Author: Katarina Zulak

Hi there! I am a health writer, health advocate and all-around health nerd. Eight years ago I was diagnosed with chronic pain & illness. On my health journey, I've learned the power of self-care skills to improve my health and well-being. As a Chronic Illness Blogger I am excited to educate and inspire others to be skillfully well, even if they have a chronic condition!

Digestively Challenged: Overcoming G.I. Tract Problems when you have a Chronic Illness

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Digestively Challenged: Overcoming G.I. Tract Problems when you have a Chronic IllnessIs eating well with chronic illness a luxury? When I first got diagnosed, I thought so. The significant pain I was experiencing in the muscles around my shoulder blades made it impossible for me to chop, stir, or sauté a whole meal – basically, to cook. My partner was more than happy to help (as long as I showed him how!), but it felt unfair. After all, he was now supporting me financially and doing the majority of the housework – since laundry, vacuuming, scrubbing and dusting were similarly impossible for me. We tried to eat the healthiest convenient foods we could. Unfortunately, convenience isn’t healthy, at least when it comes to eating. In a previous post, I wrote about how my processed diet failed me, even though I was making supposedly healthy choices. In one year, I gained about 20 pounds, ate four times the daily recommended allowance for sugar, was woefully short on fruits and vegetables, ate too many servings of grain and too few servings of protein.

I also had hypoglycemic attacks if I did not eat on time. I remember that panicky feeling of being on transit, far away from a convenience store, and starting to feel shaky and sweaty.  I also developed a number of food intolerances.  I felt anxious about eating out or trying a new recipe for fear of having an ‘episode’.  Not only did I have unpleasant digestive symptoms but also strange neurological ones – sweating, pulse racing, excessive salivation, skin crawling, restless legs, and others.  It was these two problems that made me feel like I needed to understand what was going on in my body and to regain control over my eating. It’s important to begin with a good understanding of digestive problems that affect spoonies (people living with chronic illness).

Firstly, we need to avoid food intolerances (also known as food sensitivities). Food intolerances are defined as a physical reaction to eating certain foods, such as digestive symptoms like bloating, gas, diarrhea or constipation, or stomach cramps.[i] These reactions do not occur because of an immune response to a particular food – that would be defined as a food allergy. In the case of a food intolerance, some people may be able to eat a small amount of the trigger food without having a physical reaction, up until they reach a threshold level. Food intolerances may occur because of the absence of a necessary enzyme (such as lactase to break down lactose sugar in dairy), having irritable bowel syndrome, having a sensitivity to food additives, having a problem digesting certain carbohydrates (acronym FODMAPS), or for no known reason. Food sensitivities may be more common among people living with fibromyalgia and CFS/ME because of the overall sensitization of the central nervous system associated with these conditions. Research indicates that at least half of people with FM or CFS/ME experience significant relief by eliminating certain foods.

How can you figure out what foods you are sensitive to? Naturopathic doctors, integrative doctors and nutritionists can offer tests that pinpoint sensitivities. However, the least expensive way is to do an elimnation diet. You begin by cutting out the most common foods that cause intolerances and any foods that you are suspicious of for a period of time, usually 2 to 4 weeks. These foods may include: dairy, gluten, eggs, soy, corn, sugar, citrus, peanuts, shellfish, and coffee. Then you gradually reintroduce one food type at a time to notice your physical reaction. If your symptoms reappear, then you know you are sensitive to that type of food. In my case, I am intolerant of eggs, red meat, and to a lesser extent, wheat. I am also sensitive to high concentrations of fiber or resistant starch. The elimination diet is best done with the guidance of your healthcare professional.

A second problem associated with the digestive system and chronic illness is the development of Leaky Gut Syndrome. Essentially, leaky gut occurs when the lining of the intestines becomes more permeable, which allows particles of partially digested food or waste to leak into the bloodstream.[ii] Increased permeability occurs because of damage to the tight junctions between intestinal cells. When the immune system encounters foreign particles in the bloodstream, it launches a response, including inflammation. Symptoms of leaky gut syndrome include digestive symptoms, gas, bloating, diarrhea, fatigue, joint pain and rashes. In addition to chronic inflammation, leaky gut syndrome affects the ability to digest food and to absorb nutrients. Furthermore, it compromises the immune system by tying it up responding to foreign particles in the blood, which leaves it less able to respond to actual pathogens. The intestinal lining actually is a significant site of immune activity, but when it is damaged, overall immune function is impaired. How does the intestinal lining become damaged? Through food intolerance, stress, medication, flora imbalance and autoimmune disease. Emerging research shows that several autoimmune diseases share increased intestinal permeability as a characteristic[iii].

