Was it all Celiac to begin with?

November 16, 2019

The earliest potential Celiac symptoms I remember began when I was 12. The first time a doctor suggested that I go gluten-free I was 32. Hmm. A bit of a problem there?

I went to the doctor for the extreme constipation I had as a child. I drank a lot of disgusting prune juice and still had rare, difficult, painful poops. Eventually that seemed to resolve itself. End of discussion.

A year or so later I had unexplained joint pain. I was told it was tendonitis for a long time but even the doctors had to admit that didn’t seem to fit the type of pain I had. I was told to wear braces on my wrists. The pain came and went. They didn’t know what else to do. I spent many years trying to figure out this pain but as far as they were concerned, the discussion was over.

As a teen I had horrible stomach pains, nausea, and diarrhea but had no idea how abnormal this was and told no one for several years. Eventually I did talk to a doctor. I asked to be tested for lactose intolerance. I was told there was no such test (a lie!) Instead, the doctor told me to keep a food and symptom journal. After a few weeks I gave him my notes. He told me that he showed it to a nutritionist and that it wasn’t lactose intolerance. End of discussion. No further examination of my obvious problems. A few years after that I was diagnosed with irritable bowel syndrome. I did some research and saw that my symptoms didn’t quite align with IBS, but it was the only diagnosis I was given, so I went with it.

Later in my teens I was far too thin. I occasionally skipped dinner. I was diagnosed with anorexia despite the fact that I ate breakfast, lunch, and snacks every day, I only skipped dinner 2-3 times per week at most, I had digestive problems, and I was so alarmed by my own weight loss that was the one who went to my parents with a concern that something was wrong and asked to see a doctor. The doctor put me on a high calorie diet. I eventually gained a little weight. End of discussion.

Around this time I was diagnosed with depression. I was sent to therapy that did nothing. I was put on anti-depressants with horrible side effects. After less than a year I was taken off of the medications. The depression was magically gone. End of discussion.

And lest anyone think that my medical history fell through the cracks, all of this occurred at one medical facility, where all of the doctors could see all of my records. How did they all miss this?!?

Was this necessarily Celiac disease? No, of course not. But when a child has constipation, diarrhea, weight loss (I was down to 89 pounds! I’m short, but I should never have lost that much weight – I should have been at least 100-105 at that point), joint pain, depression, nausea, stomach pain, and more, how did they not at least consider this possibility?!? This was the 1990s and while Celiac wasn’t as well known then as it is today, there was plenty of awareness. The doctors should have known.

An interesting thing has happened in recent weeks. After some time on hydrocortisone, my brain fog has been lifting and I am thinking more clearly. I have less fatigue. With that layer of haze lifted, I can better feel and understand what is happening with my body. I can think it through more clearly. And I wonder if maybe all of my problems actually stem from Celiac disease.

As regular readers of this blog know, I have a long list of diagnoses. But the thing is, a lot of them are comorbidities with Celiac. Many others are known to be secondary or tertiary issues. For example, I have polycystic ovary syndrome, but after many years of struggling with PCOS symptoms, they finally went away once I was on a proper dose of the right thyroid medication and fully gluten free. I now get my period at least every other month and I rarely have super heavy bleeding. I was recently diagnosed with SIBO, but it’s known that small intestinal bacterial overgrowth is more common in folks with Celiac. My digestive issues, aside from some SIBO symptoms, have all completely resolved now that I am 100% gluten free. I still have constant joint pain, but it has improved greatly thanks to treatments and, I suspect, being gluten free. My adrenal fatigue, one of my most disabling conditions, was caused by long term chronic illness. My Hashimoto’s thyroiditis is a comorbidity with Celiac.

All of this makes me wonder, what if I had been diagnosed with Celiac at age 12 (or younger)? If I had gone gluten free back then, could this have been avoided? Maybe the joint pain would have resolved. Maybe Hashimoto’s would never have developed? Mostly likely, if the Celiac and Hashimoto’s (if I even had it) had been treated properly to begin with, adrenal fatigue would have never begun. That means I would have never become too disabled to work.

