Rhubarb - A Public Service Announcement

Rhubarb season is finally upon us, and if you are anything like me, you went straight out and bought a bunch of stalks.  Every year I anxiously await their arrival so that I can make a batch of stewed rhubarb.  I use stewed rhubarb on everything, on toast, in a sandwich, over yogurt and over ice cream.  It is cheap and easy to make and it tastes fantastic.  However, when I first began using rhubarb I noticed a strange phenomenon - I could not stop using the washroom!  It turns out that rhubarb is high in both water and fibre and is often used as a digestive aid for those who suffer from constipation.  This certainly is no joke; even though I am aware of this side effect, I go through my annual accidental rhubarb cleanse.  

Two weeks ago, I was speaking with a friend of mine who had cooked up a batch of stewed rhubarb.  She noticed she was feeling ill throughout the weekend, and thought she might be getting the flu.  Not wanting to go hungry, she ate a lot of yogurt and rhubarb and continued to feel sick.  My friend was unaware of the stimulating effect rhubarb has on the digestive system, and honestly, it never crossed my mind to warn her.  I took it for granted that everyone was aware of what rhubarb was capable of, apparently I was wrong.  Hence the public service announcement. 

So, to make it abundantly clear - tread with caution.  Rhubarb is amazing, and because of the flavour you can easily eat too much.  If you eat too much you will spend much of your day on the toilet.  You will feel as though you have taken several laxatives.  If you are constipated, reach for rhubarb and you should enjoy a great sense of relief in very short order.  This is by no means a recommendation to avoid rhubarb, but rather a warning not to eat too much.  As with anything, moderation is the key to success; start out eating a little less than you think you should and increase your intake from there. 

Other bloggers have been covering rhubarb from a culinary perspective, check out the following post at  Bite Size Wellness for some ideas on how to prepare. 

The F word...

If you have been diagnosed with IBS you have likely talked a lot about the “F” word – F.I.B.R.E.  I feel confident enough to say that you were likely told to increase your fibre consumption, no matter the type of IBS you happen to have.  Fibre appears to be the centre of the IBS universe and at the forefront of the minds of our medical professionals.  It is often touted as the cure-all for IBS.  I am about to tell you how fibre is quite literally a pain in my ass; it is both friend and foe.  Fibre is like that person that you walk on eggshells around, too much one way or the other and this fickle friend will make your life miserable. 

It took me a long time to figure out fibre and it required a lot of help along the way.  It took specialists, a surgeon and one amazing dietitian to help me understand how fibre affects my body.  This journey also included extensive food journaling, diligence and patience to gain the understanding I now have today.  

How much fibre do I eat in one day?  Fifteen to nineteen grams (15-19g), however, I prefer to hover in around 15g.  How much should you be consuming?  According to the Dietitians of Canada, adult men should consume 38g per day and women are recommended 25g.  For those of you without IBS, you will likely be shocked at my daily intake, and some of you will likely deem it to be unhealthy…  this would not be the first time that I have heard this, and it will certainly not be the last. 

A low intake of fibre allows me to manage my symptoms and maintain a routine of three to four “movements” daily.  However, this does not mean that I do not have flare-ups at this level.  I think I hit six, seven and eight washroom trips on three consecutive days last week at my normal intake level.  So, what I am telling you is, often, IBS is kind of like gambling.  Sometimes you are cautious and win big, sometimes you throw caution to the wind and you win big, and sometimes, no matter what you do, shit happens.  What I do know for sure is that if I go above this threshold I might as well pitch a tent right beside the toilet.  

One extremely important fact to keep in mind is that everybody is different.  My fibre RDI may be the same, lower, or higher than yours, and that is okay.  Everyone reacts differently to different foods and that also applies to those who do not have IBS.  So, when it appears as though someone is judging you for eating things like gasp – white bread – keep in mind that, if it is easier for you to digest than whole wheat bread, then eat the white bread.  Eating things like whole grains can be just as unhealthy for someone with IBS as for someone else who shuns white bread.  If it makes you use the washroom all the time, forces you to take medication and/or causes weight loss and additional stress, then, this choice is unhealthy for you.   

• Never be ashamed of the choices you have to make in order to lead a healthy life. 