In terms of diet, the usual recommendations include treating Leaky Gut Syndrome through clean eating; in other words, avoiding commonly allergenic/intolerant foods, inflammatory foods, pesticides, herbicides, additives, or sugar and rebalancing intestinal flora by consuming probiotics. For autoimmune diseases in particular, some experts recommend the paleo diet, which emphasizes protein and vegetables, while cutting out grains and legumes. For example, Dr. Terry Wahls has written a book on how she reversed her MS through a nutrient dense paleo diet. Supplements that can help to repair the damaged intestinal lining and reduce inflammation include l-glutamine and DGL.

When it comes to diet recommendations, I think the most important thing to remember is that we are all genetically diverse. We will all have unique responses to different foods and there is no one-size-fits-all diet. For example, I feel terrible after eating eggs or after eating a large portion of cruciferous veggies (broccoli, cauliflower, etc) because I have a food intolerance to eggs and  am sensitive to large portions of insoluble fiber. The paleo diet isn’t for me. However, a high-protein vegetarian diet keeps my digestion happy, hypoglycemia at bay, and generally gives me more energy. The only universal truth when it comes to nutrition is that nobody benefits from eating a diet high in processed foods, sugar, sodium or fat. We all feel better on a whole foods diet. It can seem overwhelming to change your diet when you are dealing with the multiple, uncertain symptoms of chronic illness. The potential to improve your quality of life is worth the effort in experimenting to find what works. Here are a few resources to help you get started:

  • 100 Days of Real Food is a resource for transitioning to a diet free from processed foods (includes blog, meal plans, challenge, cookbook) http://www.100daysofrealfood.com/

Read other great blog posts by writers with FMS on the Fibro Blogger Directory http://www.fibrobloggerdirectory.com/

[i] http://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538

[ii] https://www.womentowomen.com/digestive-health/healing-leaky-gut-syndrome-open-the-door-to-good-health-2/

[iii] http://www.todaysdietitian.com/newarchives/021313p38.shtml

Convenience Isn’t Healthy: Chronic Illness and Diet

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When I was diagnosed with fibromyalgia three years ago, my diet was all about convenience. I came to the conclusion that eating healthily was just a luxury that I could no longer have. I tried to generally to choose healthier convenience food options. For example, a whole-grain cereal instead of refined grain, or a low-fat frozen lasagna instead of full-fat. A typical day looked like this:

Breakfast: Multigrain Cheerios with a banana (251 Calories)

Snack: Yogurt (115 Calories)

Lunch: sandwich with deli meat, granola bar, carrot sticks (348 Calories)

Snack: Trail mix (352 Calories)

Dinner: Spaghetti (store bought pasta sauce) (344 Calories)

Snack: Slice of Toast (69)

Total: 1538 Calories (Calculated at Super Tracker www.supertracker.usda.gov)

So, calorie-wise not so bad. However, as any nutritionist can tell you, calories are only a small part of the nutrition story. If I ate 1500 calories in chocolate, it would only be delicious, not healthful.

What was wrong with my diet?

  • Grain heavy: I had a total of 240 g of grains, which is over the USDA recommendation of 170g or 6 oz for a woman my age. While grains provide benefits like fiber, eating too much of this food group can lead to weight gain.
  • Protein policy: in total, 16% of my food intake was protein. While this is within the acceptable range set by the USDA, dieticians recommend your protein daily allowance should be calculated using this formula: 0.8 x weight in kg (easily converted using any online converter). For me, this comes to 52 g per day. Protein should be distributed between all meals to help sustain energy. In my case, breakfast and dinner were primarily carb based. http://www.livestrong.com/article/343966-how-to-calculate-protein-rda/
  • Sugar high: in total, I had over 90 g of sugar! The World Health Organization recommends that less than 10% of your daily energy consumption should come from sugar, with added health benefits coming from less than 5%, or approximately 25 g. My sugar total was almost 4 times that much! This is bad news for my blood sugar levels and weight management, never mind long-term health consequences. http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/
  • Nutrition deficient: I had less than four servings of fruits and vegetables (banana, carrots, raisins, tomato sauce). This means I was getting an inadequate amount of micronutrients (vitamins and minerals), and losing out on the many other benefits of these healthy foods such as antioxidants and fiber. Furthermore, the servings I did have were primarily starchy vegetables or high glycemic fruits, which only added to my blood sugar concerns and weight gain.