That’s hard to think about. This was avoidable. Somewhat. I would still have had problems, of course. I would still have had to avoid gluten, which would have probably been a lot harder as a child in the 1990s than as an adult in the 2010s. I would have still gotten glutened and had to deal with the fallout. I would still have had autoimmune disease and would likely have had some fallout from that; some folks with Celiac feel fine, but others don’t. My health would not have necessarily been perfect. But it would have been a lot better.

This is only speculation of course. I can’t be sure that all of my health issues stem from Celiac. Over the years I have had several other theories about how my health issues all connect. Each one has felt closer to the truth, and this one does as well. I don’t know if I’m right, but I suspect that I’m at least close.

We need better screening here in the U.S. and around the world. Estimates of folks with undiagnosed Celiac are high, as much as 90%. I don’t want to see others live with what I have had to live with if it can be avoided. And I’m one of the lucky ones; some folks die from undiagnosed or late diagnosis of Celiac. If you or someone you know has several of the 300+ Celiac symptoms, please consider testing. You can see a shorter list here, but it is missing a lot of categories. And if you have experienced something similar to what I have described, please comment below. It is important to gather these stories in order  to highlight the need for more testing and awareness.


When even the good things cause stress

October 27, 2019

The thing people forget is that even good things cause stress. Like the party I recently threw.

We talk about stress as an emotional condition that’s bad and must be reduced. That’s not untrue, but it’s not the full story, either. When it comes to adrenal fatigue, all stress can be a strain on the body. I explain it to people by saying that winning the lottery could make me very sick, and I believe that’s true (not that I’ve had the chance to find out, unfortunately.)

We overlook that there are different kinds of stress. There’s emotional stress and physical stress. There’s stress from good things and from bad things. Obviously I would rather have stress from winning the lottery than from the death of a loved one, but my adrenals will suffer either way. They just can’t produce the necessary hormones to handle the stress.

I feel it if I don’t get enough sleep, if I walk too much, if my body is inflamed, or if I’m dealing with some other form of physical stress. When the stresses are both emotional and physical, it’s especially rough. That’s what happened earlier this month. Several friends and I threw a surprise party for a friend. The party planning was stressful. Then the night before, I slept horribly. Some of it was from worry over the party going well, but a lot of it was from pain, probably due to the rainstorm we had. I also had a friend staying with me for the weekend, since she came from out of state for the party. I was thrilled to have her visiting me! I love her, we’ve been friends for 30 years, and I wanted to hang out with her as much as possible. But I was also exhausted, and needed to rest.

It is so hard to balance my emotional and physical needs in a situation like this. Thankfully, I was surrounded by understanding people. I’m also very thankful for my current coping mechanisms. I used some stress-relieving techniques from my therapist. I took an extra dose of my adrenal medication. I used medical cannabis. I laid down for half an hour in the afternoon to just quietly breathe and relax my body. Between the physical rest and the emotional break plus the medications, I began to feel better. My friends didn’t expect me to do as much physical setup for the party, so I was able to sit more.

In the end, the guest of honor had a great time, we all had fun, and everything worked out well. But it was still nerve-wracking. I find it frustrating that even good things can be too much for me. I wonder if I get married some day, will I even be able to have the large wedding reception I’ve always wanted? Will I have the energy to dance at my own wedding? Probably not, and that saddens me so much. Of course, I am also single, so that’s a big hypothetical! Still, the point is, will the good things be so stressful for my body that I can’t enjoy them? Right now they often are. I just hope that won’t always be the case.


Advice between chronic illness folks

October 16, 2019

I don’t know about you, but it took me a looooong time to figure out how to handle flares. The truth is, I’m still learning. But over time, thankfully, I have found some things that help. Sometimes I take the learning process for granted; after all, I have had symptoms for almost 30 years now. A phone call a few nights ago changed that.

