Happy Tummy: Found and Lost (or, Remembering to Slow Down)

Storefront, Metro Drugs (Upper East Side, NYC)

Something has happened over the past few months to re-ignite my GERD symptoms:  the clenched throat, nausea, fullness and regurgitation episodes.   Since I've mostly had this under control the past year (!) this is surprising and frustrating.  "Oh no, not AGAIN."  

Why?

• Have I been eating too fast lately?   (Yes.  For some reason, I'm inhaling my meals.)
• Eating too late? (Definitely.  Late hours at work.)
• Eating too much?  (Calorically, I think I'm okay, but I do think I'm eating too much bulk-wise.  Because I'm eating too quickly.)
• Eating too much chocolate?  (Most likely.)
• Not enough Tai Chi or breathing exercises?  (Blame the hectic work schedule and falling out of the habit.  I've recently returned to this wonderful stress reliever.)
• Too much black tea?  (I bought some high quality Darjeeling and other black tea, which I've been enjoying alongside the usual oolongs and puehr -- have I overestimated my ability to easily tolerate this again?)  
• Not enough vegetables lately?  (My hectic schedule the past 4-5 months has definitely impacted my capability and desire for home-cooking, especially my greenmarket produce.)
• Not enough sleep?  (If I'm being honest, yes.  See all of the above.)
• A compromised immune system (Due to not enough vegetables or sleep?  I just got over a 2-week cold -- my first in years.)   
• Too stressed out (leading to a compromised immune system, leading to the return of my GERD/gastroparesis) (See above, again, most likely yes yes yes?!!??!)

Sigh! 

Just around this time, I noticed this elaborate chalk drawing in a storefront in Manhattan promoting probiotics for a "happy tummy."  

Maybe I'm easily impressionable, but this drawing reminded me to take a step back -- take ten steps back -- and BREATHE and put my body first.   More and more studies are showing the strong connection between gut health and overall health, especially the immune system.  (I have some new links to share, stay tuned, future post!)

RESOURCE:  2016 GUT MICROBIOTA FOR HEALTH WORLD CONGRESS  

I was excited to come across a link for the Gut Microbiota for Health World Congress meeting taking place March 5-6, 2016 in Miami, Florida with panels such as Gut Microbiota as Therapeutics, Life Events that Alter Gut Microbiota, and other timely titles.   See the whole program here.

The meeting site includes a link to this excellent academic site for gut microbiome news:

• Gut Microbiota for Health: Public Information Service from European Society of Neurogastroenterology and Motility

Secret Weapon: Pukka Tea

Stellar packaging by Pukka Teas.

I've been puzzled about a surge in my GERD symptoms.  Over the past month, I've had daily instances of reflux, the lump in throat feeling, heartburn, belching, and/or nausea, inspiring me to chew Tums on a daily basis.  So frustrating, since my symptoms have been subsiding!   The only cause I can point to is stress.  Since January, my life has been a whirlwind of deadlines, events, late nights, early mornings, galas, blizzards, even a concussion!  No wonder my guts are responding in kind.

To ease my digestive issues, I streamlined my diet this week, reducing caffeine and dairy, and I made a very deliberate effort to eat more slowly, eat smaller portions, and avoid constant "snacking" between meals to give my intestines time to catch up.   (I'm on the fence about whether snacking is good or bad, the "6 small meals a day" plan vs "give your digestive tract a break" plan.  And when I say "snacks" I mean bananas, nuts, homemade granola, oranges, applesauce -- not chips and candy bars.)

After a few days, I felt relief (though I did feel withdrawal from the caffeine).  Yesterday, I enjoyed two cups of dark oolong tea and a few squares of 70% dark chocolate for the first time in days, without problems.   This alternating between herbal tea and non-herbals continues to be a great strategy, allowing me to enjoy my beloved caffeinated teas and happy guts.  

Of note:  I am also filling my head with amusements to replace the stress -- long walks, comics, mindless television programs, music.  I do feel better, mentally and physically!

PUKKA TEA -- HERBAL TEA FOR THE HERBAL SKEPTIC!

Herbal tea is still a challenge for me.  I don't like the taste of many herbal teas that are out there, and many have ingredients I don't want to ingest (stevia, ginseng, acai, goji, etc.).   So I was thrilled to discover the array of herbal blends by Pukka Tea at their sample station at this year's NYC Vegetarian Festival.  They have their share of tulsis and ginsengs, but I was delighted to find various chamomiles and lemongrass teas, fennel and licorice blends -- a wealth of options for the troubled digestive tract! 

