FIT Me!

Have you seen those make-up ads with the woman challenging the brand to "Fit me?"  "Fit Me!"  "FIT ME!"   Well, I'm ready for my diet to FIT ME and not give me FIT -- my acronym for that "food in throat" feeling.  I'm tired of it!   I'm cranky!


WHERE I STAND NOW

• food in throat/lump in throat feeling (sometimes I wonder if I am imagining it…but there is always a subtle sensation of this)
• waking up and 5-10 minutes later experiencing acid reflux (rarely am I woken up by this; it happens shortly after waking)
• increased acid reflux throughout the day (it comes in the morning and stays, or goes away and returns; I am definitely seeing an increase in "reflux," something I haven't had in the past)
• constant belching
• the occasional heartburn
• feeling too full too soon
• feeling like everything I'm going to eat is going to be a trigger (let's not underestimate the psychological effects of dealing w/our chronic gastro issues!

WHAT IS WORKING?

I need to step back and assess the past few months, during which I've tried:

1) a GERD Elimination Diet for 7 days (really helpful and I felt empowered afterwards!  this felt like a "cleanse" to me -- to just jumpstart good habits overall)

2) slow mindful chewing (also helpful; I haven't been practicing this for a few weeks due to guests, busy schedule, forgetting to be mindful)

3) reducing/changing my tea consumption overall (some days I don't have any tea!  most days, I start with low-caffeine teas like twig tea or herbals and may have black or green tea later in the day -- this does help and many times I don't feel tea is a trigger when I stagger it like that)

4) small portions (breakfast and lunch are set but dinner remains problematic…how to divide into two meals?  I'm not sure…)

4) trying to de-stress with more exercise, more efforts at "relaxing," more tai-chi (yes, yes and yes)  

TRIGGERS FOR MY REFLUX?

• eating too much at a sitting
• tea (ugh!  I hate to admit it.   But I do see a difference in drinking tea after having eaten something, or later in the day.  It does not bother me as much, or at all.)
• sweets (sometimes they can trigger heartburn)
• constipation (this is a definite correlation and problem…when it happens, it's a major issue for me; one preventative is a cup of tea in the morning, but this is also a trigger!)

Note that I have NOT been experiencing much nausea lately...

NEXT STEPS?

Carry on but listen to my positive experiences?

Should I again try a GERD Elimination Diet, this time being even more rigid about certain foods?  (I "cheated" once or twice on the last one.)    In any case, this might make me feel better, even psychologically.    

Should I go on a Food Elimination Diet?   I recently spoke with a woman who tried this and discovered her gluten reaction; she ate some of one type of trigger food each day for a week, then gauged her body's response when she eliminated the food.  A different tactic than the "don't eat it for weeks and then introduce it."  Hmmm.

Should I blog/log another food diary for a week with a focus on this morning reflux?   I don't think I tracked my moods and activities as well as I should have in the past entries, and this is something that I would do this time with more precision.

Am I sure I am experiencing GERD and not something else?  (Gallbladder issues?  Hernia?)   What about slow motility issues?  Could this be a factor?   Do I need to swallow those radioactive eggs?!!

Thinking about all of this -- and already feeling more empowered.  :)

GERD Progress Report: One Week Later

It's been about a week since the last day of my GERD Elimination Diet and…

I still feel good.  I have had caffeine on a steady basis in the form of black and green teas and dark chocolate, and did not feel "gerdy" afterwards.   (This was a pleasant surprise; I was expecting problems.)   I am still feeling the FIT (food in throat) feeling, and a few days ago I had more belching than I'd deem "normal."     Overall, I am experiencing less GERD symptoms.  No morning GERD either, which is a relief.

What am I doing differently?  For one thing, I've increased my daily exercise dramatically:

• More walking!  I'm briskly walking nearly 20 blocks to work each morning.  This is on top of the 20 blocks I walk after work every day.   This routine requires me to leave the house earlier -- which means more organization, and fortitude to stay "on target" in the mornings.  I love seeing the city waking up, my fellow commuters whooshing along, doormen polishing the brass fixtures, smelling the bakeries along the way.  
• I'm re-committing to climbing stairs (six flights) when possible during the day.  To distract myself from the tedium and challenge, I experimented playing an effective ball-dropping game on my smartphone while hiking up the stairs.  
• I've added an "abs" workout series to my morning strength routine that I do every other day.  I got the latest one from Real Simple, which has a good "15 minute workout" section online too, so you can just go there and craft a lovely series for yourself.

