Food Gone Wild

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

We have all been lead to assume that fruits, vegetables, lentils and whole grains are healthy and should represent a large portion of our diet.  I would also like to believe this is true, but, unfortunately, for some of us, this can run horribly awry in practice.

For the last few months I have had the sneaking suspicion that I have been heading toward a full-blown IBS episode. Firstly, as my episodes are normally about every two years or so, I am clearly due.  What tipped me off though were the minimum of seven to eight visits to the ladies room each day (double what I think of as normal) for the past eight weeks. I have had gas so badly that I have been unable to sit up straight at work and have been forced to drop everything, call a cab and head home to my magic bag on more than one occasion.  It has begun to affect my routines, my corn starch usage has gone through the roof and I cannot decide whether sitting or standing is preferable.

In an attempt to combat this I have tried a few things.  I had my first abdominal massage, I am now seeing a naturopath (the third in my lifetime).  I find myself agreeing to consume tinctures and Chinese herbs with names like bu zhong yi qi tang.  I have yet to try a rice water remedy that is supposed to help regulate me.

The likely question here is - is it something I'm eating?  I tried that experiment - I did the clean eating thing - I peeled and steamed my veg and fruit.  I ate lots of sugar-free applesauce and fruit cocktail (fresh fruit can be tricky for IBSers to digest).  I ate more fibre, I drank more water (more than my 3+ litres a day), I drank digestive teas, I did the digestive-friendly yoga poses and lots of yoga breathing.  The results?  It gave me the shits, like, have-the-flu kind of shits.

Upon realizing that this was not going according to plan I bought a lot of Boost and Gatorade (to help replace electrolytes).  On particularly high-pain days I have been drinking 1-3 Boost.  Some days I have a completely liquid day so it does not hurt quite so much by the time I hit number 8. On better days I have 1-2 Boost, applesauce, white bread with peanut butter and either more white bread, applesauce and an egg or grilled chicken with steamed broccoli.

However, a funny thing happened.  I went on vacation.  In the land of Olive Garden salad and bread sticks, pizza, fried food, dessert and alcohol.

Amazing milkshake at Duckfat in Portland, Maine

Aside from a little gas, I was at 1-2 washroom trips a day - without the big D and minimal amounts of pain!  I even hiked up several mountains at Acadia National Park without crapping my pants or popping a squat!  The only real side effects are my clogged arteries and the extra padding around my tush.

View from Acadia Mountain

Another beautiful view 

What does this mean?  It certainly goes to show that stress is the leading factor contributing to this IBS episode.  It also shows that when in an episode food can have little bearing on your symptoms.  So does this mean I plan to continue along this road to chunky town?  Definitely not.  Come hell or high water I am putting my fat pants away.  But, it does mean that as I go back on "real" food, life will be pretty awful, for quite awhile as my body gets used to trying to process fruits and vegetables.

As an IBS sufferer it is often difficult to choose the right foods because my reaction to the good food goes against everything I have been taught - from the food guide to my specialist, to all the health, fitness and wellness bloggers out there.  The healthy choice certainly feels pretty unhealthy to me as I have to go every hour, on the hour from the time I wake up.  It certainly feels unhealthy canceling appointments and making up excuses as to why I have to miss that meeting or have my colleagues believe that I really cannot shake that flu.  It is also really awkward dealing with the corn starch in a public restroom - all signs point to addiction.

So today, my first full day back from vacation I started off with my morning shake (Shakeology, cocoa powder, cinnamon, skim milk, peanut butter and banana baby food) and stuck to real food aside from my one ultra dark chocolate truffle and some butter on my white bread.  My body certainly cannot take whole wheat bread and vegetables all at once - one step at a time.  As I slowly, but surely trade in my fat pants for my skinny jeans, think of me, perpetually on the throne, in a cloud of corn starch.  Think of this as installment one in Food Gone Wild - an IBSer's tale of strange food choices, all in the name of the colon!

For those of you with digestive issues, I would love to hear if you have any recommendations!

Tuning in and raising a glass

Listening to your body – this is a skill I do not possess, but one that I am scrambling to develop.  If I had only mastered this seemingly simple skill earlier on in life I could have avoided many unpleasant situations.  

