The Thing About Trigger Foods

I have frequently advocated the value and benefit of keeping a symptom journal to help identify your personal set of trigger foods. These are specific foods or types of foods which cause your IBD symptoms to worsen. During the height of my flare up, I could not eat any spicy, acidic, dairy, fried, gassy, fibrous or caffeinated foods. The list of things I couldn't eat was longer than than the list of things I could eat. It was very difficult. Now, while I am in remission I can eat most things other than very spicy foods or much dairy.

Your list of trigger foods will be very personal to you and your form of the disease. No one can tell you which foods will cause you problems, you have to test it out yourself.

I have spoken often to other IBD sufferers and read many of their stories. I've also received several comments on this blog about food. Over time I've realized that many people have no idea what their trigger foods are. Worse, even more people know what they are, but continue eating them anyway. I find this very surprising and a bit sad.

I personally feel that most doctors and patients don't realize what a drastic impact trigger foods have on IBD and the quality of life for those who suffer with it. While a special diet will not cure your disease, it can greatly help with your quality of life. Avoiding your trigger foods can reduce your trips to the bathroom, ease your fatigue caused by frequent bouts of diarrhea, reduce gas and abdominal pain, and possibly reduce the irritation to your digestive tract. With all these benefits, why keep eating them?

Removing trigger foods from your diet requires extra work. I ended up having to cook a lot of things from scratch in order to avoid the ingredients in many store-bought packaged foods. I also had to pay extra attention to ways of getting the nutrients I might be missing due to a restricted diet. I took a multi-vitamin and consulted with my doctor about what I was doing. It was also recommended to talk to a registered dietitian about helping me to build nutritious meals around my restrictions.

I strongly believe that my strict attention to what I ate, allowed me to continue to live an uninterrupted life even while suffering undiagnosed with Crohn's Disease for 10 years. I did have frequent struggles with multiple daily washroom visits, but it never became an overwhelming number of washrooms visits and didn't interfere with my career or life very much. Sadly I wish I had been diagnosed sooner, because my digestive tract was being damaged over those years because I was not being treated, resulting in needing surgery. However, combining active treatment for your disease plus a careful diet is probably better than treatment alone.

So, next time you reach for a piece of pizza or cup of strong coffee... consider whether the short term benefit of it will be outweighed by the symptoms you'll get. Consider if there is something you can eat instead. What about some decaf tea, or baked chicken casserole? I see you're still reaching for that spicy taco... don't say I didn't warn you!

Take the IBD Trigger Foods Survey: http://www.surveymonkey.com/s/7HDTNFK so we can see what other people with IBD have learned about their trigger foods. Thank you!

Small Bowel Resection - 1.5 Years Later

A year and a half ago I had about 30cm of my terminal ileum (small intestine near where it attaches to your colon) removed due to severe inflammation and damage from my Crohn's disease. This section was causing me pain, chronic diarrhea and had started developing fistulas. After discussions with doctors and weighing the options I decided on surgery rather than stronger drugs, because I wanted to be drug free and feeling well when I started a family.

Well here I am a year and a half later. I feel wonderful, energy level is up and I can eat almost anything except dairy and very spicy foods. I'm currently on no medications. I consider the surgery to have been a success and I'm happy with my decision.

I am left with a "C" shaped scar hugging around my belly button and two other tiny ones due to the insertion of the cameras - the surgery was done laproscopically. I also have a separate scar where an abscess was repaired. These have healed well and while my stomach will never look as nice as it once did, I consider my scars to be badges of honour, reminding me of what I've been through and how lucky I am. I'm not ashamed of them at all.

I don't experience any daily pain related to my Crohn's. I sometimes have little twinges that spark old worries but that's usually when I've been eating a ton of high-fiber foods (or beef). I seem to be extra sensitive to the goings on in my abdomen - though I think all of us with IBD are much more aware of what's happening in that zone. With my current pregnancy things are stretching and shifting causing all kinds of new sensations so it is now hard to tell if a twinge of pain is from Crohn's or the growing baby and the muscles surrounding it. I'm leaning toward the latter since it occurs on both sides.

