In-depth History

From not long after the onset above until the kidney stone in Seattle described below, I ate almost nothing but boiled chicken breast, rice cakes, and mayonnaise — for roughly seven years, with virtually no deviation. About the only exception I could tolerate was an omelet with zucchini for breakfast occasionally.

I was living in Seattle, Washington, in the middle of a career transition that gave me a lot of schedule flexibility. I started exploring juicing, and then water fasting, based on autophagy and other digestive benefits, as a possible treatment.

I did one longer fast: three days of juicing followed by four days of water only. It went okay — I was still largely unable to sleep, but much less exhausted than expected, and could nap through the day to make it bearable.

At the end of that fast, I developed an obstructed ureter on my left side — I suspect related to always sleeping on my right side (see Static Sleep Position); I've always formed kidney stones on the left. It required a laser lithotripsy. Stone analysis showed it was almost purely uric acid, which tracks with how much protein I eat. I started supplementing potassium citrate afterward — 15 mEq, once or maybe twice daily, I don't remember exactly.

In the aftermath, I did several more water fasts over the following year, three to seven days each, and tolerated them fine — I think they may have reduced my overall immune reactivity. Coming off a fast, all food smelled amazing, and I tried reintroducing variety each time, but whenever I didn't return quickly to chicken and my usual consistent diet, I'd feel horrible almost immediately. I was hoping to retrain my gut to be less reactive to other foods; it didn't work.

This is also when I started eating vegetable soup with the boiled chicken mixed in, instead of eating chicken straight — my body just didn't want plain chicken anymore after the stone. It was probably at least partly beneficial just from the added hydration easing on my kidneys, plus some actual nutrients I hadn't been getting during those seven years of eating almost nothing but chicken, rice cakes, and mayonnaise.

While incredibly limiting, this condition had been stable for about a decade by 2022. That summer, I moved to New York and leased an apartment that I believe had a mold issue. It triggered a number of health crises, notably bronchitis followed by pneumonia one week after completing the first course of antibiotics.

After that month of antibiotics, and several more months in the apartment with daily doses of Benadryl, my dietary requirements — already excessive at 3–4 lbs of boiled chicken breast daily — increased about 30% to 4–5.5 lbs of chicken breast daily.

The following June (2023), I also started an extremely high-stress job — the second half of what triggered the decline described next.

Attempting to manage the increased chicken intake alongside that job for about a year and a half, I went through a number of incidents: multiple kidney stones, multiple separate episodes of bloody urine, staph infections on my face, and a severe back injury from fatigue and being unable to exercise effectively while working and meeting my food requirements. At its peak I was eating around 1,600g of chicken a day.

On November 16, 2024, I landed in the ER with a 1.6cm stone in my left kidney, completely obstructing the ureter; imaging also found two more stones in the right kidney (4mm and 6mm).

The obstructing stone required an emergency nephrostomy a few days later. It was eventually removed after a staged shockwave lithotripsy to create drainage (12/11/2024), a laser lithotripsy to destroy and remove the stone fragments (12/18/2024), and stent removal on 12/31/2024. I had the nephrostomy bag for six to eight weeks.

Two things stood out during that recovery. While I was on painkillers and my digestion was slowed, I slept much better and needed to eat a lot less — I know opioids generally slow digestion, but I suspect something in that mix was also interrupting whatever signaling drives this condition, not just slowing things down mechanically; I haven't been able to draw a clear conclusion from it. I was also on high doses of ibuprofen for a while, which seemed to help a little too.

The main lasting change from this admission was switching my potassium citrate from tablet form, which we suspected wasn't absorbing well, to a powdered form for better absorption — still 15 mEq twice daily.

I'd thought I was managing my condition in a sustainable way, difficult as it was. It's clear to me now that the increased chicken intake, combined with the exhaustion of prioritizing that job, caused my urine pH to plummet — dramatically increasing stone production and severely aggravating everything else.

About four months after the nephrostomy, I moved to Oahu, Hawaii. The new job let me work 6am–2pm, which meant a lot more morning sun exposure and much earlier hours than I was used to — I think the early schedule genuinely helped (see Sun Exposure & Circadian Rhythm below).

It wasn't a major reduction, but I was able to bring my chicken intake down slightly: instead of four ~400g soups a day (~1,600g total), I did three ~500g soups a day (~1,500g total), sometimes a little under.

Earlier this year, bad kidney pain came back. Imaging found a 6mm stone on one side and an unspecified size on the other.

I couldn't face going through another surgery, so instead I decided to just drink as much water as I could and eat semi-tolerated carbs — granola, mostly — whenever I could stand to, even though I usually get very sick and feel horrible doing that. At some point, something shifted and it became tolerable.

Around the same time I started metformin (see the Labs & Trends notable dates for the exact date — this is high-impact enough to call out here too), and I was able to significantly reduce my protein intake. I'd been eating around 1,500–1,600g of chicken a day, roughly three 500g soups; I brought that down to around 300g of chicken per soup, sometimes as low as 275g — close to what the current Meals page reflects.

I'm fairly confident this is tied to the metformin. When I've missed doses for a couple of days (late on a refill), I notice I tolerate carbs worse again and get more extreme hunger. My intuition is that it's helping me tolerate carbohydrates better, which lets me get more fullness from carbs instead of needing so much protein — I'm not totally clear on the mechanism.

Regular bright sun exposure makes a huge difference — this shows up most clearly in the scalp/beard fungal infections (see Chronic Skin Infections), which visibly improve with more sun. I've tried supplementing with intramuscular vitamin D injections, even at the highest recommended dose, and they don't seem to have much impact (see Vitamin D on Labs & Trends) — whatever the sun is doing, it doesn't seem to be just about the vitamin D level.

Early bedtimes and waking at dawn also seem to have a strong positive impact — on my tolerance for exercise, the general stability of my digestion, and other immune-related symptoms like the amount of scalp/skin infection activity (again see Chronic Skin Infections). Circadian rhythm seems to be coupled into this somehow, though I don't have a mechanism for it.