Since it is almost Thanksgiving, I thought I would write a post to wish everyone a happy, stress-free holiday, and try to help those with IBS, Crohn’s, and UC who may need some encouragement and advice.
We all know holidays can bring on the stress-inducing behaviors and hormones that cause internal signals to flare up in the body. When I was at the Mayo Clinic a few (short) months ago, I learned so much about controlling stress—make stress-reducing activities a priority, starting today, and leading up through the holiday season.
Your lifestyle structure is even more important here: daily exercise, gentle yoga, meditation, sleep, etc. Schedule appointments with professionals to help you lessen stress in your life: a talk therapist, acupuncture, massage (gift cards are good holiday presents for those you love!), etc. Do what makes you feel good about yourself AND relax! (I went to the salon yesterday for hair color!)
Tryptophan is one of the 10 essential amino acids that the body uses to synthesize the proteins it needs. It’s well-known for its role in the production of nervous system messengers, especially those related to relaxation, restfulness, and sleep.
I am now aware why I love turkey so much—I sometimes even crave it. I always feel more relaxed after I eat turkey, and this may explain why….There are many researchers who study the way tryptophan manufactures serotonin, a neurotransmitter that is found—guess where?—in the intestinal tract. Just about 90% of the body’s serotonin is actually found in the gut, so my gut tells me to eat it, and I am not even a biochemist!
Tryptophan has the ability to raise serotonin levels, too! Wow, who knew this? I love the fact that I can eat turkey and sample other holiday foods like nuts, seeds, bananas, pumpkins, squash, sweet potatoes, green beans with almonds, pearl onions (those sweet little ones, not the canned and creamed kind!) WITHOUT having a flare up. Also (again, who knew?!), Tryptophan also boosts the production of B3, and since I had a partial bowel resection in 2006, I need to keep track of my B vitamins (especially since my terminal ileum is completely gone, I have lost the capacity to fully absorb vitamin B12).
Everything I eat is sourced, and mostly bought from local farms. It is not that hard to do. For instance, our turkey is a Vermont-raised, free running turkey, and I picked it up yesterday from our local food coop. Potatoes are from here, also butternut squash, apples, pumpkins—are all from Vermont; cranberries are organic and from Cape Cod. I will be baking apples, too—delicious and easy. Some of us cannot eat nuts or cranberries, so avoid, but there is plenty to choose from!
Here are some tips: drink water before your meal to fill you up so you don’t overeat, take small portions, walk after the meal. If you have an ostomy, take extra supplies and a change of clothes to your hosts’ party. If you avoid sugar and alcohol, you will be less likely to flare up; also don’t try ANY food that is not on your list (remember the food journal from the book!).
On Wednesday/tomorrow, I will make some pies to drop off at our local Thanksgiving Day dinner for those less fortunate in our area—Don’t forget to do something to help someone else in need this week, and after. With all the holidays upon us, plan some special time each week to volunteer (soup kitchen, helping those who have been in a house fire, helping veterans, etc.). Thanksgiving was set as the fourth Thursday in November. This year, something amazing and historic has happened: After sundown on the second of Hanukkah’s eight days, we will also celebrate Thanksgiving. If you are Jewish, there is an even busier holiday!
I will post some recipes on my Facebook page! Be well, and breathe … A bit of dietary research unravels mysteries of cravings from this writer with uc/Crohn’s disease….Happy Thanksgiving & holidays everyone!
RX, Flare—Where to begin…. Here are some lifestyle tips, from Dede, who has been in remission from Crohns for almost eight years…. Do not despair.
“There is a saying in Tibetan, ‘Tragedy should be utilized as a source of strength.’
No matter what sort of difficulties, how painful experience is, if we lose our hope, that’s our real disaster.”
—The Dalai Lama
Take control: hydrate, sleep, exercise, yoga meditation, daily…
Walk 1-4 miles per day
Sleep at least 8 hours per night (take powdered magnesium bicarbonate—Dede likes “Natural Vitality’s Natural CALM in the Raspberry-Lemon flavor, drink fresh-squeezed lemon-lime-flavored water all day long (carry glass water bottle with you, and the new ones are encased in non-breakable plastic or rubber)
Drink herbal teas—Chamomile, dandelion root, peppermint— and also Green Tea that has caffeine, but also comes in decaf.
Movement & Meditation
Start a gentle yoga DvD (Rodney Yee’s a.m. Yoga is wonderful), and set up a “yoga studio” in your house or apartment somewhere (mine is in the basement with an old TV, but I have made it my own with a little table and a small wooden Buddha, candles—it is peaceful and my own space).
