Word of the Year: Healthy

While I didn't spend the last year blogging (I think I wrote one post in 2016!) I did spend it working on getting healthy.  I'm still working on it.  A friend of mine, Kate Scarlata, who is also the nutritionist in the story below, had a few of us over at the end of last year for a night of being crafty and creative and creating "mood boards" for ourselves and the year ahead.  What word were we drawn to when we think about our year ahead?  I went in focusing on health but everyone else was choosing words like love and fun and adventure and I kept looking for other inspirations as we flipped through magazine's and chatted.  I couldn't deny it though as everything that jumped out at me somehow had to do with health.  So I went with it.  Fitness (sexy abs and a tight butt!), Strong is beautiful, SNOOZE (creating a calm zone in your home), Enjoying life's simple pleasures (All the girls in my house took a break for a bubble bath on Monday!), LAUGHTER, GIVING, TALKING, getting fit (our family is going to Hawaii for our 20th Anniversary this Summer).    I am so looking forward to the year ahead and being HEALTHY in body, mind, spirit and relationships with family and friends.

My health journey started after my third baby was born in January of 2005.   I had major post-partum depression (many people don't realize that depression often shows itself as anger-especially in men but definitely in me! I was either angry or sad and crying in closets), I had suicidal thoughts, was exhausted, was gaining weight and my whole body hurt.  After I spent the day with a good friend and I mentioned being cold she pushed me to have my thyroid tested.   When I mentioned it to my parents I found out my dad has an autoimmune condition called hashimoto's thyroiditis but had never been symptomatic- his doctor had just picked it up during a routine physical.  My maternal grandmother also had thyroid issues.   My thyroid levels were slightly elevated but when they tested my autoimmune levels I was off the charts for having hashimoto's.   Hashimoto's Thyroiditis has a rather long checklist of symptoms.  I had the majority of them including tiredness, depression, hair loss, unexplained weight gain, feeling cold, muscle pain (I would be in tears walking up the hill home from my friend's house), joint pain,  and orange feet...hmm, no idea until I was reading the checklist and yep, there they were!

I was on thyroid meds for a year and mentioned to my doctor that I still wasn't feeling like myself.   She tried to convince me that my levels were almost evening out and I should be feeling better soon but I knew I just didn't feel like myself so I asked to be put on anti-depressants to get me out of my slump and asked her to do further testing into ANYTHING that could be causing me to feel depressed and tired.  She discovered I had extremely low levels of vitamin B12 and vitamin D both which can have side effects of depression and exhaustion.   I started weekly, then biweekly and then monthly shots for B12.  I spent my days when my children were at preschool not exercising or catching up on household chores or errands but driving to my doctors' office a half an hour a way, waiting for a shot, and then driving back in time to pick them up from preschool.   I finally came out of my fog enough to ask if my husband could be trained to give me my shots (why didn't I think of that sooner!  It would have saved me hours of my life!)  After I had been on the anti-depressants for a year and was feeling better from supplementing my B12 and vitamin D I asked my doctor to take me off the meds.   She wouldn't do it before the stress of the holidays (smart doctor!) but in January she took me off and I have been feeling better mood-wise ever since.  I was a neuro-psychology major in college and I will never knock medicine for helping people feel healthy and happy and getting over those slumps in life where our own brain isn't helping us feel the emotions we know we should be feeling in those moments.  

A few years ago I realized I was having adverse effects to gluten.  I saw a functional medicine doctor who did a food panel and found out I was intolerant to wheat, gluten, chicken and lobster.  My inflammation levels were high at 2.6.  We all know inflammation is bad for us but I read more about how it can lead to chronic illness, cancer and alzheimer's disease which my paternal grandmother had.   He asked me to cut out these foods and see if I felt better.  He suggested I cut out dairy as well as I told him how uncomfortable I felt after eating dairy.  I was literally starting to feel nauseous at the mere mention of a Starbuck's latte.  I had had two occasions where one or two beers along with chicken had made me feel completely drunk (as in room spinning drunk and throwing up from one or two beers!)  When I asked my doctor about it he said that if I have leaky gut and I'm eating or consuming foods that I am intolerant to it can make my gut open up and the alcohol flood into my system.  I was giving my body a double whammy with the gluten in the beer along with the chicken.   Cutting out these foods helped.  It definitely did.    A few months later my inflammation levels had dropped to .4 just by cutting out these foods that my body was intolerant too.  I started to feel better.