I'm happy with my decision because in the last 18 months I've done so much without needing drugs - went on a cruise, got engaged, bought a house, got married, and became pregnant. whew! This would have been a much less fun journey if I was still in pain or on a restricted diet. I have also left the infusion type drugs as an ace in my back pocket if my IBD comes back. My doctor and I are now aware of what's going on (instead of shrugging it off as IBS) and I can get right in for the appropriate tests if I notice any new diarrhea, pain, or other symptoms I know so well. My hope is that if and when another flare-up arrives I will be able to catch it before it does as much damage as the last one did.

It's not recommended to take drugs like Remicade while pregnant, and if you stop taking it you can develop an immunity to it. So I'm glad I chose surgery and saved this option for the future, ideally after I am done having children. Hopefully I'll never need it, but the option is still there.

The experience of the surgery and recovery was intense and sometimes difficult. There was also no guarantee that the inflammation would not return immediately after surgery in the same location. However my last colonoscopy showed everything looking pretty good so I am going to live life to the fullest, eat healthy foods and stay positive.

If you are considering surgery for your IBD, talk to your doctor and to a surgeon before making the decision.

Crohn's Disease and Considering Pregnancy

The decision to have a child is a big one, huge actually, and when you have a chronic illness such as Inflammatory Bowel Disease your decision can be clouded with extra uncertainty. Here I present some advice and tips to help get you thinking.

When I mentioned wanting to be sure "everything was ok" before trying to get pregnant, both my family and my doctor thought I was being too worried and their advice was that "when you and your husband feel ready, then you're ready." That caps off everything I'm going to say today and is the most important advice. Only you can decide when you're ready so follow your heart, talk it over together and make sure the decision is right for you.

If you're like me however, you might smile at the touchy-feely advice and then look for something a bit more helpful. I'm laughing as I type this but, yes indeed I'm geeky enough to want to put some logic to such an emotional decision. Here are some tips and suggestions you might consider.

- Try to wait until you are in a remission period. If your Crohn's Disease is newly diagnosed or tends to come and go periodically, it might be a good idea to see if your doctor can help you achieve remission before you start trying for a baby. Don't wait forever though, if you are still in a flare up but your doctor advises you are safe, then go for it.

- Women who are in a flare up before getting pregnant tend to stay in a flare up or get worse during pregnancy. Women who are in remission tend to stay that way during pregnancy. Many women report feeling their best ever during their pregnancy. Either way there are always exceptions.

- Try to achieve a healthy weight before conceiving. If you are underweight due to a recent flare up, try to gain back up to your ideal weight. Being over or underweight can adversely affect your fertility. Being underweight often goes with malnourishment which can affect your baby.

- Quit smoking as soon before becoming pregnant as possible to ensure those urges are well behind you. Quit drinking shortly before you start trying to ensure you don't inadvertently drink while pregnant.

- Ask your doctor if any medications you are taking are safe for pregnant women. If not, see if your doctor can put you on an alternative therapy or pause a drug during your pregnancy.

- Begin taking pre-natal vitamins with Folic Acid at least one month before you start trying. Dispose of any old or unused medications at the pharmacy because these can be dangerous for you and for children.

- A bad flare up can result in malnourishment. Start eating a well rounded nutritious diet of healthy foods. Consider asking your doctor to do a blood test to ensure you are not low on any nutrients. A dietitian can help you work out a menu that will be nutritious and won't trigger your symptoms (as much).

- Ensure that you are fully healed from any recent surgeries and that you get the all-clear from your doctor or surgeon.

- If you've had abdominal surgery or a large number of x-rays, ask your doctor for advice on whether you should be concerned with that. Ask your doctor if he or she recommends an Ob-Gyn who is familiar with the added risks that IBD can involve.

- Get some exercise. A flare up can cause you to limit your physical activity. Now is the time to get back into it and improve your over-all health.

- Clean out your life. Get rid of junk, simplify the demands on your time, and streamline everything you can. The less stress and strain on you the better you will do during your pregnancy.

- And finally, the best advice is that no one can tell you when the time is right. You and your partner need to make this decision together. Don't let hurdles or fears get in your way of trying to have a family if that is what you want for your life.

Good luck!

• Web MD Article on Crohn's Disease and Pregnancy

Life Is Beautiful

There are some moments which stand out as particularly wonderful, like when your Gastroenterologist releases you as a patient back to your family doctor because you're doing so well (happened yesterday).