I bought Pukka's Chamomile Vanilla tea and the Rose, Lavender, Chamomile blend.  Both are wonderful, and I am not a chamomile fan.   (The chamomile tea that is still my favorite is the Chamomile with Lavender blend by Traditional Medicine.  Really good, and organic.)   I also picked up samples of the fennel blend and a rooibus variety.

And, the Pukka packaging alone is worth the purchase.  Visual meditation!

More Pukka packaging.  Aaaaahhhhh!

GERD and Stress: A Constant Juggle!

What to eat in a heatwave.

I've been experiencing increased GERD symptoms lately:  the lump/food in throat feeling, off and on nausea, belching, bloating, and some esophageal reflux.   I spent several days traveling during the Fourth of July holiday, and the next week in a very busy work schedule.  A heatwave complicated my cooking efforts -- who wants to do anything by the stove when it's 95 degrees three days in a row?   I missed a greenmarket, have been dealing with constipation, and neglecting to eat mindfully (slowly).  What a mess!  No wonder my system is responding as it is.

DON'T GRUMBLE.  GET GOING...

I am telling myself to just "go with the flow"-- maybe this just will not be the perfect week.   Maybe I will be eating out for lunch, eating quick frozen vegetables and veggie sausages.  Last night, J. and I resorted to pierogis from the supermarket (albeit "homemade" in our neighborhood) and frozen spinach.  Do the best I can to resume my GERD-friendly eating habits -- go slow!  Breathe.    The big greenmarket and cooking-ahead are in my weekend plans.

...BUT STOP AND BE IN THE MOMENT

I strive to find daily pockets in my busy days where I am outside -- crucial for my sanity, especially since I spend so many hours in an office.  Just being mindful and in the moment helps ease my stress.

Here are some mindful moments I try to incorporate each week:

Visiting a farm -- even in New York City -- or the next best thing -- the Greenmarket.  This is Eagle Street Rooftop Farm, which sells its crops to local restaurants and in its shop.  Visitors can stop by to buy produce and pop upstairs to view the farm itself (and the Manhattan skyline from a new angle).  I'm always more relaxed after stopping by!

Leafy things growing at the Eagle Street Rooftop Farm.

Green beans at Union Square.

My weekly ritual includes shopping at the greenmarket early Saturday morning.  I am always inspired  by the fresh foods, their smells and tastes grounding me.  I was delighted to spot these beans a few weeks ago at Union Square Greenmarket.

Connecting with animals.   My GERD symptoms began after the death of my cat a few years ago.  I am thinking about adopting another cat but this may be problematic due to my schedule (I'm gone all day) and my landlord (he's not keen on letting me have another one; I barely convinced him to accept my original cat).   Meanwhile, I volunteer once a week at the local no-kill shelter, where connecting with cats and dogs (and pigeons and chickens!) who need homes is immensely gratifying.  I know I am benefiting as much as the animals, probably more.  

One of the cats for adoption. 

Replacing the hassles of the commute.   Once a week at least, I hop the ferry instead of taking the subway lines.  This involves a 30-block walk to the pier, a reasonable wait for the next boat (which gives me time to catch my breath), and a lovely ride across the river.  It is a magical and rejuvenating experience every time, even under gray skies!

East River Ferry.  

Linkage: Just Breathe

This afternoon I was on a bus back to NYC* when I experienced pressure in my chest and reflux, probably manifestations of anxiety -- a panic attack?  Of course, this led to my concern about what was happening, which made it worse.   I told myself to relax, and initiated a breathing "meditation," slow, deep breathes in while saying to myself, "I am breathing i-i-i-i-i-n-n-n-n-n-n-n."  A short hold and then slow exhalations through my mouth while thinking, "I am breathing o-u-u-u-u-u-u-u-t."   After a few of these, I realized I no longer felt the anxiety, or reflux.

Mindful breathing to reduce stress and improve health is the new "buzz," but why complain -- the more guidance and exposure we all get to this pill-free therapy, the better!

LINKAGE:

• NPR's Morning Edition discusses the merits of "just breathing:"  Just Breathe: Body Has A Built-In Stress Reliever

• The American Medical Student Association offers this introduction to breathing for stress relief.

• And, an excellent discussion about the relationship between stress and GERD discussed by UCLA's Center for Neurovisceral Science and Women's Health.