I've felt less stress throughout the day.  No night guard needed, either!

Can exercise really make this much of a difference?

GERD Elimination Diet, Day 7: Sunday, August 14

Yikes, what a gastronomic disaster.

Breakfast -- 8:30 AM
Vacation plans abandoned, J. and I decided to take advantage of being up super-early and finally try out the local five-star "foodie hot spot" before the crowds spill onto the sidewalk.   The restaurant advocates local sourcing, even including the names of the farms from where the eggs, cheese, meats come from on the menu.  This matches my efforts to eat only pastured, locally sourced eggs (and ideally all dairy), so I was excited!   We both selected the same thing:

Eggs with sage and cheddar on panini rolls.

The first bites were good.  As the meal went on, we both realized the food was too heavy for us.  Most of our meals are very simple -- hardly any salt, seasonings, sauces; we might as well go macrobiotic.   An hour later, I was walking home with a queasy gut.  When I got home, I propped myself up with pillows and slept for nearly two hours.   I woke up more queasy, and vomited.    The rest of the day was spent recovering, with a fragile gut.  I didn't want to eat anything for most of the day.

J. never got to my stage, but also felt queasy all day long.

For the record:

Lunch -- 1:00 PM
Applesauce
Graham cracker

Snack -- 6:00 PM
1 banana
Applesauce
Handful of cereal (Nature's Path Oaty Bites)
-- My first time trying Oaty Bites.  I like these!  Low sugar, simple ingredients, nice flavor.

Dinner -- 7:15 PM
1 C. lentil soup (Amy's brand)
1/2 roll from supermarket bakery
-- I don't work for Amy's brands.  Really.

Dessert -- 8:00 PM
1 C. strawberry ice cream (Breyer's)

p.s. Last day of my GERD Elimination Diet!!

Seven Days of No Tea (and What I Am Learning)

One more day of this GERD diet!  [Update: And it's a doozy.  Wait til you get to Sunday. - CrankyGerd]

Overall, I am feeling no physiological change by eliminating the GERD triggers.  If anything, I'm more cranky without my tea!  I am more and more convinced that my GERD stems from stress, and is triggered by my overall constant state of "stress."  More on this after Sunday's final diet post.

WHAT'S UP WITH ALL THIS MILK?

I am realizing, writing these blog entries, that I am consuming small but not insignificant amounts of dairy daily, with ice cream or small amounts of cheese (often on pizza).    I am pleased that I have cut out butter altogether -- a food I never thought I could "live without."   I avoid foods with milk and milk-byproducts when shopping (i.e. cereals, crackers, breads, frozen foods, etc.).  

Still, as you witness, I remain unwilling to "give up" pizza or ice cream.  I've tried the dairy-free options and they are just not as satisfying.  A hedonistic reasoning -- do I really put my palate over my health (or the well being of other creatures?!).  I am well aware of the ethical issues regarding dairy production -- and am appalled enough to be interested in cutting it out altogether from my diet.   Am I getting there?  Do I need to explore more tasty options?

Health-wise, dairy does not seem to affect me adversely -- I feel no worse for it, and often feel good in my "guts."  Historically, I have always found comfort in milk and milk products when I feel ill.   Physicians say avoid dairy if you have stomach issues; I always found a bowl of ice cream would soothe my stomach, no gut distress at all.  My dad is the same way -- after a round of stomach issues, he enjoys a milkshake.   Still, cutting out all dairy -- would that lead to "big picture" improvements in my health that I can't even anticipate?  

Maybe another visit to the NOT MILK website is in order.

Gerd Elimination Diet, Day 6: Saturday, August 13

An active day ahead -- J. and I are heading to "City Streets" on our bikes -- a car-free Manhattan from 72nd Street to Battery Park via Park/Lafayette.  I'm not sure what lunch will entail -- I'll try to stick to the GERD diet.

