20. Repeatedly Dead Fred

[00:00:00] Fred: For all the doctors out there that are just saying, " Move more, eat less", they're not even looking at the foundational aspects of why people are overweight. And part of it is the horrible diet, the ultra processed foods that we're eating now. But a large number of people, their hormones are just outta whack [00:00:20] because of this horrible diet. And that's what we have to start addressing is why are people so metabolically screwed up. [00:00:40] [00:01:00]

Introduction

[00:01:08] Fred: I was born and raised in Winnipeg, Manitoba, which is simultaneously the flattest and the coldest place in the universe. I had never had to bike up a hill until [00:01:20] I moved to Toronto. I had a pretty traditional upbringing; played a lot of hockey, played American football, played rugby, just your average middle class family.

[00:01:30] steve: This is Fred Rutman. His nickname is Repeatedly Dead Fred, and we'll find out why in just a moment.

[00:01:39] Fred: [00:01:40] I ended up going into academia and became a finance and marketing prof. I have an MBA in marketing and finance, so that was kind of a natural fit. And I also have the equivalent of a master's in adult education. So I just put those two together and started teaching the up and coming minds of tomorrow.

Early health

[00:01:58] Fred: [00:02:00] Something dramatic was going to happen to Fred in later life, so I was keen to know if there were any prevailing health issues that he knew of beforehand. I had some challenges that I didn't even know existed and I didn't find out about those until I was in my thirties when I found out[00:02:20] I had actually had a stroke around when I was born. And that was the source of most of my challenges.

[00:02:25] Fred: I've always had a weight problem. So I've always been overweight and for whatever reason it got really out of control in the early 2000's and I ballooned up to about 340 pounds. I tried seeing a bariatric doctor, [00:02:40] you know, the doctors do stomach stapling and stuff like that. And he just put me on a traditional diet like everybody else. You know, "Obviously there's nothing wrong with you. You're just not moving enough and you need to eat less". So we call that the calories in, calories out mentality as if that's a perfect formula, [00:03:00] but human bodies don't work that way.

Dying the first time

[00:03:01] steve: Well, we'll come back to the weight issue later. But first, back to the events of 2009. Life was pretty steady up until the summer, until a particular day in May.

[00:03:16] steve: I was doing possibly the most exciting thing [00:03:20] that an individual could do, and that was marking economics papers. I had my first incident and I just sort of woke up from a nightmare and I didn't understand what was happening because I was slumped over in my chair at my desk and I was sweating profusely and breathing very [00:03:40] heavily. Well, maybe I was just exhausted and fell asleep, and this has just been a very, very weird dream. The problem for Fred was that it wasn't a weird dream. He had really collapsed and before he's made it to the bedroom, it's [00:04:00] happened again.

[00:04:01] Fred: You know, I didn't even have the consciousness to say, "Hmm, maybe I should call emergency services or something". I had never experienced this. I had never heard of anybody experiencing this. I finally came to and dragged myself into bed. When I woke up again in the morning, the entire [00:04:20] bed was just soaked. I don't know how I had any liquid left in my body. So that was the beginning of... the summer I died 20 times.

[00:04:27] steve: Did you know how long an episode was lasting?

[00:04:37] Fred: I know how long I was out because [00:04:40] of subsequent episodes that we did have me on a heart monitor or in an ambulance or in the hospital where things subsequently happened and we know how long things take to get done in a hospital.

[00:04:52] steve: Fred was subsequently told that he had been clinically dead at least three times that first night. [00:05:00] What is the definition of clinically dead?

[00:05:03] Fred: The simple definition is your heart has stopped and you haven't breathed for 30 seconds or more and I know there are periods where I went a long time past the 30 second mark.

Dying again

[00:05:14] steve: A few weeks passed. Fred started to put thoughts of what happened behind [00:05:20] him, but then it struck again.

[00:05:22] Fred: What happened again is what I now call a 'brain quake'. I know that my heart was stopping. You have no blood pressure, no oxygen to your brain. It's almost like having an earthquake in your... in your head. That's what it felt like to me. And then just quickly faded to black and I collapsed.

[00:05:38] steve: The heart and [00:05:40] breathing stopping wasn't the only problem.

[00:05:43] Fred: Pretty much every time this happened to me, I hit my head on something really, really hard. So it wasn't just the... heart stoppage and the natural damage from the lack of oxygen, it was also the concussions leading to, you know, the [00:06:00] traumatic brain injury and damage.