And then there are moments which make the sun moon and stars look dull and uninteresting in comparison. Such as... when you and your husband both look at the ultrasound monitor and see your baby for the first time. Yes, I'm excited to announce that I'm 3 and a half months pregnant!! I was going to wait longer to post the news here, but I've been repeatedly moved by my fellow blogger Kathryn's inspiring and beautiful posts on her journey. I also figured it would be valuable to write future posts covering Crohn's Disease and pregnancy. Everything has gone smoothly so far so I'm losing some of my what-if-something-goes-wrong fears. Some. So I just can't hold it in any longer!

I'm feeling very good so far and everything up till now has checked out. I am not on any medications other than vitamins and already my belly has out grown almost all of my pants. I'm currently in dress-pants for work which have the button held closed with a hair elastic because I can no longer do them up! Apparently when you have been the same size for 15 years... you don't have much flex in your wardrobe. I might have to switch to maternity pants by month 4! *laughs*

So, that's my news... more personal stories and informative posts to come.

People Are Disgusting

I recently arrived home from a week long vacation to Florida. We had a lovely time in Disney World (it was our Honeymoon) and we visited several parks, saw some great shows and ate at some fantastic restaurants. We had a blast. The trip gave me the opportunity to visit more public washrooms within a 7 day stretch than ever before. My long planned rant on the failure of public washroom design will be a forthcoming post, but today I've decided I just can't keep silent about the horrific habits of people.

Disney does its best to keep its facilities clean. I often saw employees cleaning, sweeping and checking on restrooms and some of them it seemed had a permanently stationed employee cleaning all day long. It's still not enough to keep up with the pigs out there, and they must - I've determined - exist in frightening numbers.

Un-flushed bowls, sprayed seats, garbage on the floor and pure filth were some of the treats I experienced. It's not just at Disney, it's everywhere I go, but this week I experienced so much of it that I've pretty much snapped. I estimate that when I use a public restroom, there is a 70% chance that I will have to wipe off the seat as the first action when I arrive in the stall. Who are these women who do not look back after 'hovering' to see if they've left a mess for the next person?? I'm utterly shocked that I am in the minority that I always make sure to leave the stall tidy for the next person. Manners and hygiene are qualities of LESS than half of us!? Insane. I wonder if this happens in the mens' washrooms too?

I really think that if you belong to this group of people you should be ashamed. Thank you for leaving your mess behind for me to clean up. Would you do this in your own home? Just because a restroom is public, it's not a license to turn your brain off and act like a pig. My work place struggles with this problem as well. Countless memos have been circulated and notes posted in the women's washrooms pleading for considerate behaviour and yet I have a number of co-workers who intentionally clog the toilets, fail to flush, drop entire rolls of toilet paper on the ground and generally make a mess. If you hate your job so much, please just quit. Sometimes I dream about identifying these people by their shoes and coming to the defence of my employer- I work for a company which treats their employees well, is flexible, offers benefits and throws staff lunches and events for fun. The disrespect shown is baffling.

Sadly I know this won't change, but I had to vent. It is frustrating for the rest of us, especially when you suffer from a condition like IBD where sometimes in an emergency the extra time to clean up after others can feel like an eternity. It's such a shame.

While on the topic of washrooms and people, can someone explain to me the purpose of a washroom valet. An employee stationed in the restroom who hands you towels or little perfumes then expects a tip. To me it just feels like an intrusive witness to my private restroom activities. Nor will I ever dig out money while in a washroom just because you happen to stick an employee there. It also seems like a terrible job. Free these people- it's time to do away with the antiquated tradition.

The Truth About Soy

I pride myself on being somewhat of a scientific thinker. I try not to jump to conclusions or believe every little thing I hear. However, even I have started to fall for the persistent rumors about the 'dangers' of eating soy. Well, little did I know... there is absolutely no scientific proof about the so-called risks of eating soy. No peer reviewed studies. No body of factual evidence. Just rumors started by an organization which just happens to have many members who are meat and dairy farmers. Hmm.

Read this article about the issue here: http://zenhabits.net/soy/ which has a lot of links to further info and studies and decide for yourself. But as far as I'm concerned, Soy is perfectly safe.

This is important for people who are on restricted diets, because soy is often a good tasting replacement for many problem foods.