A friend was in the middle of a flare, and having a rough time. They were dealing with both the horrible physical symptoms as well as the emotional fallout of having to miss a much-anticipated event that night. There was also the all-too-common self-recrimination, wondering what they did to cause this. Maybe they should have done less the previous week when they felt so good. Maybe they should have rested more. Maybe maybe maybe.

I’m the queen of “what ifs” so I really get that. I do that to myself all the time, as much as I try not to. I’m getting better, but it’s still a struggle. This time, though, it was someone else who was struggling, so I was able to step outside of my own issues and help them.

My friend was only diagnosed last year, which really isn’t that long ago. It takes a long time to learn how to handle chronic illness. I wish I had had someone to guide me, but unfortunately, there was no one in my life at the time with that kind of experience. Now, I am glad I can be that person for others.

First, I talked my friend out of the emotional spiral. Sometimes our bodies are going to flare, and there’s nothing we can do about it. Maybe they did overdo it, but there was no way to know in advance. And maybe they didn’t overdo it, and there’s no way to know that, either. Maybe they could have done less last week, and they still would have had the flare, right? The weather was terrible; not only are we going through a seasonal change, but it was a very stormy day. There’s a good chance the weather was at fault more than anything, and what can anyone possibly do about that? Besides, once you’re in a flare, blaming yourself won’t help at all. And as much as we think we can figure out the cause and prevent the next flare, we can’t. Ok, sometimes we can, but to think we can do that every time is just unrealistic. That would imply there’s a way to prevent ever having a flare again, and we know that isn’t true. We only wish it were.

Once my friend was feeling a bit better emotionally, we talked about how to handle the current situation. I suggested some fun tv shows to watch, etc. But here’s where we get to the part I most want to share with you. Without thinking much of it, I mentioned some things I do that my friend thought was brilliant and it got me thinking, maybe not everyone does this? So let’s share our tips!

I know I will have more bad days. I don’t want them, but they are inevitable. So I prepare for them. Just like I have bandaids at home for the inevitable future cut or scrape, and acetaminophen for the inevitable future headache or fever, I also keep things around for future flares. Here’s a short list:

  • Fun, lighthearted movies saved on my Netflix and Amazon Prime accounts, plus a few old dvds.
  • Easy to watch tv series saved on Netflix and Amazon Prime.
  • Chocolate and other comfort food.
  • Frozen leftovers of healthy meals I have previously made.
  • Low-energy hobbies on hand. For me, this is currently knitting and crochet, which I enjoy on all but my worst days. I also like to read and listen to audiobooks when I feel up to it.

These work for me, but you will have your own items. On top of this, several years back I read a tip on Chronic Babe to make a list of things to do during a flare, since we can’t always remember these things when we’re dealing with tough symptoms. One problem I have found is that when I feel especially bad, I don’t even think to look at the list! So I recommended that my friend make a list, and tell several close friends and family members about it – anyone who they might talk to during a flare. That way, their friends and family can remind them to check their flare list, where they will find a list of things to do and ways to think.

My current list has fewer items like the ones above, which have become second nature at this point, and more items around my thought process, mostly recommended by my therapist. These help me to stop blaming myself or assuming things will get exponentially worse. I keep the list in the Google Keep app on my phone, so it’s always handy. Even if I don’t have the energy or am in too much pain to cross the room to my desk, I always have my phone on me. That’s key – keep your list where you can easily find it when you need it. Keeping it at the bottom of a heavy box on a high shelf is definitely not the most useful place for it!

It sucks, but we all know that we will have bad days, so we might as well prepare for them when we’re feeling ok. What do you to to prepare for the bad days? Do you have a flare list? What’s on it? Please share in the comments, because I’m certain you will have ideas that I and others haven’t thought of, and we all need to learn from each other!