Breakfast -- 7:30 AM
2/3 Wheetabix square
1 C. almond milk
1/4 C. raisins
1 hard-boiled egg
1/2 slice rye toast
-- No fruit in the house!  Had an egg for extra protein, for the ride ahead.  Felt okay upon waking; ten minutes afterward, I had the usual "FIT" and heartburn.  This lasted for a few minutes and then resolved on its own, as it always seems to -- it does not correlate with when I eat, or what I eat (though admittedly, don't I have the same exact breakfast each day?)...

Snack -- 10:00 AM
1/2 C. apple cider
-- at Union Square greenmarket

Snack -- 11:30 AM
1/2 Luna Bar (Lemon variety)

Lunch -- 12:45 PM
6" sub from Subway: veggie burger filling with lettuce, tomato, pickles, oil, and cheese
-- Eaten while on the Governor's Island ferry.  I was feeling good at this point.  Healthy!  (12 miles of bicycling can do it.)

Snack -- 3:00 PM
1 softserve vanilla ice cream cone from the Kool-Man truck, chocolate dipped.  (I honestly forgot about the no-chocolate GERD rule.)
-- Yeah, I know, I know.   No adverse concerns after eating, hours later.

Snack -- 6:30 PM
1/2 C. almond milk
1 graham cracker
-- My lack of fruit in the house is disappointing -- I would have liked to have had more fruit for snacks today.  I did not go to the grocery store to stock up, nor to the greenmarket (because we were bicycling today).


Dinner -- 7:15 PM
Pasta (Bionature brand) with tomatoes, walnuts, baby peas, olive oil and parsley.  I added Romano cheese at the table.

Dessert -- 8:30 PM
1 C. ice cream (Breyer's vanilla)

Mood: A joyful day, sunny and not too hot for most of it, bicycling almost 14 miles -- plus we enjoyed four ferry rides!   This level of exercise is very good for my stress levels.  More thoughts on this later!

Gerd Elimination Diet, Day 5: Friday, August 12

TGIF.  I stayed up late to watch the Republican debate and now a cup of tea would be my salvation.  Instead, I am drinking orange juice and looking forward to a cup of herbal.  After 10 minutes of waking up today, I felt that clenched throat feeling and slight heartburn.  This resolved soon on its own and I did morning weights with no concerns.

Breakfast -- 6:30 AM
1 Wheetabix square
1 C. almond milk
1/4 C. raisins
1/2 graham cracker square
-- Hectic morning but in a good way. I was busy with chores, though I ate breakfast slowly.  I just didn't have time for my usual fruit.

Snack -- 9:00 AM
8 oz. fresh squeezed orange juice
-- another effort to ward off the germs of my coworkers...

Snack -- 11:00 AM
1 hard boiled egg (pastured)
1 granola bar (Nature Valley Honey & Oat variety)

Lunch -- 1:30 PM
Leftover medley: corn on the cob, green beans, edamame, parsley
-- I threw this together in five minutes.  Ingredients from leftovers, except for the edamame, which I sauteed in the morning before adding to the mixture.  Delicious!
1 C.  cherries

Snack -- 5:00 PM
pretzels, crackers, 1 oz smoked gouda
-- Office party after work; I nibbled on a few things.

Dinner -- 7:45 PM
1 slice pizza (regular cheese)
1/2 slice Sicilian pizza
Salad with tomato, cucumbers, peppers and Italian dressing
-- After a long day, I was exhausted!   I decided to eat out, and did not want to make a production of it, so we walked around the block to a good pizza place and that's what we had.

Dessert -- 8:30 PM
1 C. vanilla ice cream (Breyer's)

Gerd Elimination Diet, Day 4: Thursday, August 11

Morning GERD:  Once again, shortly after waking, I went from feeling "okay" (slight FIT) to that clenched throat sensation.  I don't know what is causing this.  I am definitely hungry upon waking.

Pre-Breakfast Snack -- 6:00 AM

1 Mott's natural applesauce cup
1/2 graham cracker

-- I hoped this would calm my stomach acids.   It calmed the hunger, and by turn, the acids.

Breakfast -- 7:15 AM

1 Wheetabix square

1/4 C. raisins

handful of strawberries

-- By 7:45 AM, I felt a sharp pain in my esophagus/stomach -- a "lump in throat" feeling again.   It seems eliminating caffeine is not making any difference.  I could use a cup of tea soon -- but will delay until this week is over!