• Never forget that healthy is not a static definition; it is just as unique as you are.   

Be sure to talk these things over with your doctor, or, get referred to a dietitian.  If you do not gel with your dietitian, ask to be referred to a different one.  That is what I did, and we ended up meshing really well and I was able to learn a lot from her. 

Fibre is a beast of its own and a bit cumbersome to tackle in one post, so, I will begin a series of posts relating to fibre so that we can work through this issue together.  If you have specific questions relating to the f word, contact me and I will ensure I cover it at some point throughout the series.  In addition, feel free to share your experiences about keeping it regular!

Be prepared - your journey to a diagnosis...

WARNING:  This is an IBS-specific post, and may contain TMI - Too Much Information. 

Here is a post specifically for those of you with IBS or for those of you with questions relating to IBS.  Keep in mind that what I write in relation to IBS is what I experienced and that some of my opinions are not that same as some of the medical practitioners that I have encountered.  Over time I will cover a series of topics such as: fibre, stress, food, exercise, relief through products, various resources etc. Please feel free to send along any requests regarding topics you would like me to cover. 

My journey…

My road to an IBS diagnosis was a long one that required many doctor visits and a heavy amount of convincing to get anyone to listen.  It all started to go downhill after having jaw surgery in October 2001.  I am convinced that the medication and stress associated with getting my jaw broken was what triggered my first “episode” of IBS.  It took about a year to get to a specialist and then to finally have my first colonoscopy – on my first day of university – and of course, in true IBS style, there is nothing physically wrong with me that can be found in stool samples or any type of scope; I have a collection of symptoms that medical practitioners group under the umbrella of IBS.  Or, as I like to call it: “we don’t know what’s wrong with you, but you have poop problems”.  Over the years I have become very frustrated with the medical system in Canada.  I quickly discovered that unless you are bleeding from your bum, and even then, medical practitioners are very reluctant to spend the time to assess your illness or to attempt to treat you.  I attribute several of my worst episodes to this casual attitude and fully attribute the surgery that I underwent to the gaps in our medical system.  Unfortunately, butt issues do not appear to be a priority in Canada, and I have been told as much by a doctor in one of our emergency rooms, some practitioners appear to believe that these problems are (and I quote) “just a nuisance”.  For this reason, I avoid going to the doctor when having an episode, I trust my own judgment and know enough to be able to tell when something requires medical attention.  Keep in mind there are some specialists out there who are wonderful and helpful, but the trouble seems to be making your way up the referral chain to see one of these doctors. 

When you are initially diagnosed with IBS many doctors immediately suggest reading some books so that you can arm yourself with a bit of knowledge.  This is often coupled with a suggestion to see a psychologist.  At first, I was extremely insulted by what I felt this insinuated, and contrary to what many doctors make you feel – IBS is not in your head.  There are very real symptoms that present themselves on a daily basis.  However, it is triggered by stress; some of my worst IBS episodes were triggered by a stressful life event.  Stress is the number one trigger of my more serious episodes. 

My advice to anyone with IBS would be to summon all of your patience to travel the long road to any sort of diagnosis or treatment, most especially in Canada.  If you think something is wrong, it probably is.  Believe your gut and keep on top of the doctors until you have exhausted your options and arrived at a specialist.  It is imperative that you be persistent because once you are armed with a diagnosis, you at least know what you are up against.  The important thing with bowel problems is to rule out anything more serious such as Crohn’s or Colitis.  

Be prepared…

1. Be prepared to describe your poop: green, brown, yellow, hard, rabbit-like, soft, liquid, bloody, mucousy, gassy, frequent, difficult, easy, etc;
2. Be prepared to poop in an ice cream container (ie. stool collection);
3. Be prepared for blood work;
4. Be prepared for laxatives, enemas, swallowing barium, barium enemas and colonoscopies; 
5. Be prepared and willing to see many types of medical practitioners: specialists, naturopaths, dietitians;
6. Be prepared for varied and strange diets in an effort to identify your trigger foods; 
7. Be prepared to journal; and
8. Be prepared for many fingers up your butt.