Crohn's Disease Tips For People In Remission

There are many articles and strategies geared toward achieving remission when you are in a flare-up, however there is not much information to be found on what we should do when we are currently in remission. How do we take care of ourselves aiming to maximize the length and quality of our remission period, and how to make the most of it. I've been doing some research into this topic and here is my list of suggested tips and strategies.

The number one suggestion is and should always be to talk to your doctor and find out what he or she suggests. Are there maintenance medications you should take? Vitamins you should be taking to augment absorption problems? Ask a professional first and foremost.

Avoid alcohol and tobacco. These substances irritate the intestinal lining and can degrade your overall health.

Try to attain a healthy body weight. If you are thin, it might help to have a few extra 'insurance' pounds. If you're overweight, try to focus on a healthier lifestyle to help your physical and emotional health.

Eat healthy, fresh, and nutritious foods. Remember that restricted diet you were on for so long? You missed out on so much. Go for the nutritious foods and a few of the treats you missed out on. Pack on the vitamins and minerals you may have been lacking. Your doctor may advise the value of taking probiotics as a supplement. You'll feel better and your immune system will thank you.

Tackle large or important projects or goals. Remember all the things you wanted to do when you were in a flare-up and unable to contemplate getting off the couch? Now that you feel well it is too easy to push things that you recognized as important onto the 'later' pile. Don't! Grab those projects and goals and throw yourself into them. Create! You'll regret it if you don't. It will also give you a needed sense of well-being and accomplishment to achieve your goals; even if it's as simple as putting up that bird house that's been in the garage for a year.

Detoxify your life. We don't know the cause of Crohn's Disease or Ulcerative colitis, but the medical community is starting to suspect genetics combined with environmental factors. We can control our environment so it can't hurt to give that some attention. Try to incorporate more wholesome, fresh, organic foods, and natural cleaning products and cosmetics.

Simplify your schedule and your relationships. You don't have to say yes to everything, and due to the cyclical nature of IBD, you need to streamline your life to get rid of any un-needed or un-wanted obligations, tasks, meetings, etc. Do you have friends or family members who are always negative and toxic? Reduce your time spent with them and focus on the people who enrich your life and create happiness around them.

Minimize your stuff. Extra belongings and junk can clutter up our homes and offices and create a burden on us for cleaning, organizing and just living. Begin a thorough sifting of your belongings and get rid of things that you don't need. If your IBD flares up again it can be a blessing to have fewer things to clean and think about. In the future when we pass, it will be a blessing to our families if they don't have to process room upon room of cutter. Simple surroundings help us have time, energy and focus for what's important.

Get some exercise. While there may not be a link between IBD and lack of exercise, exercise does contribute to your overall health. Months or years of being inactive can take a drastic and hidden toll on your body. Now that you are physically feeling well, treat yourself to some movement! Run, dance, kick-box, take the stairs, hike, play a sport, wrestle the kids, walk the dog, anything at all is better than nothing.

Create awareness of IBD. Consider volunteering or donating to support IBD awareness and the search for a cure.

Remember that you're in remission. Let that thought remind you to appreciate this blessing. Squeeze the most out of every moment in life, and don't sweat the small stuff. Make the most of your current situation. Live fully and with enthusiasm.

Starting A New Married Life

Last Saturday something awesome happened. I got married! We had a beautiful day full of love and friendship, and I married the man of my dreams. DH is fun, handsome, smart, creative and amazingly supportive. He stood by me during my bad flare up that happened last year and was by my side through surgery and hospitalization. He takes some of the stress out of having Crohn's Disease by joking about it with me and making up teasing puns based on digestive terms. Having the right person in your life can make all the difference.

My life is slowly evolving and I am trying to move from a goal and to-do list obsessed busy person, toward pursuing a life style and outlook that is healthier and happier. I am kicking off a long term adventure of learning how to garden, since our new house has a lot of gardens and lawn, and I love working outside. I am also moving a little bit (baby steps) toward Minimalism and trying to simplify my possessions, obligations and tasks.

Hopefully children are in my future and we are looking forward to experiencing our house when the weather warms up - opening the windows and enjoying our sun-room and pool. Now if only the weather would co-operate. It's at the freezing mark today.

On the IBD front, I have an appointment next week with my GI to get the results of my colonoscopy. I've been having some pains so I am looking forward to getting some answers.