Grieving all over again

September 30, 2019

Chronic illness is never easy, and some days it feels harder than others. Lately, what has been getting to me the most has been my limitations, especially the ones due to Celiac Disease. I am angry and resentful that I can no longer attend an event and eat the food, friends no longer invite me over to dinner, I can’t simply grab lunch someplace while I’m out for the day. I hate having to worry about every little trace amount of gluten, having to wash my hands carefully before eating or taking a pill or getting a hair off my tongue. I can’t stand that I will never again be able to spontaneously kiss someone without first making sure they brushed their teeth.

But why now? I gave up gluten almost eight years ago. Is it because the increasing restrictions and caution came on so slowly? It took years for me to realize how sensitive I was to gluten. Even so, it’s clearly bothering me more now than it ever has before.

It was my therapist who pointed out what should have been obvious: I was grieving. It’s natural to go through the 5 stages of grief multiple times with chronic illness. After all, we don’t suffer a single loss, but many losses, which come up at different times.

Thinking about this several days later, it occurred to me something else that should have been obvious: the reason this is happening now is because I didn’t have the capacity to grieve before. I didn’t even have the capacity to acknowledge the magnitude of my loss before. I was busy surviving. I gave up gluten just a few months after leaving my job. At the time, I still hoped to return. During the next year I realized I would not be going back to work any time soon, I eliminated even more gluten from my diet, I found a naturopath, I researched new doctors for my thyroid care, I signed up for government benefits, I hired a lawyer, and more. I didn’t have time to care about giving up gluten. Besides, back then I thought it was just a matter of giving up some foods. I didn’t yet know all of the other things I would be giving up.

Over the following years, I continued to research treatments, doctors, tests, and more. I dealt with government benefits, changing apartments, and other logistical issues. I started businesses and had them fail. It was a busy time, and I remained in survival mode.

And then it slowed down, in a way. I am not looking to move right now. My benefits are stable for the moment. My health is always a concern, but with the latest addition this summer of hydrocortisone, my brain fog has lifted and my energy has somewhat improved. My health felt more stable for a bit, my mind was more clear, and I was able to think. At the same time, in the past year I have come to realize more than ever just how cautious I must be about gluten. The two came together and hit me hard, all at once. It’s no wonder I’m grieving.

Add to all of that one additional fact: the permanence. All of my health issues are permanent, but there are degrees. My pain will never go away, but it could improve. My fatigue may or may not ever go away, but there’s hope that it will, or at least that it will improve. I can work towards these goals. But when it comes to gluten, there’s no way I will ever be able to tolerate even the tiniest crumb again unless there is some medicinal breakthrough. Maybe that will happen, but I can’t count on it. Right now, there are no treatments on the market. That means I can’t let down my guard at all, and possibly never will. Again, it’s no wonder I’m grieving.

The important thing now is to let myself grieve. I have lost a lot, and I have years of it all catching up to me at once. This is hard, especially for someone who prefers to avoid unpleasant emotions, but I know it’s important. So these days, I am trying to sit with my feelings, to acknowledge them. It’s not easy, but I know that one day the worst of the grief will pass. I may never again be able to kiss my mother on the cheek, but one day I will come to accept it and it will make me less sad.

Do you grieve your chronic illness’s impact on your life? Please share in the comments. Sometimes it helps just to share what we’re going through.


Trying to be careful without getting in my own way

September 18, 2019

I am super sensitive to gluten. I have known that for a long time, but it amazes me every time I get glutened. One time, the culprit seemed to be some grapes that someone (who had been handling bread) picked up and then put down, and which I then ate without realizing (until it was too late) that they had done that. This last time, I think it was gluten on my own hands that did me in.

Last month I wrote about starting a new medication and the difficulties in getting my doctor to increase my dose. What I didn’t know when I wrote that piece was that I had just been glutened. That might explain some of my increased anxiety, though not all of it. It definitely explains why I wasn’t responding enough to the medication. As soon as the gluten symptoms went away, I felt how much the new med was helping. That took 19 days. Yes, 19 days. Yikes!