Finally, know that very soon you will have no problem dropping your pants for any doctor (male, female, hot intern, nurse, group of doctors), in any state of mind or position: conscious, unconscious, drugged, standing up, bent over, in the fetal position – or, my personal favourite – rotated forward and up in the air (ie. semi-handstand on what you initially thought was a kneeling station, but in fact is the medical community’s last laugh as they propel you into the air and look up your butt-hole). 

Know that you are not alone, know that many, many others suffer as you do and all you have to do is look around on the internet and you will find someone to talk to whether it be me or IBS Forums.  My final and most important piece of advice would be to have a sense of humour, because, if you can’t joke about butts and poop then this will be a very miserable experience indeed. 

For the love of yoga

Tomorrow is the two-week anniversary since my last run, and the day I plan to hit the pavement once again.  My heel is almost back to normal, so, my body will at least be intact enough to go.  However, with such a long break I am nervous at the thought of what I can or cannot accomplish.  While ingesting several spoonfuls of Nutella, I did briefly contemplate running tonight, but after a few moments deep in thought I took another spoonful and decided to make it an even two weeks.  Instead, I think I will do some yoga.

I have discovered that yoga has many benefits aside from the zen-factor.  First of all, it does not require me to run through the streets dressed up as the abominable snowwoman in the dead of winter.  (It appears as though I may be a fairweather runner.)  Secondly, a good yoga session can be completed virtually sweat-free, which is excellent if you happen to do yoga in the middle of the day. I have also discovered that yoga can be hugely beneficial to those suffering with IBS.  It has taught me valuable lessons about remaining calm, learning to relax my body and to breathe properly.  This can be especially helpful when in a panic situation; concentrating on your breathing can enable you to reach a safe zone before the shit hits the fan.

Yoga is also a great complement to running given all of the wonderful hip-opening postures that exist.  I do yoga 2-3 times a week, unfortunately, I have yet to enjoy any moment of those postures, specifically, pigeon pose.  I find pigeon pose to be the most excruciating posture imaginable and although I am told to form an intention at the beginning of the class, or to dedicate my practice to someone I love and admire, I mostly dedicate my practice to praying that our instructor will choose to completely forget about pigeon pose...  I am still praying... The name alone does not evoke images of calmness or serenity, instead, I see flying rats, disease and filth.  During pigeon pose I endeavour to direct my breathing to the areas that hurt so that the energy will relax those muscles.  I also clench my teeth, hyperventilate, swear (silently) and pray for the end.  And then we have to do the other side.  Yoga is nothing if not equal.

But, in all honesty, I do love yoga and have enjoyed many benefits to practicing regularly.  I notice that I am more flexible, it helps my back and neck and it provides me with a calm interlude throughout the week.  For the past four years I have been attending a weekly lunch hour yoga practice, and I must admit that I look forward to each and every Yoga Wednesday.  When you are required to sit at a desk all day, yoga comes as a welcome break, leaving you both mentally and physically re-energized.

With that, I will strike a runners' pose as a tribute to tomorrow's torture.

Glamour Guts

As a quick recommendation for any of you out there who suffer from IBS, Crohn's or other bowel problems, please check out this video.  It is a fabulous depiction of what life can be like while living with these issues and I am sure we can all see a little bit of ourselves in this video.  Jasmine Oore manages to make an embarrassing topic hilarious and relevant.  This just goes to show that we are not suffering alone.

Cursing out the run...

So, my new resolve to run actually started before I penned this blog, near the end of November, but it wasn't until January that I started to take it seriously.  Our training strategy was to be able to run 10 minutes straight with one-minute rest (walking) periods. Luckily, we are well-matched in terms of pace, so we were able to begin at four minute intervals, followed by five and then six.  We are allowed to move on once we achieve a minimum of six repetitions of the interval.  I thought that the five-minute intervals would be the death of our running careers, but, luckily we have made it through to six minutes.  Aside from the occasional trumpeting coming out of my backside, my IBS has not been too bad.  We have had times when I was required to do longer walking intervals in order to ward off bathroom sessions, but, no real emergency situations occurred until last week.  During our last run I had to abandon ship after only two and a half sets of six minutes.  I did not feel that our friendship was strong enough for me to soil myself in front of him.  I was extremely frustrated and disappointed as we felt ready to tackle the six-minute interval hurdle, but, that was not to be.  It was a miracle that I made it to the washroom in time.

