Emma and the Leaky Gut

While this may sound like a new Judy Blume novel, it’s really just my latest batch of experiments.

In August, when I met with my Case Manager, I was a bit weepy about the verdict of my pulmonologist (Obesity is the root cause of everything), trying and getting sick on a ketogenic diet, and the increasing pain in my knee.  Depression had trundled out the “Hopeless” cart, and I had climbed in.

My Case Manager is a lovely, up-beat, supportive darling, so when she suggested I see a hospital dietitian I felt instant betrayal.  Visions of scales and tape measures goose-stepped through my brain.  But, she asked me to think of this dietitian as someone I might add to my small support system—someone I could talk to and have on my side.  Framed that way, I agreed to meet with her.

In the meantime, I had been visiting my chiropractor for my knee and recurring TMJ.  Over the summer, she heard all about Dr. Obesity, my binge eating disorder, and all my other mental and physical woes.  For good measure, I came down with bronchitis a few weeks ago.  Along with prescribing additional protein powder to my morning shake while I’m sick, she also wondered if I might not have a Leaky Gut.

Basically, this syndrome is caused by a loosey-goosey gut allowing too much junk to pass into the blood stream, setting off an immune response that never shuts down.  Chronic inflammation of the gut follows.  Treatment involves getting rid of foods that irritate the gut and adding foods that soothe and heal it.  Dr. Ash has a quick take on Leaky Gut here.

Being sick with bronchitis turned out to be the perfect time to implement these changes.  Since I’m already lactose intolerant and get a gut ache eating bread, going dairy and gluten free was a no-brainer.  I can add bone broth to my gluten-free chicken noodle soup, eat a little kefir as a snack, and alternate my Breathe Easy tea with a variety of kombucha teas.  And my gut has stopped aching all the time.

I started to wonder:  What if obesity isn’t just a cause, but also a symptom?  What if Binge Eating Disorder isn’t just a mental illness, but also has a physical component?

These are the questions I took with me to the dietitian.

Emma is a sweet, young, cheerful professional, but had no answers.  She had heard of Leaky Gut, but knew nothing about it.  She knew about Binge Eating Disorder, but knew nothing about that either.  However, she was absolutely willing to learn.  She took all the information I brought with me and made copies for herself.  Our weekly sessions focus on what I want and my goals, not weight loss.  She is, as my Case Manager predicted, a wonderful addition to my support team.

My bad knee and intermittent TMJ turned out to be arthritis, no big surprise since my dad was a Bionic Man of joint replacements and—you know—that obesity thing making everything worse.  Whenever I think of arthritis, Mammie from Gone With The Wind pops into my head.

Arthritis waits in its web, swooping in after an injury.  An opportunistic little shithead.

Oh, well I’ll think about that tomorrow.  I have sauerkraut and wild salmon to eat now.  And tomorrow is another day.

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Challenging the Truth

My therapist and I finished the program specific to PTSD in Seeking Safety by Lisa M. Najavits.  Some of it was good, some lame, but one particular exercise moved my whole life in a different direction.

We all have beliefs—things we know to be true.  But beliefs can keep us stuck if we don’t risk challenging them.  In “Discovery,” we take beliefs and create a plan to find out if they are really true.  In my first round of Discovery, I looked at how I believed I was helpless to stop getting lung infections every year.  I did two things to test that truth—I hired someone to come clean my apartment once a month to see if getting rid of dust on a regular basis would help, and I arranged to see a pulmonologist.

The effect of better housekeeping won’t show up for a while, but the pulmonologist I saw a week ago gave me some straight dope.  It’s doubtful I even have asthma (though I went through more testing earlier this week to be sure), and aside from anemia there was only one other cause for all my physical symptoms.  Obesity.

When I read that in the doctor’s report, I phased out for a bit.  Dissociated is the clinical term.  The brain protects itself by going bye-bye (My experience of dissociation feels like I’m about to faint—my hands and feet go numb, I can’t hear, and I lose time).

There’s something about food, dieting, fat and binge eating that feels too horrible to face.  If I thought I felt helpless about my lungs, the belief is multiplied a thousand fold around controlling my intake.  I can’t control it.  I never have been able to control it.  I firmly believe I never will.

But, I also knew the doctor was right.  I used to be a nurse.  I still remember a little physiology.  Increased risk of infection, higher blood pressure, skin breakdown, joint pain and damage can all be hitched to the Obesity Train.