This yoga will lead to guided meditation. Even 5-10 minutes a day improves patient outcomes! A local class or “sangha,” is a nice way to learn to meditate.
Watch Your Diet
Once you get in tune with your body, you can start to really tell if certain foods make you begin to flare and you can back off immediately and note in your journal to keep track.
Keep a list of safe foods, foods to avoid.
Body Care—It Pays to Be Beautiful!
Use essential oils to sniff daily. I like lavender oil in my bath, eucalyptus oil in the shower
Massage your feet every night before you go to bed. Use a nice moisture lotion (with lavender, if you like it), and I add organic apricot or sesame oil to make it thicker.
Take some “Natural Calm” magnesium powder each night in a hot glass of water before you go to bed… You will sleep better!
Massage the back of your neck—press with acupressure in the “still point” at the base of your skull—get a friend, or spouse, to help.
Speaking of….ASK FOR HELP! Don’t do what I did, which was to lie in bed and retreat from the world for days at a time…the only trip to the bathroom for a journey…. Ask for help—on Facebook, or pick up the phone.
See a therapist, once a month, or join a group for IBD, Crohn’s, colitis, or autoimmune disease.
Volunteer at a soup kitchen or homeless shelter, or environmental action group…. Altruistic behavior helps you to let go of stress.
Last, but not least, LAUGH every day! Watch the stupid pet videos… Or this goofy video my friend, Dodie, sent me this morning… She is going through cancer treatment, and she is very brave and a wonderful friend, who retains a sense of humor!
Greetings from Vermont. I am the co-author of Living With Crohn’s & Colitis: A Comprehensive Naturopathic Guide for Complete Digestive Wellness (with a nationally-known naturopath, Jessica Black, ND). Our book has helped so many people afflicted with Inflammatory Bowel Diseases, part of the growing auto-immune diseases that cause diarrhea, bloating, nausea, vomiting, and cramping. These inflammatory bowel diseases, and other auto-inmmune disease are on the rise exponentially across the world, especially in the developed countries where processed food is available.
Think about it: There are certain behaviors that cause body/mind stress: We address this in the book, but I want to tell you that I am a patient/survivor of a stress-induced flare-up in 2006 that almost killed me. On my 5 foot 8 frame, I weighed 117 pounds. I spent a month at Dartmouth Hitchcock Medical Center. I was 45 and very sick, with 3 children at home and a business to run.
Stress was the way I worked, and I was on autopilot without taking time for myself. That has all changed, and I have been in clinical remission for the last 7 years! Let me tell you more….
As many readers know, I went to the Mayo Clinic in Rochester, Minnesota this past May to have a complete second opinion. I spent two days of my weeklong stay, at the wonderful stress reduction clinic.
Here are some of my tips gained from my research, and how I try to keep my disease in remission:
A lot of us have low level stress. Most of us don’t live in the hyper-aware world, and we suffer the autopilot behaviors that contribute to what I call “the slow burn of stress response.” Our heart rate and blood pressure might be elevated, and our breathing and muscle tension is like this — shallow breathing and knots in muscles. There is an area at the base of the brain called the amygdala. This is the seat of our emotional reactions, or “flight of fight” response to stress. Many Americans live with this elevated, but low level elevation daily… a little bit of “Flight of Fight” stress is really okay, but not on autopilot.
Look at our brains — In our pre frontal cortex, there is an area responsible for relaxation, and it is not easy to stimulate and not an adrenal release, as per the amygdala part of the brain.
First we need to be aware of this pre frontal cortex We have to explore our own behaviors and habits, break out of autopilot, and participate in a personal practice. There are some things you can’t control, like weather or traffic jams; however there are some things we can control, and are important… An example from the workshop was if you have an overbearing mother (don’t worry, Mom, not YOU!), and how you need to take care of yourself first and use the excuse of health, and scale down. Awareness helps, and limit your exposure to stressful people and situations. It’s a process… keep boundaries in your mind, but “caring boundaries.”
Unhealthy responses to stress in our life are anger, etc. It is important to develop a healthy exercise routine, learn and use relaxation techniques (see below), and take care of yourself. This neural pathway gets easier and easier to tap into (see diagram at right). For example, my body knows and relaxes immediately when I walk into my home “yoga area” where I have a TV, and a carpet with a yoga mat. I use Rodney Yee’s DvD, “AM/PM Yoga,” and do the exercises every day… it gets easier and easier to tap into the relaxation part of my brain, and it is replenishing.