For the first week and a half or so, I barely left the house. Then I started to venture out a bit as needed. The final week I was mostly ok, at least enough to resume most activities, despite the extra pain, fatigue, and bloating. After almost three weeks, the symptoms subsided. The thing is, once I realized that I had been glutened, I tried to figure out how it happened, and there was no obvious culprit. I had not eaten a single thing all week that didn’t come out of my own kitchen. I quickly narrowed down the possibilities:

  • Something labeled gluten free actually had gluten in it.
  • I didn’t wash some produce carefully enough.
  • Twice I ate a meal outside of my home. I brought the food with me. Maybe I got crumbs on the container and transferred those to my hands somehow, and then ate something with my hands.
  • I ate a sliced apple and after a slice or two I realized I hadn’t cleaned my hands.
  • I had a hair on my tongue. I did my best to remove it without using my fingers, just in case they were contaminated.

These all suck. They suck because I am already being so careful in each of these areas, yet I got glutened anyway. There’s no doubt that it was gluten, the symptoms were very clear. I will never know for sure how it happened, but I know that all of these are hard to avoid in the future.

Before this latest glutening I was incredibly careful. I promised myself that this wouldn’t change anything. I would continue to be as careful as I had been before, and I wouldn’t try to control things more. It’s not healthy for me to be so hypervigilant. It takes a severe toll, emotionally and physically, and it doesn’t stop me from getting glutened. It can’t. I will get glutened many more times in my life. I try to keep it as minimal as possible, but there’s only so much I can do, and I have to be realistic.

Yet I have found myself being even more careful over the last few weeks. I hate it, and I am trying not to let this control me, but I don’t know how to do things differently. I don’t want to get glutened again if I can help it, and knowing that it’s inevitable to some extent isn’t enough to make me relax when I am out and about.

For example, I played a card game with friends. They were all eating appetizers and cookies, and I was very aware that they were probably transferring gluten onto the cards that I was touching. I made sure not to eat anything without first washing my hands. That’s fine. The problem is how anxious I felt about touching the cards to begin with. It made me anxious to know I was getting gluten on my hands. I feel like my own body is constantly unsafe whenever I leave my home, and that’s no way to live.

I am trying not to worry about the many ways in which my own home is not completely gluten free. I am sure that my phone is contaminated from being out in the world. I don’t clean every item that comes into my home. Grocery packages probably have gluten on them. My purse probably has gluten on it. My winter jacket will probably have gluten on it. My library books probably have gluten on them.

And there is nothing I can do about any of those things.

I must learn to stop being scared of gluten. Yes, it can hurt me. It could even kill me. But I have to continue living my life, and I can not do that if I am always afraid.

I am trying. It is not enough, but it has to be enough for now. Because what other option is there?


Reminded that my body can feel good

July 12, 2019

It’s not that I intentionally try to think of my body in negative ways, it just happens. My day is focused on which pills to take, how to moderate my activity enough to not cause fatigue, but so much that I don’t get enough exercise, how to sit and stand to lesson musculoskeletal pain, and being super careful about my diet. That’s before I research symptoms, diagnoses, and treatments. I am frequently aware of aches and pains, fatigue, nausea, and other symptoms. I don’t look for problems with my body, but I think about them constantly anyway.

And then this week I was aware of good sensations, and it made me realize just how much I think about the bad stuff. The good stuff came in two forms. First, there was physical therapy. That often makes me feel good, and I appreciate it every time. Still, it doesn’t make me aware of the juxtaposition as much as I was this week. The other thing that happened was that I had sex. I hadn’t had sex in a while, and when I did, it was just a fun night with a former boyfriend who I fool around with whenever he’s in town. This time, he was in town for a week, and while we didn’t have sex every day, we still had quite a good time. He’s very understanding about my health issues. One night he was in the mood and I didn’t feel up to it. No big deal. Another night, I felt really sick, and he simply held my hand until I felt well enough to go to sleep. He knows what will hurt me and avoids those things. Having that level of trust and understanding makes all the difference for me. It allows me to simply enjoy myself.