*Dr. C., my GI doctor, told me many New Yorkers have complained about GERD symptoms increasing when they return to the city after being away.   I know what they mean.

Inspiring Things

FOOD WHEELS

I picked up this Local Food Wheel for NYC at a local kitchen shop last year, and it's still a thrill to watch the produce roll in each month, giving me ideas for what to look for at the market.  And, the graphics are so lovely!  I have mine hanging on my refrigerator door.   There are several local food wheels available for different parts of the country.

NEW BOOKS TO READ

My latest read.   Thich Nhat Hanh applies Buddhist approaches to weight management and healthy eating.  While geared for people interested in weight loss and those who struggle with weight management, I'm a few chapters in, and am finding this a good refresher for mindful eating and mindfulness, overall.  I would like to lose "a few pounds," but the parallels and points raised in Savor reach beyond weight -- they provide guidance for approaching life's struggles in general.  There's also a Savor blog/website worth a look.

GOING OFF THE CLOCK

Despite the hectic holiday season, I spent time exploring and being a tourist in my own city.   I allowed myself to take time, take photos, and take a breath.  Wandering around without a plan or time commitment is its own form of meditation!

GERD Food Diary, Day 2: Tuesday, January 3, 2012

Today is my first day back to work after the long holiday weekend.  I feeling anxious as I recall how much effort it requires to juggle healthy eating, exercise, recreation, commuting, household tasks and the workday.  It's so much easier when you don't have a clock looming!  I woke up a few times during the night and took a TUMS around 3:30 AM when I felt slight reflux.   The alarm rang at 5:05 AM and ten minutes later, I felt strong reflux while I was in the kitchen.  My symptoms after breakfast include the wet feeling in my chest, and bloating.   I did some deep breathing and movement after breakfast to relax, which helped.

5:30 AM: Breakfast

1 Wheetabix square

1 C. almond milk (Blue Diamond unsweetened vanilla)

1/4 C. crushed walnuts/pecans

1/4 C. raisins

Hot Oolong tea

10:00 AM: Snack
Cold water with Meyer lemon half
1 and a half homemade apple-cinnamon-oat muffins (these are very small in size, about 1/3 C. size)

11:30 AM: Snack
1 clementine
1 square Dagoba dark chocolate


Very busy work day, deadlines: feeling like I cannot take a break.  My back hurts between the shoulder blades and at one point I had lower abdominal pain.   My upper intestines feel bloated all day. 


1:30 PM: Lunch
1 C. vegetable soup (homemade kale, carrot, potato)
1 medium Bosc pear


NOTE:  My meal day is a "disaster" in terms of planning. I forgot I had a morning meeting and an evening event today -- so my initial plan to eat modestly and head home for a bean and grain dinner is up in the air.  Hence, the day of "snacking," just trying to stay satisfied and focused.  The event this evening will include appetizers and light refreshments -- I am not sure what I can eat there!  

3:30 PM: Snack
1 container Au Bon Pain hummus (I did not eat the olives or cucumbers; I do not like the former, and the latter can give me an allergic-like reaction)

I had slight reflux before the hummus; feel ok now.

5:30 PM: "Dinner 1"
I attended an evening reception, and planned to eat mindfully, making this part of my dinner.  I successfully navigated tables full of cheese, crackers, sweets and other party foods by grabbing a tiny plate and providing myself with a proper portion: a few pretzels, a single cube of cheese,  a few almonds, a few spoons of hummus with carrots, a small cluster of green grapes, and -- my indulgence -- two "oil infused" bread crisps.  (In the past, I would have had more cheese, crackers, and more than a few grapes and crisps.  And definitely both kinds of rugelah and a brownie.)

Before leaving, I had a few bites of cinnamon rugelah.   I left pleased with my restraint and relatively happy gut.  (But a little tired from comments about my vegetarian diet. "Would you like this meat on bone?"  "How about shrimp?  What, you don't eat shrimp either?"  I'm not the first veg who's wondered how people cannot equate seafood with animals.  But that didn't bug me as much as the follow up comment, "You're really missing out on life."  I had to swallow my sassy come-back for the sake of courtesy.  Bah!)

7:00 PM:  Banana
On my commute home, I experienced low blood sugar and had a small banana.