As a runner, I have come to learn this lesson the hard, and expensive, way.  I am still recovering from the crushing blows to my IT bands, knees, hip flexors and hamstrings.  I have been in physio for several months and have seen improvement, but I am still in pain and still not allowed to run.  I continue be outpaced by the geriatric crowd in the row of recumbent bikes at the gym.  I am capable of taking my legs out for a spin in the evenings, but the crunching noises when I do my calf raises, quarter squats and lunges remain worrisome.  

All of this could have been avoided if I had heeded the warning signs – the limping during or post-run, the leg stiffness that never seemed to end and the searing pain throughout the upper portion of my lower body.  All of this because I was afraid of looking like a wimp.  Well, now I am the wimp who listens to her knees snap, crackle and definitely pop going down a flight of stairs, who is too sore to handle a foam roller.  Instead, I am armed with ice and a rolling pin to treat the pain.  I spend at least an hour each day doing my physio homework to atone for my sins.  

This is not the only time I have been punished for not listening to my body.  My whole existence as an IBS sufferer exemplifies this.  My biggest issue with IBS has always been tuning in early enough to what my body is trying to tell me.  Specifically, I have difficulties realizing that I am stressed and/or sick.  I never clue until I am already in the midst of a full-blown IBS episode.  

Since my last episode in late 2009 I have been trying to pay more attention to these signals.  Yoga is certainly helpful – first and foremost, by the end of a class I am utterly relaxed.  In addition, the yoga breathing has helped me through many close calls and through the pain often associated with IBS.  Yoga breathing is a small miracle, I kid you not.  Finally, yoga encourages you to pay attention to your body and to relax targeted areas.  Through yoga I am slowly but surely tuning in and trying to listen.  

What I have learned since my injury is that I should not be too proud to slow down when trying to achieve a goal.  It is certainly more worthwhile to slowly improve than to go out guns blazing and injure myself.  I have also learned that patience really is a virtue, even though I curse patience on a daily basis as I diligently stretch and roll my way to an injury-free body.  I have also learned that a glass of wine can cure a multitude of problems – like “I feel sorry for myself”, or “I cannot face doing another clamshell” or “no, I cannot go for a run, I am still injured”.   With this, I raise my glass of Nova 7 and propose a toast to being a wimp.  

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. 

An almost pleasant experience

As a quick information bulletin to my readers, and potential readers, there are several reasons why I have begun this blog, some of which I examined in my first post.  However, there are other reasons that I have yet to touch on.  This blog is an opportunity to share my experiences with people who have IBS or other digestive issues in an effort to give an honest account of what these experiences might look like.  Having had a few occasions to connect with other sufferers, I can say that it is always a welcome change to open up to someone who is going through the same issues, we seem to be forever silenced by that social taboo called poo.  To this end, I will endeavour to speak honestly about day-to-day life with IBS and also GERD, but, be warned, some of you may find these accounts to be too honest.  I will share as much as I feel comfortable with, but for those readers who may have any additional questions, please do not hesitate to ask.  My hope is that by sharing my experiences some of you will recognize that there are others out there who have struggles very similar to your own, and, maybe we will be fortunate enough to learn something from eachother.  For those of you who do not suffer from IBS or other related issues, think of this as a window into that world.  There are far more IBS sufferers than you think, likely many people that you know, but nobody talks about it.  There is one very important thing to note, I have very mild digestive issues compared to those who suffer from other bowel-related problems such as Crohn’s and Colitis.  I do consider myself lucky to be in a place where my IBS is manageable; having experienced what I consider to be some very painful episodes, I cannot begin to imagine what those with severe digestive problems must endure on a daily basis.  It is always important to be thankful for the blessings that you do have… 

Last night was my first run with my running partner in quite awhile.  I was so relieved to be heading out with him again; I find it so much easier to run with a partner than to run alone.  No matter how fabulous my playlist might be, running solo feels like a chore.  