Until I didn't.   In the Spring of 2015 Rod and I decided to whip ourselves into shape.  I usually focus on my health around my birthday in April, MY new year ahead.  For our 40th I convinced him to run a half marathon with me.  We trained and ran side by side so in the end we ran a full marathon, we just did it together.   By the end of our training my hip was killing me but I pushed forward and we ran the Providence Rock n Roll half marathon in August (thank god it was raining and not 100 degrees!)  We decided the spring of our 43rd year to try a Beach Body program along with their shakes as a friend Wendy from high school was a Beach Body coach and was always on Facebook touting their effectiveness.   We decided to do Shawn T's Max Out program.  It was 30 minutes a day and seemed like a program that would push both of us.    I loved the program but I was having aches and pains in my ankles and joints and found I was modifying all the time and couldn't keep up with my husband or the tape which was very frustrating.  Why was my once healthy body that has always exercised and hiked and roller bladed and run failing me at such a young age?  Was my half marathon training too much?  Why was my body in pain when my husband's was not?  We ran all of our training runs together.  My joints ached.  My achilles killed.  It hurt to just walk up my stairs and sometimes I would yell out in pain just stepping backwards while doing laundry.   I had to get to the bottom of my pain so that I could exercise again.

The fall of 2015 I was miserable.  I couldn't tell what foods I was reacting to but I knew I was spending entire days in the bathroom.  I had to bow out of social commitments, I was nervous to eat and then go someplace because I didn't know how my body was going to react to food.   I had a beach body shake one day in NH, and this might be too much information, but it literally went right through me.  I credit the Beach Body and the shakes for giving me a wake up call.  Something was really wrong with my body and my digestion.  That day I realized how sick I was.  I had to figure out what was wrong with me!

In our annual Yankee Swap I got a book about Mindfulness and kept it despite all the other tempting wine and food gifts.   It felt like something I'd like to read and focus on in the coming year.  Focusing on myself and being mindful in my day to day life, being in the moment with my family and friends, meditating and slowing down.   I also decided I was going to start 2016 with my friend Kates' book called 21-Day Tummy:  The Revolutionary Food Plan that Shrinks and Soothes Any Belly Fast.  It is a book that helps you get to the bottom of what ails your gut and helps you determine what foods you can cut out to feel less gassy, bloated, uncomfortable after eating them.  We all have foods that bug us.  I had given up gluten, chicken and dairy a year and a half before and while that improved my gut I knew there was a piece of my picture that I was missing. I already had an autographed copy of the book in my kitchen and figured what the hell!

When I mentioned that I was going to start her book in January she said "But first I want you tested for SIBO (small intestinal bacterial overgrowth)".   My first thought was "me?"   That was something her patients had who had been dealing with IBS and had been sick for years!  I had issues with food that sometimes made me run for the bathroom, but IBS?   I had heard her talking to patients and mentioning deficiencies in vitamins like b12 and vitamin D and I had both of those.  The more I read about it the more my symptoms matched up.  I had almost all the symptoms, plus appeared to be at such an advance stage of it that I also had malabsorption and fat absorption issues as well.  I also have hashimoto's thyroiditis, appeared to have lactose intolerance, was showing signs of developing rheumatoid arthritis and had been having trouble losing weight which I had never had an issue with before in my adult life.

SIBO Symptoms:
IBS Symptoms
Abdominal bloating (gas)
    –belching, flatulence 
Abdominal pain, cramps
Constipation, Diarrhea, both

Other symptoms
Heartburn (Reflux or GERD)
Nausea

Leaky Gut Symptoms (I prefer to call this Leaky Small Intestine)
Food Sensitivities
Headaches
Joint Pain
Fatigue
Skin symptoms (such as eczema or rashes)
Respiratory symptoms (such as asthma)
Mood symptoms (such as depression)
Brain symptoms (such as Autism)

Malabsorption Symptoms
Steatorrhea (fatty stools)
Anemia (Iron or B12)
Weight Loss

Associated Conditions- see SIBO Diseases for Study links
Acne Roseacea
Acromegaly
Age: Elderly
Alcohol Consumption (moderate intake)
Anemia
Atrophic Gastritis
Autism
Celiac Disease
Chronic Fatigue Syndrome
CLL (Chronic Lymphocytic Leukemia)
Cystic Fibrosis
Diabetes
Diverticulitis
Dyspepsia
Erosive Esophagitis
Fibromyalgia
Gallstones
Gastroparesis
GERD (Gastroesophageal Reflux Disease) 
Hepatic Encephalopathy (Minimal)
Hepatic Steatosis
H pylori Infection
Hyprochlorhydria
Hypothyroid/ Hashimoto's Thyroiditis
IBD (Inflammatory Bowel Disease)
    -Crohn's
    -Ulcerative Colitis
IBS (Irritable Bowel Syndrome)
Interstitial Cystitis
Lactose Intolerance
Leaky Gut
Liver cirrhosis
Lyme
Medications:  Proton Pump Inhibitors, Opiates, NSAIDS Myelomeningocele
Muscular Dystrophy (myotonic Type 1)
NASH/NAFLD (non-alcoholic: steatohepatitis/fatty liver disease)
Obesity
Pancreatitis
Parasites
Parkinson's 
Prostatitis (chronic)
Radiation Enteropathy
Restless Leg Syndrome
Rheumatoid Arthritis
Scleroderma
Surgery:  Post-Gastrectomy