8:30 PM: "Dinner 2"
I had planned to have a bowl of soup for my "actual" dinner but when I got home, I was craving something more substantial.   One of my quick go-to dishes is sauteed edamame and green peas.  Just heat up some olive oil in a cast iron pan, toss in the legumes, and cover, cooking til desired softness.   I had 1/2 C. edamame with 1/3 C. peas and a slice of white bread (from the local bakery).

9:30 PM: 1 cup pu-erh tea with a spoon of sugar
I usually drink tea black, but I was in the mood for a small bit of sweetness, and lightly sweet pu-erh is divine indulgence.

I went to bed an hour later, feeling on the road to being mended.  No major gut issues, except for awful bloating and a heavy feeling in my intestines.

What Not To Do on a Friday

Yesterday was a gastronomic disaster.   My emotional state was grim* and I know this translated to stupid food choices.  Which translated to a cranky gut.  Here's what I did, and shouldn't do again:

1. Did not pack adequate snacks due to laziness and apathy.   Regretted this later.

2. Hungry around 11:30 AM so I snacked on an office platter of cheese cubes and crackers.  Dairy, I know, I know.  I actually enjoyed it very much.  I ate around 6-7 cubes of Swiss and cheddar, and the same number of assorted crackers.  I did make an effort to chew adequately.  

3. I decided to make the cheese and crackers my lunch.  To boost the nutrition value, I ate my apple, which tasted bad.   (A disappointment since I got it at the Farmer's Market.)

4. Between 10 AM and 1 PM, I ate two mini cupcakes (vanilla with chocolate frosting) from Magnolia Bakery.  Leftovers from Thursday's reception.  Yeah, this is all sounding pathetic.  I ate them with excitement, feeling I was breaking a "taboo" (non-vegan crappy baked goods!  sugar sugar sugar before noon!) and I did also enjoy these.

5. I left work early at 2 PM intending to go shopping.  Instead, I felt frozen by my grim thoughts.  And I was caught in a rainy deluge.   My shoes were soaked and my interest in doing anything was thin.     So I just wandered around, accomplishing nothing -- and not enjoying my lack of accomplishment.   I did buy squash at a greenmarket, though, and looked at new eyeglasses.

6. I was hungry at 4:30 PM but instead of eating something nourishing, I had a cup of Darjeeling tea.  With two packets of sugar.

7.  J. met me and I "had to eat" so we went to the local pizza joint and had slices for dinner.

8. By the time I went to bed, I was feeling all bloated, reflux-y, overall "not good."  

I'm not proud of this day's intake, but there it is. 

Saturday morning --  I woke up determined to not repeat those mistakes!   Today's day-long art festival will not be conducive to eating the right foods in the right way -- it is a challenge to eat "in a crowd" and on the go, all day.   Where can I get vegetables?  Foods that are tasty but not overly seasoned?  Will people care that I am eating slow as molasses?

*My grim mood today is due to my realization that I can't have any pets right now for various good reasons.   There is a great cat up for adoption at the corner pet supply store and it's killing me that I can't take him home.

Acid Reflux, Again

Most of my GERD symptoms have been minimal -- that "lump in throat" feeling being the main concern for a long while.  Every now and then I'd get "heartburn" but this is rare -- months between episodes.   Regurgitation, or acid reflux, is not a regular symptom, either, but more prevalent than classic "heartburn."  None of my symptoms are "painful" but, rather, they are uncomfortable and the thought that I'm causing damage is the most troubling part of what I am going through.

Still -- when it happens, waking up to acid reflux is one of the worst sensations.    This is not common for me, but it happened this weekend.   And why not -- what a stressful bunch of days!

BUSY DAYS, NO BREAK, COLLAPSE = NIGHTTIME REFLUX

After a very busy work week -- many competing deadlines, my own self-inflicted pressure to "do it all" -- I had to continue the pace.  I worked on Saturday as well, staffing an information booth at a street fair.   By the evening, I was exhausted to my core, collapsing in bed far too soon after eating dinner -- and paid the price!   There was also a heightened alert for New York City due to possible terror threats.  

I had horrible acid reflux Saturday night.   I woke up around 1:00 AM and took two Tums, which may or may not have helped -- I fell immediately asleep.   I forgot to wear my nightguard -- I can definitely sense my jaw is clenched these past days, too.

Whenever I feel reflux, I engage myself in some "self talk," telling myself it will be okay, to relax, imagine the acids receding and a normal GI tract. 