After a stressful day:
- Call a friend
- Read a book
- Walk the dog
- Ride a horse
- Volunteer at a soup kitchen
- Play the piano
- Do some gardening
In order to break out of autopilot, do a few things on this list on a regular basis.
Benefits: Concentration, Problem solving, Sleep…
We need to be participants: This involves “letting go of the wheel,” loosening your grip, and takes time and experimentation.
In the wonderful workshop, our instructor gave the analogy of flying on an airplane, and how you put the oxygen mask first, then help the child.
Talk therapy is another way to help relinquish the autopilot lifestyle… A regular monthly session with a trained, recommended therapist will do wonders for helping to care for yourself, establish boundaries, and feel safe.
Evaluate your stressors and prioritize your time, as you move forward in the break from autopilot.
Give yourself permission eg., “Be kind to yourself and ask for help.”
Often we don’t think about our career as a choice made for healthy reason, and it might be time to reevaluate what we do for work.
It is important to spend time with friends, develop hobbies…. Hanging out with people who make me laugh is a goal. A hospital study involved a control for two groups with the same malady: One group watched funny movies every day, and got out of the hospital faster.
It’s a process, and it is important to practice positive self talk.
Start a simple practice of Tai chi and chi gong
Walk around with a gentle smile on your face and try to share it with strangers—you use less muscles and tension when you are not frowning, which can contribute to an overall sense of well-being and a way to focus on releasing the internal stress caused by being on autopilot…
I have found this “small smile” technique that is practiced by Amit Soud, MD, the head of the Eastern Medicine Section of the Mayo Clinic to be essential as a way to lessen internal stress.
TAI CHI AND CHI GONG: These ancient exercises are easy and relaxing, often available in small towns across the United States. For example:
We breathe with about 40% of our lungs. If we can learn to take slow diaphragmatic breaths, we can effortlessly lesson our stress levels. These exercises are the foundation and essential for relaxed breathing.
A simple exercise I learned at the Mayo Clinic:
Take in a slow deep breath,
and fill your lungs so even your belly sticks out;
hold for a couple of seconds;
pretend you have a lit candle and exhale
so that the candle flickers.
Note to reader: it might take 8 weeks or so to start seeing results.
I am leaving today until Thursday …. It’s for a good reason: Mayo Clinic for a second opinion on just how “severe” my Rx is. I already love them — the GI nurse calked to schedule me for stress management & relaxation class, also Tai Chi, Chi Gong (begin the video at 0.26), and a sleep workshop!
In addition, I will be in the hospital Monday for tests, too. I plan on recording my meeting with Dr. Tremaine, so I can really focus on what he says… there is a study that says patients only retain about 30% of what the doctor tells him when they deliver a diagnosis… fear, anxiety, etc., can cause this…. I guess that should be pretty obvious, but I am going to be prepared.
This is a good thing! Preventative and integrative medicine, as it should be . . . more to come.
Thanks for all your support…
“One thing I teach: suffering and the end of suffering.
It is just ill and the ceasing of ill that I proclaim.”
In a recent study, Mental Training Increases Physical Strength, by Erin M. Shackell and Lionel G. Standing from Bishop’s University in Quebec, a group of college students were asked to IMAGINE strength training versus a control group who did nothing and another group who did the actual physical work.
One area (hip flexing) was identified for groups of 10 college student-athletes to work on for the two-week study. The 10 college students who did the actual strength training five days a week did four sets of eight repetitions, adding 5lbs of weight, and they saw strength training improvement of 28%. The group of 10 that did nothing saw no gains; and the group that practiced visualization saw gains of 24%! This study was unique in that the group imagining themselves doing the reps actually did nothing after that—it was pure visualization.
The idea of using mental practice to improve performance has been around as long as Buddhism, founded 2,500 years ago. Exactly how visualization changes physical health remains a mystery, but the Dalai Lama spoke of the process of training the mind through meditation when I heard him speak this past October. I was profoundly affected by his talk; in fact, I am writing a book with Travis Hellstrom, called Questions for the Dalai Lama & Daily Quotes for Hope, due out in 2014—visit our website here, and please join us—we like to receive questions, and you may be in the book! Those of us in the Crohn’s-Colitis community live with suffering sometimes on a daily basis. It is important to develop and train your mind as a way to cope with this.
Additionally, studies have shown that altruistic behavior (the inherent, and possibly genetic ability to help) improves medical outcomes—so a good New Year’s resolution:
Do something kind for someone or something every day. My own daily intention is this: May our thoughts be kind and clear. May our words and communication be kind and clear. May our actions and intentions be for the greater good of all beings.