Now let’s face it, even healthy people often feel more positively aware of their bodies after good sex, so that isn’t unusual. It’s just that I became aware of the fact that the good feelings were displacing the bad ones. In the afterglow of a particularly good orgasm, I was too focused on the good feelings to notice any pain or fatigue. I knew those would likely hit me later, but for a while, they were held at bay. This wasn’t new. In fact, there were a few times when I was dating this same guy that I specifically said I wanted to have sex because I was in a ton of pain and I knew sex would help, thanks to the lovely brain chemicals that are released. Unfortunately, my dating life is pretty much nonexistent, so that hasn’t been an option for me lately.

When I went back to physical therapy at the end of the week, I paid more attention to how good I felt afterwards. She had spent a particularly long time working on my knees, and I noticed how different they felt now that they were full extended (something that doesn’t yet happen without her assistance.) I felt the lack of knots in my neck. My body was relaxed and, while not pain-free, definitely pain-lite.

Most days I won’t be at physical therapy or enjoying sex, and I won’t have those moments with few symptoms. But this was a good reminder that when I do occasionally notice my body feeling good, I need to revel in it. For as long as it lasts, feeling good is important, and something worth savoring.


Feeling a mysterious new contradiction

June 19, 2019

Last night I went to a Meetup group for the first time in 7 or 8 months. The folks there greeted me warmly and asked what I had been up to, and why I hadn’t been around. And the thing is, I found it hard to answer, even to myself.

I had been thinking about that before I went. At first, I was busy. Then I didn’t feel well. Then I felt better, but I was trying to catch up from not feeling well. It was never a priority – yes, there were times I could have gone but chose not to. But also, lately I have either been feeling too ill to go out, or else I’m feeling pretty good and I’m using that opportunity to catch up on household chores, fun projects, and spending time with close family and friends.

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Most recently, the surprising thing is that for the past month or so, I have been feeling so much better, while at the same time I feel that I am struggling more than usual. This is new to me, and hard to wrap my head around, much less describe to someone else. The closest I have come so far is a battery metaphor, since this is mostly related to energy and fatigue (though other symptoms play a role, too.) My battery never gets to 100% anymore, and probably never will. But lately I feel like I struggle to get my battery as high as it had been. If prior to the past month it sometimes got to 65% on good days, now it never gets above 50%.

But here’s the surprising part: it goes down more slowly. Before, it wouldn’t take much for me to go from 65% to 50% to 40%, but lately I feel like I can do a lot more at 50% before I drop down to 40% or lower. It’s an odd feeling. I’m more tired on my best days, but I can do more because I stay at 50% for a lot longer.

I want to know what this means. Is it a sign of improvement or a sign of deterioration? I believe it has to do with going off of an adrenal supplement. The goal was to stop the supplement for 2 weeks so I could take a test, then resume it. The first few days were horrible, but then I actually started to feel better. I had to put off the test for an extra week because of scheduling issues, and by then, I wanted to see what would happen. After all, I really did feel better than I had in a while. Now it’s been 5 weeks and I am anxiously waiting for the test results. What will they show? Will I need to go back on the supplement? Will I instead need the prescription that we were contemplating? Or is my body better off on its own? I am figuratively chewing my fingernails in anticipation.

My body is a series of mysteries. Sometimes there are answers, but far too often I never find out what is going on. I have learned to accept that for the less pressing issues (though sometimes I later find out they were more important than I had realized) but since fatigue has been my most disabling symptom for many years, this is tantalizingly close. I can almost feel the answer to the mystery dangling in front of me, but I can’t quite reach it. I am aching to know, though, if I am improving or deteriorating. Could I be on the verge of a breakthrough? Or is it the edge of a downward slide? Maybe the iron infusion that I had dreaded is having an affect? My fear is that the test won’t give conclusive results, and I won’t know why I feel this way or how to proceed. I should find out any day now, and until then all I can do is wait.

I see doctors constantly, and when they ask how I have been, it is almost always hard to explain. But now the answer is that I feel both better and worse at the same time. I hope they can help nudge towards more of the better.

 


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