In particular, if the symptoms of IBS are present, or one of the associated diseases along with digestive symptoms is present, consider SIBO.

I decided I would go forward with the test and then could follow her book if I didn't have SIBO.  I had the test last January.  I didn't get a call from the doctor saying whether or not I had it.  I did get a call from CVS saying that I had been prescribed Rifaximin and that they had to check with my insurance company as it is a very expensive medicine ($1000 a prescription!).   I actually asked the pharmacist on the phone if that meant I had SIBO.   A year later I am on the meds again.  Turns out the first round I wasn't prescribed the right amount.  One round doesn't always clear you of SIBO so after extensive tests through a Gastroenterologist (colonoscopy, upper endoscopy, swallowing a smart pill which is a small camera that takes pictures of your entire GI tract) I truly feel like a lab rat!  The good news is they didn't find Chrohn's disease or any other major issues...the bad news is they don't know why I developed SIBO in the first place.  I have had a B12 deficiency for over 10 years.  Turns out I just found out I don't have an autoimmune cause for it.  They always just assumed since I was deficient of B12 at such an early age that it might have to do with my autoimmune issues and labeled me as having pernicious anemia.  They tested me recently and I don't.   All my thyroid issues and anemia and depression issues started postpartum after my third baby.  I was pregnant with her in Mexico and got traveler's diarrhea which they think could be my root cause.   I may have had this for over 12 years.  It explains so much.  My weight gain and inability to lose (despite training for a half marathon, trying weight watcher's, eating healthfully), my fatigue, depression, joint pain, food sensitivities, headaches, and malabsorbtion issues.

At the same time I was getting to the bottom of my digestive issues I reached out to Wendy and asked about a less demanding Beach Body program.  I knew fitness needed to be part of my journey to good health and that walking my dogs in the woods daily wasn't enough.   She suggested 21 Day Fix and 21 Day Fix Extreme.  When I first started I could barely do some of the exercises.  I definitely had to modify.  Some of the moves I wondered if I'd ever be able to do them.  A year later I can say I truly am stronger and fitter.  I have moved on to 21 Day Fix Extreme and now have upped my weights and repetitions for each movement.  There isn't one work out I can't do.  I may still modify in some of the moves but I always start with what I can do and then modify when I'm too tired to move on.  In this way I am able to complete entire minutes of moves I was unable to even do one repetition of last spring.  Yesterday I bought heavier weights.  It's exciting to feel myself growing stronger and looking for more challenges.  I have the DVD's  but right now there is a great deal for all of the beach body programs on demand for $99 for a year so Rod and I might go for it.  There is such a variety of programs and Rod and I really prefer exercising at home.  Plus if we have it on demand we can do the programs in our bedroom, attic, in NH-wherever there is space basically the size of a yoga mat.  Beach Body is a great program because while you are working out at home and often alone it allows you the support of a coach to encourage you to push your limits and many of these coaches also have online Facebook support groups.  They help you keep accountable, have clean eating challenges, set goals for the group, and offer support when you have questions, are feeling frustrated or like you need support.  I posted the following along with the picture below on the page this week:   Cardio fix extreme and 10 min hardcore -Happy & Healthy 2017 everyone- let's get in the best shape of our lives!  Dirty 30 extreme. I usually wipe away sweat before I take pictures but I was thinking about how impressed I was how I've been doing one of the 21 day fix programs for a year and I'm still getting a good workout every time. I have upped repetitions and weights over the year and just do the extreme program now but Autumn, Wendy, Melissa and all of you have kicked my butt into shape and I am thankful!  