Snack -- 9:10 AM
1 bottle Odwalla Strawberry C-Monster
-- Everyone at work is sick, and I felt run down this morning, so on to my "secret weapon" -- Odwalla C-Monster, with 1500% of the Vitamin C needed in a day.  This usually gets me past any germy episodes.

Snack -- 10:00 AM
1 slice rye bread (Syrena Bakery)
1 cup of decaffeinated Ceylon tea (Harney & Sons)
-- Feeling mentally better just steeping a cup of "black" tea.  Had bread since I was hungry; I think I need to have more protein in the morning as part of one of my breakfasts.  Some ideas: nuts, nut butters, tofu, pastured egg, edamame.  It's no wonder I am hungry since I am eating only a "half portion" of cereal earlier, but I think more protein early in the day would be beneficial.

Snack -- 10:45 AM
1 C sliced strawberries

Lunch -- 12:00 PM
1 Amy's Burrito (Indian Spinach and Tofu)
8 oz Poland Spring water
-- Amy's burritos are heavenly.  Wholesome, delicious, perfectly seasoned to my taste.  This variety sounds like it would be spicy, but it is mild.

Snack -- 2:30 PM
1 Mott's natural applesauce cup

Snack -- 4:00 PM
1 single serving almond milk (Silk brand vanilla)
1 Nature Valley granola bar (Oat & Honey)
-- I do love these bars, but am trying out other brands for my "go-to."  I'm trying to avoid honey...

Dinner -- 7:45 PM
2 Morningstar vegetarian sausages
2/3 C. baked beans (B&M vegetarian)
2/3 C. mixed vegetables (Birdseye)
1 slice rye bread
-- No time for elaborate cooking, so this is our quick meal.  Racing around before and after dinner with chores. Feel ok, though while eating the sausages I felt some heartburn come on during the meal.  This subsided quickly during the meal, as well.

Gerd Elimination Diet, Day 3: Wednesday, August 10

Woke up with FIT and belching but otherwise a peaceful night.   I am meeting a friend for lunch today, so I am already strategizing about where we should go.  It needs to be not only veg-friendly but also GERD-diet friendly!

Breakfast -- 6:15 AM
1 Wheetabix square
1 C. almond milk
1/4 raisins
1 Mott's natural applesauce cup
1 graham cracker
-- I ate the applesauce 20 minutes prior to breakfast, and the graham cracker a few minutes after breakfast.

8:23 AM -- running late and definitely feeling it in my esophagus.  I am feeling very "full" and my throat is clenched, burning.  Yikes!

Snack -- 10:00 AM
1 medium banana

Snack - 10:45 AM
1/2 sesame bagel (plain; bagel was on the smaller side)
1 C. hot tea (decaffeinated Harney & Sons Ceylon)
-- I am drinking DECAFFEINATED tea.  (Shocking!)  I hear you can decaffeinate any tea by steeping it, pouring off the water, and re-steeping.  Each new steep will have less and less caffeine.  With this Elimination Week, I did not want to take a chance so I am going commercial for the precision.  Regarding the bagel, I was hungry and decided to have more breakfast; since reducing my breakfast to a smaller portion, I am ready for a second breakfast later in the morning.  I plan to make a better effort to bring my second breakfast, which should include vegetables and protein.  This will take more planning!  Having to plan means more stress!  It's a gruesome circle.   But I think more planning will ultimately reduce the stress!

Lunch -- 1:15 PM
At Le Pain Quotidien
1 Butternut squash soup (cup size)
1 small slice baguette
1 side salad topped with tomato, cucumber, cantaloupe, and white beans
-- This was a relaxing lunch with an old friend.  We took our time eating (she, too, has had GERD!) and I think this helped.  No symptoms except slight FIT as always.

Snack -- 4:00 PM
1 bag Bazzini nuts (Pecan Surprise variety)
-- I love this NYC brand, and always buy the Pecan Surprise with pecans, walnuts and black/golden raisins.

Snack -- 6:30 PM
2/3 C. almond milk
1 graham cracker

Dinner -- 7:45 PM
1 corn on the cob (greenmarket)
1 C. green beans (greenmarket)
1 veggie burger (Amy's All-American)
1/2 C strawberries
11/2  T Earth Balance
-- ate slowly, feeling okay but somewhat "stressed out" during dinner prep. I'm trying to eat as early as possible to avoid sleeping on a full stomach -- but it's stressful to be "racing against the clock" every night!