Since that day I have managed to rip open my heel on a pair of winter boots, but, as it isn't healing and it hurts like hell I am trying to take care of it with the goal of beginning again on Monday.  Fingers crossed that I will "heel" in time!  This was actually one of the warmest weeks we have had and I was so excited to run.  In previous weeks our run days seemed to land on -20 celsuis weather, so this week would have felt balmy by comparison!  It has, however, been somewhat of a blessing that the heel catastrophe landed this week as my IBS has flared up for a reason unbeknownst to me.  With any luck I will be able to get both issues in check before next week.

I must admit that I have been really enjoying the running sessions thus far, I do dread the run, and normally hate every second of it, but, I do feel a great sense of accomplishment after it is done.  Also, it is amazing to me how much two people can swear in such a short period of time ... between the cold and the running the only thing we can seem to wheeze out is the f-bomb while gasping for breath.  We are trying to think of a few more positive things to say, but honestly, we are just hoping that the calm feeling that runners lovingly refer to will sweep over us at some point in time.  We have convinced ourselves that the 10 minute interval will be the moment where we cross into the world of running enjoyment.  Until then I guess we will have to hope and dream about it and get some sort of satisfaction from cursing out the run. 

The dawn of my running "career"

After many lengthy discussions with a friend of mine about life goals and career aspirations, I am taking my first real crack at writing in a public format. My current career path is extremely different from what I envisioned 10 years ago upon graduating from high school. I pictured myself as either an English or French teacher, or professor. Upon completion of my MA in French I knew without a doubt that teaching was not for me. With this began my career as a public servant. I cannot complain about my career thus far, I have lots of job flexibility, I have worked within a variety of branches within my agency, however, none of this has left me fulfilled. If anything, this has left me aspiring for more. The problem is, I am unsure what it is that I am aspiring to be. So, in a nutshell, I am trying to double back to my first love, writing, editing and literature, and along the way I am trying to discover new ways to motivate myself and find my calling in life. I have a hunch that the written word figures in somewhere, but I am still trying to determine how and to what extent. Ultimately, I would like some type of career that would allow me to feel rewarded and challenged. I would like to enjoy my job and I do not want to be destitute in the pursuit of fulfillment. Given that these are my only parameters for finding said job, it is a little bit difficult. So, in a round-about way, this brings me to the title of this blog: "Running from the Runs".

It has been 10 crap filled years since I was first diagnosed with Irritable Bowel Syndrome (IBS), type D (for Diarrhea). I have had many "episodes" resulting in great discomfort, weight loss and finally surgery. IBS is something that I struggle with every day of my life, and it literally consumes most of my waking thoughts, especially in public. Throughout my undergrad and MA I spent much of my time scoping out the good washrooms around campus. A good washroom consists of either one single stall/sink combo or a larger washroom with many stalls. In addition, good washrooms are located in low-traffic areas. I could probably provide you with a blueprint for washroom locations on each university campus that I attended. All of this to say, IBS controls my life, it controls what I do and when I do it, and, no matter how much I try to plan around it, it always seems to change my plans. So, in an effort to find a way in which I can control the IBS, I have taken up running. The reason why I have chosen this path is because running, and often walking, are huge triggers for my IBS. If I could run 10 minutes without running to the washroom, that would be a Christmas miracle. Therefore, I am on a mission to run a 10k, and in order to do that I have been running three times a week with a friend of mine to try and prepare and build up my endurance both physically and in relation to my IBS.

Before training began for this challenge I had to have a very frank conversation with my running partner. I had to forewarn him that running with me was not like running with your average person. Much like the washroom blueprint at the university, I have mapped a run through my neighbourhood that allows me to be in close proximity to my home at all times. What this means is that our route is very boring and repetitive, however, it allows me to get home ASAP when the wave of IBS and panic washes over me. In addition, he was forewarned that many sound effects and strange smells would likely join us on our runs, especially if the goal was to try and "run" through them in order to build up my endurance, for some reason he agreed to join me on my journey to outsmart my colon and learn how to run.