My diet on Saturday was spotty -- no real lunch:

Breakfast -- 6:00 AM

1 C. Oaty Bites

1/4 C. raisins

1 C. almond milk

Snacks - 2:00 PM - 5:00 PM

Since I couldn't leave the booth for long, I stepped aside and snacked on:

1 banana

1 Odwalla Strawberry C-Monster

1/2 breakfast protein bar from Long Island City bakery (vegan!)

4 Oreo cookies 

Dinner -- 7:30 PM

1 corn on the cob

2/3 C. beans (heirloom yellow eyes)

1/2 C. frozen spinach

Earth Balance

1 semolina roll with olive oil for dipping

Dessert -- 8:30 PM

3/4 C. chocolate chip ice cream (Breyer's)

My reflux settled down by breakfast the next morning, Sunday (9-11).  I spent Sunday in a constantly fatigued state, barely willing to do anything but J. dragged me out for a long walk.    I decided to avoid all caffeine -- no tea! -- on Sunday, to see if this would help calm my gut.   Not sure if it did, but sometimes tea negatively affects me, so I'm learning to avoid it some days.   By this morning (Monday), I am still having the FIT (food in throat) feeling, but I hardly am aware of this -- I am still too tired to register any other sensations!

Views: Saturday Greenmarket

I bought a bunch of these purple long beans.  Fantastic!

Union Square Greenmarket -- where I get to shop alongside the chefs of NYC's best restaurants!

GERD update: after a day of "my food" I feel great.  I did a volunteer shift at the animal shelter, which always de-stresses me -- I love doing good there, and the animals can only uplift.

Dinner will be pasta and broccoli -- which these chefs also purchased, by the pound!

Green Beans and Bees

Finally, on to the Union Square greenmarket!  It's been three weeks since I've been there -- and my psyche and stomach are feeling deprived.  I've loaded my grocery cart with three tote bags (one is a cooler-style bag) and two plastic containers in which to stash fragile things like peaches and tomatoes.  My journey to the greenmarket involves a lot of walking and a subway ride, so preparation is the difference between getting things home in one piece or finding all of your cherry tomatoes turned into a mash.

As I've been grumbling in the past posts, my diet this past week has been lacking fresh produce, let alone my beloved greenmarket produce.  Blame it on the hurricane, my schedule, family visits and a lot of eating out.   So, I cannot wait to get green beans, chard, kale, tomatoes, other leafy things, maybe cauliflower if they have it.

 Of note: I've had green or black tea every day this week, and any effects were modest.  Right now, I am drinking an oolong and admit I feel a minor "lump in throat" feeling.  If this is all I experience, I'm not concerned.  (Unless it's pathologically affecting my esophagus.  Then I have trouble.)

My GERD is minimal today.  I spent the past two days eating smaller portions -- back to the "two breakfasts" scheme -- and minimizing my dairy intake (just the nightly ice cream).

I've been sleeping hard and long, even with strange dreams, and have started a reading-before-bed routine to help me de-stress.  Reading before bed -- it's been a long time that I've done this, and I LOVE IT!  Right now I am in awe of Motel Art Improvement Service, a comic by Jason Little.  (Whom I met at a local comics convention and he drew my own personal Bee for me in the cover flap of my book!)

Detective Work -- Did the Red Grapes Do It?

Am I trying to prove to myself that it is stress and not food that is my GERD trigger?  Well, maybe.  That would be a lot less complicated, right? 

In this spirit, I was pleased to find a link to a 2006 study linking GERD symptoms to stress.   The study's caveat is that stress does not predict GERD's impact on the esophagus.  (The study is flawed in a few ways, but I was interested to see the distinction made between GERD symptoms and endoscopic results.)
 
While I'm getting back to my regular diet, I am experiencing a lot of GERD symptoms today.   Here's my intake so far:


First Breakfast - 6:30 AM:
1 Wheetabix square
1/4 C. raisins
1 prune
1 C. almond milk

Second Breakfast - 10:00 AM:
1 package Irish instant oatmeal with my own cinnamon
1/2 C. orange juice
I managed to have an expanded brisk walk this morning, as well.

Snack - 10:30 AM:
5 red grapes
2-3 cherries

This is where the problem exacerbated.  I have been belchy (and gassy) for the past days, and experienced definite heartburn pain yesterday and the day before, to the point of reaching for Tums.  (Which did not help.)
I was feeling a little better this morning with less symptoms overall. 