Overall, I gained 20 pounds in a year and went up a dress size. I was also permanently fatigued. For anyone coping with chronic illness, sustained energy is a significant challenge. Balancing macronutrients – carbs, protein and fat – along with factors such as fiber and sugar, is important for preventing spikes in blood sugar that inevitably lead to energy crashes. According to the Mayo Clinic, based on a 2000 calorie/day diet, the total daily allowances should be:

 

Nutrient Percentage Grams
Carbohydrates (vegetables, fruits, grains) 45-65% 225-325
Fiber   Female: 22-28; Male 28-34
Sugar   Female: 24g; Male: 36
Protein 10-35% 50-175
Fat 20-35% 44-78
Saturated Fat 7-10% 16-22

http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/how-to-eat-healthy/art-20046590?pg=1

Maximizing micronutrients (vitamins and minerals) is also key healthy eating. Adequate intake of nutrients like Iron and B vitamins have been linked to improved energy levels, while others like Vitamin D and Magnesium help reduce chronic pain. In addition, chronic illnesses like fibromyalgia have been linked to high rates of oxidation, so eating antioxidants is important to counteract these effects.

The USDA recommends at least 2 ½ cups of vegetables per day for women and 3 cups for men, and 1 ½ cups of fruit per day for women and 2 cups for men. The USDA recommendations have been critiqued, which is another post altogether, but provide guidelines that are much healthier than the Standard American Diet www.choosemyplate.gov.

Reasons I Meditate

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1. To take a moment to appreciate what my body does for me, all the time, underneath my usual awareness. Breathing is crucial to living. This gratitude towards my body helps me develop a better relationship with my body, because I usually feel locked in an antagonistic struggle – pain, stiffness, insomnia, digestive problems, etc.

2. To take a moment to be amazed at the interdependence of life on our planet, as we cycle oxygen and carbon dioxide between animals and plants. It’s also incredible that the air we breathe has been breathed since the dawn of life. This helps keep things in perspective for me, when I remember to keep a sense of wonder, and stay connected to the environment around me.

3. To soothe my nervous system, which spends too much time in sympathetic fight or flight mode and not enough time in parasympathetic rest and digest mode, thanks to chronic pain. Over time meditation can help rebalance this tendency.

4. To practice being present, which is a skill. This skill can help me enjoy the moments we rush past (stop and smell the roses), and help me respond more calmly to difficult situations. Both of these outcomes are especially important for chronic pain and illness, where we enjoy too little and feel overwhelmed so easily because of the enormous challenges these conditions pose for us.

5. Develop body awareness: To be able to be in touch with my body more readily, so I can better work within my limits. It’s easy to ignore the early warning signs and then crash from pain or fatigue from overdoing things.

Homeopathic Remedies for Muscle Adhesions in Chronic FM Pain! Why not?

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At a recent appointment to my naturopath,  to the wonderfully named Dr. Love, the topic of recurrent muscle pain flares came up. Anti-inflammatory interventions and nervous system calming remedies had not broken the cycle of muscle pain I experience. My pain predominantly occurs in my upper back/shoulder blades on either side and my glute muscles/SI joints. Even though I stretch and strengthen, which helps, I have not broken out of these painful cycles. My naturopath asked what my osteopath had to say about whether my muscles are particularly restricted and not very responsive to treatment. My osteopath said that my thoracic spine and pelvis area were particularly restricted.

Dr. Love explained that tightness and restriction can occur when muscles are contracted for a long period of time, leading to adhesions in the connective tissues. Adhesions are a form of scar tissue that cause connective tissues to stick together in a way that restricts normal movement and function. There is evidence that adhesions in the fascia (a network of connective tissue throughout the body, like a soft skeleton) can contribute to fibromyalgia pain.*
Dr. Love felt that it might be helpful to give me some support for breaking down adhesions, to complement the work of my osteopath and physiotherapist. She prescribed a homeopathic remedy with two ingredients. The first was theosinaminium, which is a derivative of mustard seed oil. It is used as an internal solvent for dissolving scar tissue, fibroids, tumurs, and adhesions.** The other ingredient was silicea, which  “can stimulate the organism to re-absorb fibrotic conditions and scar-tissue”.***
In the last month, I have experienced decreased night time back pain, and greater resiliency in my upper back/shoulders (for example, I have been able to type this entire post without pain, when usually I use voice-t0-text technology). I am not sure if this supplement is the only reason, but since it has no side effects, I am happy to continue to take it to see if it will help me further!

*http://chronicfatigue.about.com/od/glossary/g/Adhesion.htm

**http://www.webhomeopath.com/homeopathy/homeopathic-remedies/homeopathy-remedy-Thiosinaminum.html

***http://abchomeopathy.com/r.php/Sil