to drink enough on any given day. I have learned that getting dehydrated actually makes the burning pain of CRPS worse on any given day. Go figure!
I have a fasting window of 14-16 hours daily, where I just don't eat from about 9 at night until 1-2 PM the next day. This is kind to my sensitive gut (I'm one who has small fiber/CRPS digestive issues) and is an eating pattern that indigenous cultures adapted to over time, due to their hunter-gatherer lifestyle; they went into ketosis easily and efficiently so they could continue to function optimally while seeking out food sources, and had very low incidence of obesity as a result. I eat 2 meals per day, one at about 2 PM, one at about 7 PM, though it may change a bit if I have MD appointments, etc..
Lunch is usually a lean protein and greens and/or mixed low-carb veggies of some sort; I eat some meat substitutes such as tofu, and a great product called Beyond Chicken is a current fave of mine, too. If I wasn't vegetarian, I'd also include fish, chicken, etc., ofcourse. Dr. Fuhrman has GREAT lunch salad recipes that hit all the nutritional goal posts as well.
Usually I eat up to about 60 grams of carbs per day, total. On holidays or special dinners, etc., this may go up to about 100 grams net carbs per day. Dinner often includes a modest helping of beans and gluten-free grains (I don't think I'm actually allergic to gluten, but I do note that I feel better on a refined sugar/refined carb/gluten-free diet overall; less pain, less anxiety, more energy). I may have a relatively low-carb dessert, based on a bit or organic, pasture-fed dairy and/or berries. You can buy bags of frozen berries for cheap, so if you need that little bit of sweetness at the end of the day, you won't be so tempted to go totally off the wagon and do donuts or brownies on a regular basis (Sorry; that's probably just me, not you). I lost over 50 lbs a couple years back, just following this dietary strategy. I have no idea if it will work for everyone but it is working well for me. And incidentally, just like for most other chronic illnesses, overweight and especially obesity, just make pain and functioning worse than they need to be for a lot of patients, statistically speaking.
This is probably Too Much Information... But hope some of it at least gives you some avenues to investigate to find your own best strategy
sabrina51474 jess73631
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Hi Jess,
Turns out that it's not even so much your fasting blood sugar or hemoglobin A1C, but instead your glucose tolerance, as you mention; CRPS seems in the literature to correlate with abnormalities in glucose metabolism, including inappropriate insulin release. Dr. Robert Schwartzman, professor of neurology, emeritus, at Drexel University, has a great comprehensive CRPS article published in 2012, I believe, and now online: Systemic Complications of Complex Regional Pain Syndrome. It covers this topic and more, in spades!
It explains SOOO much. I think every healthcare professional out there who treats CRPS patients should have to be MADE to read this article. Patients would ultimately be better off if their doctors, nurses and therapists had that information.
jess73631 sabrina51474
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I will have a read of that article Sabrina. It is shocking how very little that heathcare workers know about chronic pain (or diabetes, fibromyalgia, CFS, ME, depression, allergies etc. All the 'chronic' diseases that patients are just left to live with). But it forced me to find my own solutions. I am 68yrs old and am not medically trained....but, I can read and I have a brain. I knew that all the terrible pain and symptoms that disrupted every system in my body were NOT 'anxiety' or 'depression'! Your muscles do not disappear overnight, your eyesight and voice fade away, you stomach and digestive system stop working completely, ....you don't wake up every 40minutes and have vivid constant dreams for months on end, or terrible itchy rashes with 'anxiety disorder either!. (rash disappeared when I gave up grains. Dermititis Herpetiformis). My first Hb1ca(?) was 41 (UK number for diabetes diagnosis is 42) but this was not a 'true' picture of my status because I stopped smoking abruptly 6 weeks before the test was done, and I had eaten hardly anything in that time as I had been too ill...I had lost over a stone when I dragged myself to doctors, so probably when I was smoking my numbers would have been off the scale....the Hbc test is the AVERAGE of the last 3 months! But...41 told my GP that the very ill woman before her was NOT diabetic!. I have bought a monitor and eat very little carbohydrates (50grams) and feel already that this regime is working..symptoms are lessening and strength returning. Its worth a try for anyone. May take some time to fully recover but what else have we got?