Around 10:30 AM I decided to have some fruit, but after a few grapes, I immediately felt that "food in throat feeling" more severely than in recent weeks.  It was as through the grape skins were stuck to my esophagus.  The skins were especially thick and bitter -- does this mean anything?   Usually, I don't have problems with grapes.

Lunch - 12:45 PM:
1 serving chickpea-eggplant-tomato dish (homemade by me)
My accompanying rye bread was moldy.    Darn!

Snack - 2:45 PM:
1 white roll from Le Pain Quotidien
1 packet maple almond nut butter (3/4 finished; interrupted by meeting)

At 4:21 PM, I feel ok.  FIT but heartburn.  Some belching, more gassy.   This, despite a super busy day.  I don't feel "stressed" but rather excited and even a little manic, with all the projects swirling around me. 

Dinner - 6:30 PM
Bean curd with basil and brown rice at local Thai restaurant.  I had an unpleasant sensation while eating the green peppers and eggplant that were part of this vegetable-loaded dish.  I felt unsettled in my stomach afterwards, and took a Tums to see if this would help (it did).   In this case, the veggies may have been bad; I don't think this was GERD-related.  I felt very full after this modestly sized dinner despite having been "starving" at the start.

During dinner, I learned that J. also had trouble with the red grapes.  Earlier, he had a few and said he did not feel right afterwards -- they made him feel "funny" in the stomach and head.

Dessert - 8:00 PM
1 C. Breyer's ice cream (Vanilla Fudge)
By this time, I felt fine.

I am looking forward to the greenmarket on Saturday, and resuming my normal diet full of fresh produce, grains and beans!

GERD Update: Earthquake Arrives, Symptoms Return

On Monday and Tuesday, I noticed an upswing in my GERD symptoms: belching, food in throat (FIT) feeling, some acid feeling (not heartburn but I noticed "something" was brewing in my gut).  And, yesterday, on my afternoon walk to the subway, I had sudden nausea, something I haven't experienced in a few months.

DIET?

My diet was excellent yesterday in terms of the so-called trigger foods and portion size, though on Monday, my work colleagues held two birthday cake parties.  I got by with very small slices (one of which I did not entirely eat).  (I am ready to feign a "dairy allergy" to avoid eating cake and other dairy infused products at work.  People seem to respect "allergies" more than "I choose to not eat dairy.")  In any case, I had a few bites and felt immediately ill -- stuffed and refluxy -- that I think was more about the "richness" of the food.

On Tuesday, I ate an eggplant-chickpea-tomato dish I had cooked.  Too many classic GERD trigger ingredients?  (Do I even believe I am sensitive to them?)  I also had green tea in the morning and a black tea from the new Starbucks after lunch.

STRESS?

As for yesterday's nausea attack, and even Monday's FIT, there definitely seems to be a stress trigger going on.  I'm catching myself grinding my teeth.  I've been very anxious at work about the massive number of projects that I am responsible for getting done NOW.  There are other stressful office issues underway as well.  Coinciding with this is my excitement over possibly adopting a new cat or cats -- or the more likely possibility and agony that this is not a good time to do so and I'll delay adopting.  (Either way, I'm an emotional wreck about this.)   And, I'm healing from a minimally invasive procedure that has me in stitches and on antibiotics.   

EARTHQUAKE?

On top of that -- NYC experienced an earthquake Tuesday afternoon.   My desk, computer screen, chair all rattled!  I thought I was losing my mind until all my coworkers streamed in to the hall corroborating they had felt this, too.   A few people mentioned their bodies felt "scrambled up" and "hung over" afterwards, and maybe I know what they mean.

BANANA!

I bought a banana on my walk home yesterday, in the middle of the nausea, and immediately felt better after eating it.  It's possible I was lacking nutrients or didn't eat enough that day.

Looking forward to my morning walk (if I can squeeze it in -- I am running late)!

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?

Stress, Stress, Go Away! (And Take My GERD With You!)

A few days into my "non-GERD" diet and I am feeling no different than during the Elimination week.  Perhaps I was even a little less "gerdy."  I have had the past few days off for a "staycation," and what a difference in my stress levels to not have to worry about schedules, work deadlines, commuting dramas, looking Professional.