For a year now I have been following the Low Fodmap diet. It is a diet that many people with IBS find helps alleviate their symptoms.  It also helps people who have SIBO.  My friend Kate Scarlata specializes in this diet as a dietician and she is also someone who has had SIBO herself so she "gets it!"  https://static1.squarespace.com/static/53ced146e4b0ffc87f7fe427/t/555e7063e4b07f0c9541fd9d/1432252515481/FODMAPS101_handout.pdf
I try to focus on what I can eat rather than what I can't. http://www.katescarlata.com/lowfodmapdietchecklists/
Kate's blog has been an amazing resource for me in terms of new foods I can try, recipes, and lists of what I can and can't have.   I try to plan activities with family and friends that don't involve food (every event involves food!!) which is depressing when you can't eat most of it! I enjoy hiking with friends and my dogs, going for pedicures, seeing movies and just hanging out.  As long as the focus isn't primarily on food!  I can't have onion, garlic and other basic ingredients that are found in most foods especially sauces and dressings.  There is however a lot I CAN eat.  I find I do best when Rod or I cook for me.  I can eat burgers or salmon out in restaurants and I can have salads with olive oil, lemon and salt for dressing.   I have to be careful.  Eating at events and eating out makes me nervous as I don't want to be sick the entire next day.  I have found what works for me and try to stick with it.  This year I hope to expand on the foods I can eat and continue to add foods to my diet.  As I tell Kate it is hard to liberalize your diet and add foods back in because there is never a day where you want to plan to be sick or tied to a bathroom the whole next day.  It is definitely a long road to recovery but I feel like I am on the right path.

The funny thing is now that I know what I can and can't eat I probably eat more than I did in the past.  I have a larger breakfast and lunch than I have ever had in the past and I eat huge dinners and the weight just keeps falling off me.   I'm never sure how to answer the comments about looking good and losing weight.  Apparently I'm sick and have been for the past 12 years and now that I've figured out what is making me sick (bacterial overgrowth in my small intestines) I have a limited diet but that doesn't mean I don't eat.  I actually chow down.  Since I don't eat gluten I often eat twice as much meat as my husband.  Two pub size burgers are not unusual for me to consume for dinner yet I'm still hungry after and I'm still losing weight.  The difference is I am now eating food that isn't feeding the bacteria in my small intestines, producing waste that causes me to have diarrhea, my joints to hurt, and causing excess weight gain.  When Kate saw my SIBO results she immediately said this explains your weight gain.  I am positive for a kind of bacteria that causes many people's guts to produce more calories from the same amount of food by consuming it.  Most of the people that have this bacteria have difficulty losing weight.  I realize getting SIBO under control is helping and that following the low fodmap diet and avoiding foods that increase my inflammation is speeding up my recovery.  I also know that I have worked my butt off this past year (literally and figuratively!) to get in the best shape in my life.   I don't remember ever having ab muscles and if I did they've been hidden under SIBO bloat for so many years I didn't know they were there (many people with SIBO call it their SIBO baby because they look pregnant they get so bloated after eating certain foods!).  I honestly didn't know it was possibly.  Now I proudly show them off (just to my family).   My tweens and teens aren't all that impressed because they have them too!

I feel like this is a bit of a public service announcement to remind ourselves that we know our bodies best.  We know when something is amiss.  We know when we aren't ourselves.  Sometimes we have to be our own advocates and push our doctors for more testing when we feel like we haven't found the answer yet.   It took a lot of digging and a lot of tests and I'm still not sure of the whys and the whens in my story but I am sure of what works, for now.  It might change but I hope that it doesn't.  If a doctor diagnosis you with something make sure you see the tests that document it.  If mine hadn't diagnosed me over 10 years ago with pernicious anemia due to my low b-12, she might have questioned why I wasn't absorbing b12 and we might have figured out that I had SIBO sooner.  Every time I saw my doctor she would say "work on your weight!"  I wanted to punch her!   I was working out, eating healthy, and trying everything!!!! If she had looked deeper into why I was suddenly having issues with my weight when I never had before she might have seen the signs.

I've started the New Year like many others.  Dialing back on treats (although there aren't many I can partake in around the holidays, partake I did!), cutting back on wine (my favorite nightly companion), drinking more water (running around in December doing errands and wrapping isn't conducive to bathroom breaks), journaling (my girls and I are starting bullet journals (BUJO's) this year and I feel like this blog is a form of journaling for me (so thank you to my dear friend Kirsten who encouraged me to start it and questions me when I haven't written in a while!), meditating, fitting in daily exercise (I feel so much better when I take time for my body to work out the kinks and sweat a little- I recently read that Aries best form of stress release is exercise- I believe it!  I feel so more centered and in control of my emotions when I take time to work out!)

I'm off to do yoga after I drink my first of six glasses of water and then heading out to find the perfect bullet journal (BUJO) ...stay tuned!  Wishing you all a healthy 2017!