Weight Loss and Exercise #5 – Page 33


I had two consecutive injuries: left ankle in Sept and left hamstring in October. So I did much less exercise, due to that. I have now recovered from the ankle injury and am slowly recovering from the badly pulled hamstring. Have been doing strength training, mostly of the upper body, and went to yoga once last week, for the first time since all of that happened in the fall, and ever so slowly am getting back on the treadmill. Very slow speed, medium incline. I feel like in Chutes and Ladders, having fallen all the way back to the start and needing to slowly climb back again.

But I have very good news to report: the non-alcoholic fatty liver disease which was caught on ultrasound in February 2021 has completely resolved per my latest (second) ultrasound. And learning it was like a gift due to an accidental discovery:

Last Saturday, I started on a low dose Naltrexone, hoping it would reduce my hunger. On Sunday, I had acute pain the upper right quadrant of the stomach. On Monday, the pain was still there but less acute and more spread out throughout the abdomen. On the phone with the advice nurse, she and I discussed that all of that could be a side effect of Naltrexone (actually quite common) but also could be something serious. So I went to be seen, was sent for an ultrasound and it came back completely normal. I could not believe my luck and sent both ultrasound reports, this one and the one from Feb 2021 when I was done in ER, to the GI Nurse Practitioner who saw me in 2021 for non-alcoholic fatty liver disease. The confirmed that the liver is now completely normal. She warned me that NAFLD can recur and advised to continue with exercise, eating well etc. One has to be vigilant and never rest on one’s laurels.

Naltrexone is not working for hunger reduction, alas. Initially it did but it was all due to abdominal pain. Once I accommodated to it and the pain went away, hunger came back. But there are some options experimenting with dosages, so who knows.

I am afraid Naltrexone is not helping because it has demonstrated effectiveness helping with cravings and I have none. I do not want to eat and would much rather do something else, but I get that frequent painful hunger that needs to be satiated to make the pain go away. And I usually wake up in the middle of the night from it, too. It is discouraging that nobody knows why this is happening, and all my labs are normal. I mean, I am, of course, happy that all the labs are normal, but I wish there were some clue as to why this painful hunger, again and again.

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Bipolar I w/psychotic features
Last inpatient stay in 2018

Geodon 40 mg

Seroquel 75 mg

Gabapentin 1200 mg+Vitamin B-complex (against extrapyramidal side effects)

Long term side effects from medications, some of them discontinued:

– hypothyroidism

– obesity BMI ~ 38



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