I have used mediation and mindfulness steadily since my bowel resection six years ago, and I have made a daily practice of morning yoga and mediation. When I sit at the end of my yoga session (I use the gentle Rodney Yee DvD, “A.M. Yoga,” I let Rodney’s soothing voice guide me into a place where my breath is quiet, my mind quiets (that can take a while with me!), and my shoulders and ears and limbs are relaxed (look at statues of sitting Buddhas, and you will notice the elongated ears, the fingers in the lotus position, the downcast eyes…). I chant “Om,” before and after I sit, and I have a visualization that I let pass through my body from my head down through my spine, and out my lower back—it is a ball of white light. While this luminescent ball moves down my spine, I have a mantra I chant over and over that goes like this:
White light healing
It is amazing to me how grounded and refreshed I feel after each morning session.
Now that my Crohn’s has gone into a full-blown flare, I am sobered by the realization that the disease has been spreading back up my small intestine from the site of the surgery (see my recent post, What Causes a Flare Up). However, I have heard from numerous health practitioners that a positive outlook actually affects disease outcomes, so my goal is to be as upbeat as possible while I begin this new drug-and-naturopathic protocol (low dose naltrexone, Glutamine, vitamin D and C, high potency turmeric/curcumin, and the rest of my daily supplements including increased probiotics).
I am also committed to getting back on the Specific Carbohydrate Diet (SCD) that helped me so much six years ago! My colleagues, Jordan and Steve, have since developed a really great website and resources based on the original book, Breaking the Vicious Cycle, by Elaine Gottschall.
How Does the Specific Carbohydrate Diet Work?
By eliminating complex carbohydrates, lactose, sucrose and other man made ingredients from the digestive process, the body is finally allowed to start healing. As gut flora levels start to stabilize, the reduction of irritants from undigested foods, toxins and other man made ingredients allows inflammation levels to retreat.
So, for all my readers, followers, fellow uc-ers, Crohnnies, and friends—keep on with visualization and positive thinking, especially as we embark on a new year with new beginnings.
My article was published this morning….
Kind of excited. Hope my fellow Crohnnie/uc-ers like it! I got some help from ccfa.org, too! I worked with editor, Travis Saunders, a PhD student researching the relationship between sedentary time and chronic disease risk in children and youth. He is also a Certified Exercise Physiologist and competitive distance runner.
I had a hard time finding studies that were recent, dealing with the impact of exercise on Crohn’s and Colitis. Research that I found shows that it does help, and I would love to hear from readers who have some things to add, or if there are problems associated with exercise and IBD.
Obesity Panacea is an awesome blog, and I am trying to help promote it. Thanks!
Photo © 2012 “Mike” Michael L. Baird
Greetings fellow Crohnnies and UC-ers, and summer travelers,
I love to travel, and left home when I was eighteen even to live in Europe by myself for a year. I settled in Vienna, Austria, and loved the culture and the people. The diet, however, was not the healthiest, and I gained twenty-five pounds by subsisting on Würst, and bread, and of course beer. I remember, when I came back from Europe, my father looked at me and said, “you’ve gained twice the Freshman 15, and you didn’t even go to college!” ha, ha ha.
Well, here I am, many years later—with college, marriage, and three wonderful children behind me, and I have to say that the one good thing that having Crohn’s disease has done is I don’t give a shit about my weight, and I just eat what I can and make no apologies to anyone! (Sorry to use a swear word, and be so blunt!). My weight has stayed at around 140, which my gastroenterologist says is “perfect,” because I eat healthy food all the time—hardly any sugar, no fried food, no fatty food, no wheat, very low-fat dairy, exercise daily, and maintain a low-stress lifestyle.
The reason I am writing this post today, is not to talk about our American culture’s OBSESSION with food and being thin as a sign of success; no, it is to talk abut the opposite—love your body and cherish your family and take responsibility for your own health and education.
I say this because for years, seriously, I wallowed in self-pitying behavior during my Crohn’s flares, which pretty much happened monthly, and had the nasty habit of joining with me having my period (good timing, eh?). I used to crawl into bed, and sometimes cry quietly, so as not to disturb my kids. After driving them to school (during one of these flares), I would frequently pull over to the side of the road in my car, and just put my head on the steering wheel and sob. It took me years to ask for help, and by the time I was finally diagnosed, my disease had basically devoured my terminal ileum, for it was beyond repair due to repeated flares leading to scarring.