Simplification Changes Everything

I received a comment from a new reader and as I sometimes do I followed her profile to her own blog. There I read a familiar story. Someone struggling to take care of kids, family, social obligations, a relationship, pets, errands, chores and more, all while dealing with the pain and fatigue of Crohn's Disease.

As I wrestle with the emotions brought on by my own resurgence of faint Crohns-y pains (it's been one year since my surgery and I had a follow up colonoscopy last week; I should get results in a few weeks) and remember how drained I felt during my flare up a year ago, I ask myself what the solution is to lives that need us to be active and busy, but bodies that need extra rest and care. I've struggled with this question for a while.

I haven't found The Solution, but I have found a solution. Taking the first steps on this path has already started changing my life.

I don't normally endorse products, services or programs on this blog, so when I do, I take it seriously. Today, I am talking about a book, even better, a free book, a blog by the author and a philosophy about a way of life.

I started by stumbling upon this blog: http://mnmlist.com which contains posts about Minimalism. I then found the author - Leo Babauta's other blog: http://zenhabits.net/ and then his book: Focus, which you can read and download for free without restrictions here: http://focusmanifesto.com/.

I have read the whole book and am making my way through his blog posts. The man has a point. A good one.

While I'm not saying we should all get rid of all of our belongings and live in empty rooms, I am saying that we pile way too much 'stuff' onto ourselves. Too many junk belongings, too many obligations, too much work, too much TV, too much stuff on our plates. What happened to saying 'no'? What happened to actual living?

What if you didn't have so much junk to clean and organize? What if you didn't have obligations every evening? What if you said 'no' to working on the weekend? One step at a time.

I've started on this path already. I am gathering bags of belongings to donate or sell. I'm starting by setting the bar very low. If something has not been touched, used, or looked at in over a year AND if it does not evoke any memories or actual emotional connections then I want to get rid of it. This is very hard but I'm starting with one step at a time. I'm also simplifying my projects and learning to say no to things I know I won't enjoy. It's a process but it's making a difference.

What if you had less to worry about, less to do, less debt, and less to clean? What would you do instead? Have fun? Rest? Spend time with family? More is crushing us, less is better. Simple is good.

Interested in reading the Zen Habits book?

Canadians use:
Amazon.ca

Washroom Access Laws and Resources

When 1,400 people were asked to answer the CCFC's bathroom access survey, the results revealed that about three-quarters of IBD sufferers avoid leaving their homes during a flare up due to unpredictable access to washroom facilities. (Source: CCFC.ca) These numbers throw a spotlight on the number of lives being restricted or limited due to something which seems so fixable - washroom access.

In both Canada and the USA this issue is being addressed and people are finding solutions. The CCFC has released a new web and mobile phone application called Can't Wait (http://www.cantwait.ca/) which helps people to find and report on public washroom available across Canada. In Washington, bill HB1138 has passed which mandates that businesses provide emergency washroom access to people with bowel disorders. That's a start!

While I have never been denied washroom access when I needed it, I've also never had to explain my condition or state that it's "an emergency" in order to get access to a washroom that's not otherwise available to the public. I'm not sure if I could really get past the shyness enough to do so. Could you? I find it alarming that people are staying home and missing out on life due to fears around washroom access. Let's encourage each other to get out there, be brave, and insist on using the washroom if necessary. After all, in many places the law is on our side, and in others, society is moving in that direction.

A New Year, A New Life

I say farewell to 2010 with some mixed emotions. I'm saying goodbye to a huge flare-up, major surgery, pain and sadness. However, I'm also saying goodbye to the year that saw me go on a cruise, get engaged and buy my (our) first house. 2010 was very transformative for me.

2011 promises to be a big one. My wedding shower is this month, and the wedding is in the spring. We're also taking a small trip to New York with my soon to be husband's job, and then a honeymoon possibly to France in the summer. Whew! I'm excited and impatient, and stressed! I can't help praying that my remission remains long enough for us to do all these things unencumbered. I can’t believe how much work goes into planning a wedding. It’s insane. It will almost be a relief to have it all done. I don’t want to wish away a time in my life that will only happen once, so I’m trying to relax and take it all in.

I will be planning to have another Crohn’s / IBD online chat soon. Let me know if you are interested and I’ll add you to my list of people who get emailed about them.

It’s been a while since I’ve made an actual informative post about Crohn’s Disease, so I’ll be working on that next.

Happy New Year to All!

Good Luck in 2011!