Dessert -- 8:30 PM
1 C. Breyer's ice cream (strawberry/vanilla)

Gerd Elimination Diet, Day 2: Tuesday, August 9

I really want chocolate!  And tea!!

I woke up feeling a slight "food in throat" issue, but this grew into "heartburn" (not so much burning as a clenched feeling, slight gnawing in my throat).  This is the pattern -- wake up, feel "the usual" FIT, ten minutes later, I feel worse.   I am definitely hungry.

Breakfast -- 6:30 AM
1 Wheetabix square
1 C. almond milk
1/4 C. raisins
1 graham cracker
-- I eat the same thing every morning, with slight variation (different cereal, different fruit).  I don't mind this one bit.

Snack -- 10:00 AM
1 Nature Valley Oat & Honey granola bar
8 oz. Poland Spring water

11:13 AM -- gnawing feeling in stomach/esophagus (I think I am getting more savvy at "feeling" the source of the gnawing, rather than the "referred" pain -- or maybe I just think I am.)    I am hungry and looking forward to lunch.  Feeling a little stressed out with many projects in front of me.

Snack -- 11:30 AM
1 Mott's Natural Applesauce cup
-- I ate this to stave off hunger before lunch and to get rid of slight nausea and grinding stomach.  (It worked.)

Lunch -- 12:10 PM
Amy's Veggie Loaf meal -- I had the low-sodium version, with 340mg sodium.  I am a real Amy's Foods aficianado.  Like this blogger. 
-- I felt great while eating this, and aside from the ever-present FIT sensation, minutes later, I feel pretty good.  Ready for part two of the work day!

Snack -- 2:00 PM
1 Nature Valley granola bar (the rest of the pack from this morning)

Snack -- 2:30 PM
4 sugar plums (from the greenmarket)

Snack -- 4:15 PM
1 small Delicious apple
-- Worried about being hungry before dinner as I am attending a late meeting; I don't want to succumb to the leftover pizza in our conference room!

Snack -- 7:30 PM
Seltzer with lemon and lime

Dinner -- 8:30 PM
Bean Curd with Basil and brown rice on the side (Brooklyn restaurant)
-- The subway was flooded last night, making my commute home long and arduous.  I had to take an alternate route and this led to me eating out.  I met J. and we went to our favorite Thai restaurant.   I was worried eating so late would give me agita but I had no concerns.  I had two sips of J.'s Coke before realizing I am not having any caffeine on the elimination diet.   Whoops.

Dessert -- 9:15 PM
1 C. strawberry ice cream (Breyer's)

Lost Weekend (and Nights of Gerd)

Despite eating out, eating too much, and eating too much of the "wrong" foods (chocolate, tea, fatty things), my GERD seemed no worse than average.   The weekend was a whirlwind, and my stomach followed.

I am starting my GERD Elimination Diet today for seven days.  No chocolate sounds extreme to me and continuing with no tea is uncivilized.  I have been falling asleep at my desk at work in fits of narcolepsy.  But, it's only seven days and I will probably learn something.

Another thing I would like to try this week is not reclining until after three hours from my last meal in the evening.   Over the past months, I'm increasingly prone (no pun intended) to GERD-y symptoms in the middle of the night and in the morning:  belching, regurgitation, slight heartburn.   This is new for me, and irritating.  

GERD is stressful!  Which only produces more GERD!

Food Diary: Thursday, August 4

RANDOM OBSERVATIONS

GERD elimination diet is not underway, yet.    My 48 hours without tea ended with a cup of a white and green tea blend this afternoon.   It was a weak cup and I did not feel any different after drinking it, except happier.

I started the day with a glass of Gerolsteiner mineral water and that "food-in-throat" (FIT) feeling.

WHAT I ATE

7:00 AM - Breakfast:
1 Wheetabix
1 C. almond milk
1/4 C. raisins
handful of grapes

10:00 AM Snack:
1 slice rye bread (plain)

10:30 AM Snack:
Brownie (my homemade dairy-free, egg-free, chocolate-full brownies)
- No adverse effects from the brownie.