jess73631 brenda_savvy
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Hi Brenda.....people always say 'well done' to me for giving up the cigarettes....but doing that was what catapulted me into this awful illness so I wish I had not done it really. lol! If you see my reply to sabrina you will see some of the symptoms I have had to deal with. As for what I eat now.......it is what I on't eat that is important. I don't eat carbohydrates.....and that included fruits and vegetables too!. I know that this would be very very difficult for anyone with a family to look after and feed, but my children are all grown so I only have to feed myself, so my weird eating habits don't impinge on anyone else. If you read William Davies book he has lots of very good advice (and motivation), especially in the centre part of the book which discusses blood sugar specifically. A monitor will show you what your blood sugar is doing, and if you keep it below 6 (I don't know the US equivilent) you will see a lessening of symptoms very quickly. Well, I did anyway. As my symptoms lessen I will be able to eat a bit more carbs....but giving it a few weeks for my body to get a head start on repairing itself is not that difficult if you want to rid yourself of pain and burning without dosing yourself silly on painkillers. I am not a diabetic (acording to my GP??) but I am eating as a diabetic should.....and you have seen that lowering your blood sugar (when you were given metformin which lowers blood sugar)) helped your body to become healthy enough to carry a pregnancy. So keeping blood glucose at a level that suits the body is a good thing. Diabetics keep it stable with drugs, but I am keeping it stable with food, and I aim for a reading below 6. Please try it Brenda and I hope it will give you some relief, and some hope.
brenda_savvy jess73631
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jess73631 brenda_savvy
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Don't have much time Brenda, but don't eat breakast as I leave at least 16hrs window without eating anything, a sort of mini fast every days. I just drink tea or coffes (without sugar) in the mornings. one tip...never eat carbs without eating protein at the same time. This slows down the absorbtion of the carbs, and it is carbs which raise blood sugar! Protein and fat will not raise your blood sugar so eat more of those, they will help stop the sugar cravings, and you will not feel hungry. The aim of this 'diet' is to NOT raise blood sugar too high! The aim is to keep blood glucose somewhere between 4-6 at all times, and certainly keep it below 7.. The 16hrs that I don't eat at all means my BG has 16 hrs with no BG spikes....which gives my tissues time to recover a bit. Protein will NOT raise BG, so protein foods are not a problem (eggs, chicken, meat, fish, seafood, nuts and cheese). The carbohydrates you do eat should be vegetables and a small amount of fruit...preferably berries. The vegetables should not be starchy types (potatoes, carrots, swedes, sweet potatoes, squash) but should be leafy green vegetables or salad foods. I eat 2 eggs (fried in best block butter...not 'spreadable' butters....they are not butter....real butter is not spreadable. I put the butter I will need for the day into a butterdish, and leave the block in the fridge.That on the worktop will become 'spreadable' at room temperature). Later I may have a steak with small amount of salad with garlic and olive oil. Or may roast a chicken which I can 'snack' on when cold. Or salmon steaks cooked in foil in the oven. I always cook 2, so that always have something in the fridge to snack on. leave defrosted prawns in covered dish in fridge to snack on also. another snack is cheese cubes with maybe celery or red peppers, or a dish of mixed nuts...cashews, walnuts, hazelnuts, almonds, pistachios, peanuts etc. If you snack on these things you will not feel hungry at all. Lamb/beef curry with a small cup of cooked rice is ok, it is the rice that may spike blood sugar so don't have huge amount of that. ...the curry part is fine. I don't eat any grains, so no pasta, pizza, bread, cakes, buscuits, cereal, granola, cakes, pastry, pies etc. Sounds difficult but it is not if you organised. I still make a bolognese sauce but put it on veg such as cauliflower, kelp, cabbage or spinach. (I dont bother with 'spiralising' things...no need). Sausages, bacon, and cold meats are also good standbys. I also parboil some brocolli or cauliflower, cover with cheese sauce (or just grated cheese if lazy) and put in the oven for a while. Thats eating a carb (brocolli) with a protein (cheese) so slows the sugar spike that just the brocolli would give. Ooops...just looked at the time!! will come back later
Jess