So, I went back to Discovery, because I’m very stuck in these beliefs around food.  I talked to both Megan, my therapist and Sarah, the nurse practitioner, who are my mental health team.  We drew up a plan to test my truth, and I decided early on to say, “yes” to whatever they proposed.

Sarah suggested I try switching to a low carb/high fat diet (one diet I’d never tried).  It seems counter-intuitive, and feels really weird, but I’ve been doing it for four days now.  After eating vegan for a couple of years, it seems wrong to buy sirloin and pork cutlets.  But, I’m doing it.  I still feel like I have the flu—urpy, roiling gut, drop-dead exhaustion—but I was warned about this “adjustment period” as my metabolism switches from burning carbs to burning fat.

The compulsion to binge eat is still there, but there’s not much to binge on.  It seems easier (at least in this initial phase) to go do something else.  But, I hate the way food feels in my mind.  It’s like a rubber band that’s stretched too tight.  I don’t know that I’ve ever noticed that before—the discomfort, the pressure, the tension.  I’m seeing how I seek to be numb where food is concerned—something to explore in therapy.

I will lose weight, I always do.  It’s just that I’ve never kept it off and usually gain back more.  This feels like my last chance to figure it out.  I would love to have a toolbox for Food as comprehensive as my toolbox for Bipolar Disorder.  Pretending the problems don’t exist isn’t much of a tool.  Neither are the industry standards in nutrition.  As Sarah said, “We have to do more than think outside the box.  We have to create a whole new box.”

They’re both doing this low carb diet with me, and when I go for my appointments, we’ll do them walking around the block.  I feel like there’s a chance we could actually create something new.

Life is never what one dreams.  It is seldom what one desires, but, for the vital spirit and the eager mind, the future will always hold the search for buried treasure and the possibility of high adventure. — Ellen Glasgow

Fat Girls Rock

I swam 30 laps in the Y pool yesterday.  Fat girls rock.

SoulCollage card "The First Way"

SoulCollage card “The First Way”

Old Song

Uplifting Songs

The bronchitis has run its course, but the wake of bipolar ping-ponging still bounces me.  And I’m desperate to find some equilibrium.  Looking at my journal entries from last year around this time, I was a little shocked to see that I’m repeating myself.

From last year:

Kind of back to normal.  I’m still not sleeping well.  Just want to curl up in my chair and watch back-to-back movies.  Feels like I’m starting over after being sick.  So maybe I should look at what I want my life to be now.  What do I want to focus on?  Work toward?

I could have written that yesterday.  It makes my ass tired to think I’m back at this place.  Every time I get sick, every time I go through a long episode of mood swings, I have to pull up my socks and refocus.  I’m always battling my weight and compulsive eating, my inertia, my disappointment in absent friends.  BlahBlahBlah.  I’m sick to death of this same old song.

My TOPS membership will be due in December, and I decided not to renew.  I’m also resigning as the Weight Recorder.  Now I know that making decisions under the influence of bipolarness is unwise.  I also recognize this throwing in the weight loss towel as part of a different cycle.  I give up, say I’m going to accept myself the way I am, gain weight, panic, and go back to trying to control my eating.  So I fully acknowledge that these decisions are sick-brain-driven and, most likely, temporary.

But, I would like to accept myself the way I am.  I would like to, once and for all, let go of the fantasy that I can lose 150 pounds and be at all desirable to the opposite sex.  I’m not hideous.  I’m just an obese, middle-aged woman on the way to crone-hood.  I want to accept that and find some happiness in THAT, not wait for a body or a partner that are never coming.  I mean, I went to freaking England by my fat self and had a fabulous time.  I don’t want to wait anymore.  For anything.  Or anybody.

And I guess I’m grieving that old fantasy, both embracing the full truth of who I am and pushing it away.  But the more I can wrap my arms around myself, the braver I’ll be about going after what I want.  Like deciding to spend two weeks in Tucson this winter.  I’m renting a little house on the desert because I loved Tucson twenty years ago when we vacationed there and have always wanted to go back.  Because my allergist said I would do better in a warm, dry climate.  Because my shrink said to get out of the dark this winter.

So, I’ve been taking my cats on practice runs to get them used to being in the car for long stretches.  Because I want them with me in the desert.  And we’re figuring it out.  Like I’m figuring me out.  And we all may get car sick on the way.  And we all may cry, and mew, and protest.  But at least that’s a new song.