Hospital

[00:06:01] steve: And finally, perhaps somewhat belatedly, Fred called the hospital.

[00:06:07] Fred: And the hospital had no clue what was happening. You know, they looked at me and, you know, here's a middle-aged white guy who's overweight, must be having a heart attack. So they kept trying to prove I was having a heart attack and [00:06:20] checking my blood enzymes and stuff like that. But none of those were... showing up. So I wasn't having a heart attack and they should have said, "Okay, we've tested you like 10, 15 times for a heart attack. It's obvious you're not having a heart attack. Maybe we should look at something else". But we, we really didn't get to that point.

[00:06:38] steve: [00:06:40] So of course, one of the problems is you never know when it's going to happen.

[00:06:46] Fred: Which is why I stopped driving because you don't want to be on the freeway or the highway, and all of a sudden you're unconscious at 130 kilometers an hour. That would be a bad thing. I went to mostly riding my bike or walking.[00:07:00] If I crash riding my bike, the likelihood of me hurting somebody else is pretty low.

The diagnosis

[00:07:05] steve: Although Fred's first incident was in May of 2009, it took until the August to work out what was actually happening.

[00:07:14] Fred: I had what is called a severe onset full heart block, which means[00:07:20] the electrical system in the heart that tells your atria and your ventricles to beat... those nerve bundles were dying. This is a condition that you usually see in men in their mid-seventies, not men in their mid-forties, which is part of the problem. They didn't figure it out cuz they just had no in inclination to look for this. [00:07:40] It's not unheard of, it's just nobody looked for it. So the solution for that is a pacemaker, which is a little computer about the size of an old pocket watch. They put it in your chest and they run a couple of wires... into your heart and it replaces your heartbeat. I'm a hundred percent dependent on the [00:08:00] pacemaker.

[00:08:00] Fred: if it stops, I stop.

Chances of survival

[00:08:05] steve: The chances of surviving that first clinically dead moment sounded fairly remote. But Fred had now died at least 20 [00:08:20] times. What are the chances of surviving that?

[00:08:23] Fred: Dr. Stephan Neff, who's an emergency room doctor in Australia, an anaesthetist, he said people with my condition, if they have one of these severe heart blocks happen outside the hospital, the odds of you surviving are one in a hundred. [00:08:40] And when you have them happen to you cumulatively, like I did, the numbers get smaller and smaller and smaller and smaller as you go. So I'm in the 40 to 50 range, and the large majority of the times that my heart stopped, I was not in a hospital. It's just one in billions that I should be alive and [00:09:00] any degree of functional.

[00:09:01] steve: It was during the many hospital visits relating to Fred's severe onset full heart blocks that he was introduced to the subject of intermittent fasting.

[00:09:13] Fred: I was going to see my cardiologist. I was sitting in the exam room and he came in. After some preamble, he [00:09:20] literally threw a book at me, and the book was The Obesity Code by Dr. Jason Fung. And he said, "Buy this, read this, do it, but wait until we get clearance from all your other doctors 'cause you're a complicated case".

[00:09:32] steve: So what is intermittent fasting?

[00:09:36] Fred: Intermittent fasting is a style [00:09:40] of eating... or not eating. It's limiting your eating window to a certain number of hours per day or over a couple of days and allowing your body to rest and not have to worry about digestion and things of that nature.

[00:09:56] steve: And in Fred's case, it was recommended by his [00:10:00] cardiologist with his condition in mind. So what was his specifically prescribed version of intermittent fasting?

[00:10:08] Fred: When I started off, I did a 12/12 window. So it's a 12 hour window where I was allowed to eat, not that I had to be eating for 12 hours continuously. And a 12 [00:10:20] hour window where I stopped eating and the only thing I would drink was water. You could have black coffee, black tea, but nothing sweetened or anything like that. I was on a bunch of medications. I had just come out of a... couple of heart surgeries, so the doctors did not know how my body was gonna react to any of this. So I had to get, I think [00:10:40] it was six doctors, to sign off on me even trying this.

Why Intermittent Fasting works

[00:10:43] steve: I asked Fred why intermittent fasting seems to work. Remember any advice shared on this episode is for educational and informational purposes only, and does not constitute medical advice. But it does represent the learning of someone who has embedded [00:11:00] themselves in the subject over some time for the reason of keeping themself alive.