So, having first had symptoms of ulcerative colitis (I have this, too!) after I returned from Vienna (remember my unhealthy lifestyle, horrible diet, and self-loathing attitude?), fast forward to 2006, to when I was admitted to the ER with a stomach the size of a basketball, and a severely impacted bowel that was about to rupture…I finally admitted that I was one sick person and I needed help.
That was my first step toward getting well.
Inside my head, I was constantly thinking about what I could or could not eat to stay thin, and be attractive—I smoked cigarettes to curb my appetite and utilized the diuretic aid that nicotine provides; I also worked all the time and exercised in fits and starts, and tried to diet, off and on, but always gained the weight back.
Having my kids and childbirth helped me let go of inhibitions (having my third baby stark naked in the OR and not caring one bit about my big belly or flabby legs 😉 was a great release for me—I always wanted to be trim and fit and “in control.”
One thing having Crohn’s has taught me is that sometimes when you lie on the cold and smelly bathroom floor with your arms wrapped around the toilet crying for your (not very nurturing) mother, you are clearly not in control!
Here is a link to a recent article about yoga and body image, and I was interviewed by the wonderful writer, Linda Sparrowe!
A disordered body image isn’t always about weight, of course. Dede C., a graphic designer from Vermont, remembers the time she was in a yoga class practicing handstand and her shirt came up, revealing a huge scar on her belly that she hated and felt ashamed of—a result of multiple surgeries. Her yoga teacher told her she was beautiful. “But my scar,” she said. “Your scar is beautiful, too,” he said. “It’s a part of who you are.”
So for my fellow Crohn’s disease and ulcerative colitis readers, and people who love you who may also be reading: let go, and by that I mean ask for help, but also study everything you can about your disease and admit you have a serious disease that can even lead to death. Don’t be polite at potluck dinner parties; at restaurants, ask for rice, well-steamed fresh local veggies (especially available in summer), and baked fish especially made for you if the menu doesn’t have easy-to-digest food (I just did this in Rhode Island on vacation last week, and I also politely sent back a dinner because something didn’t taste right and I trusted my gut—the fish was a bad piece, it turned out! And no way am I going to get food poisoning again…).
As I write this blog, I pledge not to offer “tips for this or that, digestive disease.” Instead, I offer up my interpretation of current medical research (remember, I follow gastroenterology papers, studies, and the like, with the zeal of a pre-medical student!), and personal stories that will, hopefully, help people cope and learn about their disease, and thrive!
I’ll post a few vacation photos (that’s me with my daughter and I wore a “tankiny” bathing suit that occasionally showed my scar and I did not even think about it!). I would love to hear how people are doing—travel with IBD is a challenge, so if you can’t take off this year, have a “home vacation,” with a week off from work and time away from computers! Get a hammock, read a great novel (Shadow of the Wind is my current favorite and it is set in post WWII Barcelona!), and watch movies….. Release stress daily, which is key to long-term health.
My quest to lower inflammation in my body, actually throughout my body but focused on the enteric nervous system, is ongoing. Since the enteric nervous system is intertwined with the lining of the gastrointestinal system, it makes sense to pay attention to the one hundred MILLION neurons in the gut, home to the “second brain.”
Another little-known fact is that more than 90 percent of the body’s serotonin is found in the gut. My own experience is that I function better when I am actively releasing and secreting serotonin, which, for me, is achieved by riding my bike, and/or running, mostly.
I like to think that the gut needs to be toned, like a muscle; it is fact loaded with muscle and the lining is multifaceted and complex. When inflammation occurs in the gut, usually a combination of things contribute to a build-up of this, and the white blood cells and helper cells that normally race to an infection can’t do their job properly, and things get out of balance.
The parasympathetic and sympathetic nervous system is a complex, and sometimes emotional, system within a vertebrate body. I often go to a physical therapist who specializes in a technique called Integrative Manual Therapy. Her name is Deborah Feiner, and I consider her a kind of healer. I have benefitted tremendously from working with this type of therapy. I relax totally on the table, and we often joke about the rumblings of bowel sounds that immediately occur when I relax (these are good bowel sounds, not the loud rumblings I had before my surgery!). During my session, a kind of toning occurs along my intestines, and she guides her hands around my stomach, almost intuitively. It is amazing, I would never have done this before my surgery, when my life changed totally. I would have been too insecure.
I will leave off this entry with a photo of me, with another photo of Debbie behind me by Phil Innes.
I was going to post a recipe… But will do that next time! I have been getting lots of sleep, exercise, and doing daily gentle yoga (Rodney and Colleen Yee) and guided meditation. I also take the ground flax seed and probiotics every night after dinner…. I am regular in my bowel movements, and much less stressed in my daily life: it seems to be working!