1:00 PM - Lunch:
1 small salad from Le Gourmet deli that I composed myself.  It contained leafy greens, peas, walnuts, tomatoes, chickpeas, balsamic dressing.   Slice of foccacia bread on the side.
1 small brownie (1/2 inch) piece
-  Strong "food in throat" feeling.  This feels like a "lump in the throat" that you get during a nervous moment.

At some point today, I also had 1/3 C. unsweetened applesauce.

2:30 PM - Snack
1 cup white/green tea

8:15 PM - Dinner
1 C. kidney beans (from dry organic beans I made last night)
1 C. broccoli (frozen florets)
1.5. slices of rye bread with Earth Balance spread

9:45 PM - Dessert
1 large bowl of mint chocolate chip ice cream (Breyer's)
- My diet is vegetarian-veering-to-vegan.  I can't seem to resist ice cream and pizza, still.  When traveling, I shift to vegetarian, though I seek out vegan options.  I buy pastured eggs and eat these almost exclusively.   Soon, I'll devote an entry to my diet, or maybe a page, just for context. 

Food Diary: Wednesday, August 3

RANDOM OBSERVATIONS

This is the second tea-free day of my "GERD elimination test."  Is that why I am so tired?  I fell asleep at my desk both days.  Is it the lack of tea that's causing my narcolepsy?  A few times, I also felt unable to mentally "get with it."  I knew if I had some tea, the afternoon would go more smoothly.  As for how this is making my guts feel, I have to admit I feel less "gerdy."  No belching, no regurgitation, nothing.   Note that I am still having chocolate (bar and brownies).

I've decided to omit my bathroom goings-on in this blog, which will already be full of gratuitous information about my guts.   However, take note:  anyone interested in improving their GI issues -- or their health, in general -- should track how their intestines are functioning.   For Android phones, I recommend the PoopLog.  (iPhone users -- any suggestions?)

WHAT I ATE


6:00 AM - Breakfast
1 Wheetabix biscuit
1 C. almond milk (Blue Diamond unsweetened vanilla)
1/4 C. raisins (Sunmaid)
1 peach
1/2 C. blackberries
2/3 C. mineral water (Gerolsteiner)

10:00 AM - Snack
1/3 sourdough bagel, plain
1 individual applesauce (Motts Natural)

12:00 PM - Lunch 
1 white flour roll (from Employee Appreciation Day free lunch)
1 vegetable "potsticker" (from Employee Appreciation Day free lunch)
1.5 C. squash casserole (mine)

1:30 PM - Snack
1 Mr. Softee vanilla ice cream cone

3:30 PM - Snack
1 C. cherries

7:30 PM - Dinner 
Warmed in cast iron pan:  kidney beans, fresh corn kernels scraped off the cob, 4 cherry tomatoes, fresh parsley

9:00 PM - Snack
Brownies - from a recipe I found on Allrecipes for Vegan Brownies

The Plan: GERD Elimination Diet

THE PLAN

Dr. C. suggested I try an "elimination diet" for GERD.  This means avoiding the following for 1-2 weeks and introducing them back in, to see what/if anything triggers GERD:

• Alcohol
• Spicy foods
• Chocolate
• Caffeine
• Mint
• Fatty foods

PROGNOSIS

Alcohol: Easy, as I am a teetotaler.

Spicy foods:  Also easy, as I am a spice wimp.

Chocolate: Problematic.   By 11:00 AM, I have usually had a square of dark chocolate.

Caffeine:  Tea is my life.  I have been experimenting with drinking caffeinated tea every other day.  For the elimination diet, I will have to cold turkey it for 1-2 weeks.

Mint: I can take or leave it.  This should not be a problem to avoid.

Fatty foods:  I will need to leave my olive oil at the kitchen door for the next few weeks.

OTHER ISSUES

I have been a vegetarian since the age of 12, and am striving to a vegan diet altogether.   This does not affect the GERD diet but if I also try a classic allergy elimination diet, things get complicated.

I am not supposed to recline until 2-3 hours after eating, but logistically, this is ridiculous.  By the time I get home, cook, and eat, it's already 8:00 PM.  That means going to bed at 11 PM but this is too late if I want to get up by 5:00 AM.   How do people manage?

Did I mention tea is my life?