[00:11:06] Fred: So the first thing that happens is while you're fasting, your body produces less insulin. So many of us now are metabolically inflexible. We're pre-diabetic, we're diabetic and we [00:11:20] have too much basal insulin floating in our system. So, the more your body produces insulin, the more it needs. It's like an... addiction cycle. It causes many of the cravings we have, it causes hardening of the arteries and all sorts of things. But the insulin levels are also a linchpin to [00:11:40] many of our other hormones. So once you can sort of drain the pool of this excess insulin over time, it allows all your other hormones to get back in lockstep of where they should be going. So your leptin and grelin, which are your hunger and satiety signals, they start [00:12:00] to make you more aware of when you're actually hungry versus the false hunger most of us have, and the big thing we don't have is knowing when you're full. I never knew I was full before. Now I know I'm full. So all sorts of things happen.

[00:12:14] steve: And one of those things that start to happen relates to the gut [00:12:20] microbiome.

[00:12:21] Fred: The gut microbiome starts to reset. When your gut microbiome is out of whack, you're prone to all sorts of autoimmune disorders because you get leaky gut and the bad bacteria leach into your system. You get a form of sepsis and... rheumatoid arthritis, many of [00:12:40] the skin... conditions, psoriasis, eczema, things like lupus. The other thing that fasting does for you is accelerates something called autophagy. It accelerates your internal protein cleansing system and your body says, "Hey, we don't need that protein. We can repurpose it". And [00:13:00] I know that's true with the scars I've had from my various surgeries, that they're clearing up way faster than other people who have had similar surgeries.

The science of intermittent fasting

[00:13:10] steve: Intermittent fasting was sounding like some sort of wonder cure, so I wanted to come back to the science behind it.

[00:13:19] Fred: It's always [00:13:20] gonna be a bit behind because it's really hard to get direct human evidence when you're not introducing a drug that you can track.

[00:13:29] Fred: What I found in my experience is that if doctors can't see something on a test, your condition doesn't tend to exist.

[00:13:36] Fred: So you have to look for doctors like Mark Mattson at [00:13:40] S ir Johns Hopkins, who's probably the grandfather of intermittent fasting, or Dr. Peter Attia who studies a lot of intermittent fasting and longevity. Dr. Mattson has an article about how intermittent fasting contributes to longevity. So there's a lot of it out there. [00:14:00] It just hasn't hit the mainstream. There comes a point where a million people are doing this and they're all getting similar results, there's a pretty strong trend to say, "This works".

Fred's view on the science

[00:14:11] steve: Not surprisingly, having been the victim of a life-changing medical condition that has been with him for over 14 years, [00:14:20] Fred has built some clear views on the common sense behind intermittent fasting.

[00:14:25] Fred: Before we were a seriously agrarian society. That's how people lived. I mean, there were no guaranteed meals. There was nobody telling the kids to, you know, leave the cave, go play on the soccer field and we'll give you orange slices and... kool-Aid.[00:14:40] If you were eating every other day cuz you were able to kill something or find a plant that didn't seem to poison you, you were essentially intermittent fasting. And that's the way our bodies were designed to work. You know, as we became more industrialized and we've learned to mass produce foods that are ultra [00:15:00] processed, we've gotten away from that.

Early results

[00:15:02] steve: And what early results did he see?

[00:15:04] Fred: Within six months of starting fasting on a regular basis, I was off insulin. I had cut a whole bunch of my medications in half. My asthma had been reversed, my sleep apnoea was no more. Weight loss was really good. I [00:15:20] lost about 10 pant sizes in my first 18 months. I had horrible body-wide inflammation and now I don't have an ache or pain in my body. I don't have headaches, I don't have migraines. I rarely get a cold. It's just phenomenal.

Reflections

[00:15:35] Fred: Looking back over that 14 year period, [00:15:40] how did Fred psychologically manage to keep going? I Have a couple of communities that have been just unbelievably supportive, you know, my brother and sister and... my immediate family are great but I've met a couple of communities through my ties to the Jewish world and these are just outstanding people that [00:16:00] barely knew me and took me into their own families. Next level people.

Message of help

[00:16:05] steve: There's plenty to contemplate from Fred's experience, and he spends much of his time now helping other people in similar situations. What is the fundamental advice he would share for anyone going through a tricky time [00:16:20] in their life right now?

[00:16:22] Fred: It's okay to listen to your emotions, but there are people out there who you don't even know yet that are willing to help you. Give yourself permission to let these people help you. Sometimes it's not easy, it's embarrassing, it's frustrating. Sometimes we don't even know [00:16:40] what we're asking for or how to explain what we need. But keep on working at it because there is somebody out there who's willing to lend a hand. [00:17:00] [00:17:20]