I was very apprehensive about last night’s run as my IBS has been acting up quite a lot.  I have spent the majority of the last week in the washroom, in the last two days alone I have used the washroom 13 times.   I have no idea why I have been having so much trouble; I have not eaten anything that would normally set me off, if anything, I have been extremely prudent with my food selection.  Furthermore, I can think of no possible stressor that could have triggered this flare-up.  However, as I write this post I have only used the washroom twice, by this time yesterday I think I was at four or five.  So, for some reason there has been a drastic improvement today.  What a treat to finally have a break.  One of the worst things about having IBS is trying to handle it in a public environment.  It is always difficult to determine at what point I should call it a day and head home from work.  A friend once asked me this question, and I guess my rule of thumb is that if I hit double digits while at work, it is time to leave.  But, often the pain-tolerance threshold can be a more accurate judge of when enough is enough.  If I find it too painful to sit on my office chair, it is a sure sign to call it quits.  

Given my washroom track record this week, I shuddered to think what a run might cause.  I seriously considered cancelling the run, but, as I had made the commitment to go, and I have signed up for the 10K, I decided to honour those commitments and hit the pavement.  Of course, true to form, I was late for the run because I was stuck on the toilet.  After I finally managed to peel myself off my porcelain throne, I experienced what was probably the best run I have completed in recent weeks.  We managed to complete six sets of six-minute intervals and covered roughly 6k or so.  What a shock!  With that being said, we did take two-minute walking breaks in between our running sets, I had mixed feelings about this, as it was not the six to one ratio I had been aiming for.  On the other hand, I certainly attribute the two-minute breaks to my ability to complete the full six sets without going to the washroom!  Woohoo!  In addition, it was actually an almost pleasant experience, the weather felt spring-like, the sidewalks were clear of both snow and black ice, it was not raining, and we went early enough that it was still light out.  We are scheduled for a run on Sunday and with yesterday’s success I am hoping that we can build on it and finally move on to seven minutes.  I certainly feel more positive given both our collective improvements and my personal improvements.  I might just be looking forward to tomorrow’s run! 

Confessions

Since my last post I have begun to tell people about my new endeavour.  I have found this to be the hardest part about the blog.  I told my husband on Friday evening; the poor guy, I was so worked up about telling him that I laughed hysterically, off and on, for about ten minutes before I spit it out.  (I should note that this is one of my quirks, I laugh hysterically when uncomfortable or overtired.)  With that kind of lead up I am sure he thought that I was shagging some other man, but no, just writing a blog.  I tried to explain that my apprehension was stemming from the fact that I am essentially laying myself bare for all to see, or rather, writing myself bare.  Also, the “p” word does factor in here.  Poo.  I am writing, essentially, about running and shitting, and, as we all know, poop is a taboo social subject.  The experience of trying to share the creation of this blog with my friends, family and colleagues is very reflective of the whole IBS experience.  Sufferers tend to approach the issue in different ways, depending on their comfort level.  I used to approach it by not approaching it.  It used to be something that I really tried to hide, and, I think this is the norm for most IBSers, especially for those who are newly diagnosed.  With time I began to realize that trying to hide it was more exhausting and stressful than not hiding it.  I should note that stress is one of the major triggers for IBS.  My approach to IBS and whether or not to reveal it to people has gradually changed over the years.  For the most part, anyone close to me knows about it, and, unfortunately for them, likely know too much.  I have decided that I do not want to have to spend my time trying to explain away the five 20-minute trips I took to the washroom today, why not say it, everyone is thinking it anyway!  By telling people it lets everyone off the hook, I don’t have to come up with a random excuse for my conspicuous absence and others don’t have to pretend to notice the length of time I have spent in the washroom.  

Now that I have that out there, I must tell you, it has been several days since my last run.  With a brisk -13 temperature I layered up and hit the road.  Overall, I was able to run 3.5 intervals of six minutes (just over 4k) before I had to visit the loo.  I suppose this is a slight improvement over last week, if only in the sense that I did not visit the ladies room until after the intervals.  I very briefly contemplated my “run after the run” strategy, but, changed my mind immediately at the thought of the length of time it would take to get my layers back on.  I should really be more motivated.  

Where all the magic happens...

Tonight’s run marked one of the few times in my life that I thought I was going to get run over by a car.  As you can see, I lived to tell the tale.  I can assure you that I was wearing light coloured clothing and looked both ways before I crossed the crosswalk;  there was a stop sign, so the driver really had no excuse.  I was pretty peeved about the whole incident as he proceeded to beep and gesticulate after nearly killing me.  I will let your imagination run wild with thoughts on how I responded.