Back to Work

handmade greeting cards, collage artI just finished reading Fat City, an article by Dr. Karen Hitchcock about the convoluted problem of obesity (Thanks to David Kanigan for leading me there).  It’s a long article, but worthwhile.

My main take-away is that there are no easy answers to obesity.  I knew that.  I’m proof of that.  But the article made me want to try again.

Like everything else in my life, I swing to extremes with weight loss.  I either set unrealistic goals and hate myself for not meeting them, or I stop thinking altogether and ride my compulsive eating into the sunset.  I’m swinging back from that mad gallop, but I’d like to find a place in the middle.  I don’t like the self-loathing, hot, itchy drive to be something else any more than I can stand the free-fall gobbling.  I have no idea where that place is.  I’ve never found it before.

I’ve learned a lot this past 18 months.  I made it my mission to understand my compulsive eating, to stay awake as much as possible through the binges and the cravings.  I studied the connection between my eating, loneliness and watching TV.  I marked how a vegan diet made my body feel.  And I watched the extremes of my bipolar disorder wink my Will out of existence when I thought it was firm.  I learned a lot but, as my friend Marshall is fond of saying, understanding is highly overrated.

I still can’t control the life-or-death compulsion to eat when it takes me.  At times I can temper it, make less horrible choices, but I’ve never been able to deny it altogether.  So, no matter how many good choices I make in a day or a week, the compulsion can wipe out the benefits in a few hours.

So, okay.  That’s my Constant Companion.  Maybe I can make friends with it.  Maybe I can work around it.  Maybe I can find some compromise that will satisfy both of us.  I have no idea.

What I will do today is pull out my food journal again and write down what I eat.  I’ll resist.  I’ll forget.  But this is one tool that seems to help.  We’ll see.

As always, I’m on an Adventure.

Zero Sum Bad-Assery

hand made card, collage artI happen to be a Libra.  And bipolar.   The irony of this tickles me no end.  While the Libra part of me strives for balance and harmony, the bipolar part makes sure that doesn’t happen.  It’s a conundrum, really, this constant, internal tug-of-war.  I feel like a mother with two teenage girls who share a bedroom.  Please just give it a rest, kids.

But, I think it’s the Libra part of me that keeps the bipolar part from overthrowing the entire Sandy government.  Take my current Zero Money Initiative.  In my quest to save money for a new car on a Disability income, and to practice some deep Work with my compulsive spending, I’ve tallied 31 days of success.  I’ve put money in the bank and not used my credit card once in that time.  Huge success.  Huge.  The only problem is I’m eating everything in sight.

I get the psychology of this—concentrate on one compulsive behavior and the others will flare—and I’ve tried to be gentle with myself about it.  Take away too many coping mechanisms and the stress could trigger a total meltdown (I can hear Scotty now—”Cap’n, she’s gunna blow!”).  I figured I was doing well to be cooking all my meals at home when, for so long, cooking created enormous anxiety for me.  No take-out, no restaurants—I was saving big money.  I also continued my vegan diet—quadruple portions, but vegan portions.

bowling ballThe sorry fact is that I’ve gained back 17 pounds.  That’s the weight of an average bowling ball.  Pick up a bowling ball sometime and carry it around all day.  Granted, I’m still carrying the whole tournament, but one less ball makes a big difference.  On the joints, on self-esteem, on buttons and zippers.

I really don’t want to continue this slow creep back to 300 pounds.  I’ve worked too hard to whittle that down, and still dream of the day when I can claim to be simply “obese” instead of “morbidly obese.”

So, it’s time pull out the old tools that have worked in the past.  I dusted off my Food Journal yesterday.  And my calorie guide.  And my food scale.  Even if I continue to compulsively eat, at least I’ll document accurate information about what I’m consuming.  I can’t change something I can’t see.

I’ll go back to eating my meals at the table instead of in front of the TV.  I may have cancelled my cable, but I can still watch movies on the DVD player.  And once I start eating in front of the TV, the grazing can go on for hours.

As always, it’s a matter of attention.  I’ve focused so much on Ninja Tightwaddery that I didn’t think I had any left for Sane Eating.  But, I have to try.  It’s the Libra in me that won’t let the chaos go on forever.  It’s the Libra that wants to pull both compulsions onto her scale and find what will balance them.  The bipolar part will play merry hell with Her, but that’s to be expected.  Let them scream at each other—I’ve got Work to do.

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