In my appointments with Dr. C., we have talked about the role of stress as a GERD trigger.  More and more, I think that is what is responsible for most of my problem.   For one thing, I have other health issues that are triggered by stress:

1. Tooth Grinding:   Mostly on my left side, I am most definitely a grinder.  I can feel my jaw clenching during the day.  My dentist picked this up right away, and suggested a night guard.  I was appalled but finally got one and I am SOLD.   He told me he wears one, his staff wear them, and I learned my coworker wears one.   Is this a secret must-have NYC fashion accessory?   Apparently!

2.  Pre-glaucoma:  My dad has glaucoma, so perhaps I was destined to get this, but its onset now is a little strange.  My ophthalmologist says stress can be a trigger.

3. Sebaceous cyst flare-up:   I'm falling apart!  A long-time cyst on my shoulder has flared up and will be removed (tomorrow!).  When I read up about angry cysts, I was not surprised to find out that "stress" can cause these things to get exacerbated.

4.  Swallowing difficulties/panic attack-like episodes:  Stress produces these syndromes.  Stress!!!

WHAT'S MAKING ME ALL STRESSED OUT!?

1. Death of my cat last year.   My 16-18 year old cat died.  More accurately, I took him to the 24 hour vet to "put him to sleep" after he had a tough week.  He was diagnosed with pancreatic cancer.  "It was the right thing to do" but the vision of him looking "just fine" minutes before the needle haunts me.  Not only does his death/absence stress me out, the lasting reality that I was Death's henchman really freaks me out.

2. New York City.   "If you can make it here, you can make it anywhere."  Indeed.  The cliches are true.  This is one stressed-out place.  Every day is a psychological drama on top of physical challenges (crowded subways!  stinky streets!).    Just being here requires a veneer of steel and a large sense of humor.

3.  Not enough exercise.   Most of my life has been spent in conditions of "extreme activity."  I held jobs which required 6-8 hours of nearly non-stop physical labor indoors and outside.   I do not drive; my vehicle has been my bicycle, which I used to bike to and from the physical jobs.  When I went to graduate school and then a desk job in a university -- a more sedentary day -- I still maintained an "extreme" biking schedule, riding to and from work, around town, and long rides on weekends.  Moving to NYC has radically changed how much exercise I get.  I bike once a week, and try to walk as much as I can, but I am not getting a quarter of the physical exertion my body is used to getting -- and this, I think, "stresses out my body."  Or, maybe I'm always "stressed" but all that exercise tempered the effects.

4.  Not enough time.  Or faulty time-management.  But doesn't everyone complain about this one?  

5. Clutterclutterclutterclutter.   Over the past 7 months, I've been "de-cluttering" my apartment.  It is improving, but there is so much more I can do to streamline, improve efficiency, install order and create a calming environment and space to BREATHE.  

6.  Other Things.   Not living up to my own ideals.  Not having enough opportunities or vacation time to see family/friends.  So on and so on.

HOW WILL I ADDRESS THIS STRESS, THEN?

Time to do more of what works, less of what doesn't.  Make some changes, listen to more music, climb stairs at work.  Operation Stress Out (as in Out It Goes!).

Resources: GPS for Your Gut!

Dr. Andrew Weil is raving about his colleague's new book on gut issues, The Inside Tract: Your Good Gut Guide to Great Digestive Health.    The author, Dr. Gerald Mullin, seems credible enough -- he works at Johns Hopkins where he is the Director of Integrative GI Nutrition Services.  I haven't located this book yet, but here's an interview with Mullin that offers a peek at his philosophy.

Gastrointestinal Patient Symptom Tool -- I am curious about this!

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.

Color Me De-Stressed

Three days into the elimination diet and I don't feel any difference.  I am still waking up with that "food stuck in throat feeling" and all belchy, symptoms which continue throughout the day.    

Could my triggers be non-food related?  I am feeling especially overwhelmed this week:

• too many coinciding work project deadlines
• too many personal errands going undone (new eyeglasses, haircut, sorting the recyclables) 
• too many depressing news stories (debt ceilings, rioting youth, abused animals)
• too many postponed vacations 

After measuring my GI tract's response to food triggers, I would like to make a calculated effort to reduce non-food "stressors" to see if this makes a difference.   If I can't "eliminate" them, maybe I can increase my de-stressing tactics.

For instance:  Look at charming blogs!  

Like Color Me Katie, a wonderful blog of art, performance and observation by Brooklyn artist Katie Sokoler:

The Stereotype is True; The Stress-GERD Connection

So, what triggered my GERD, anyhow?    I've never had GERD issues, though I know I have always seen stress manifest for me in my guts.   The "classic" union of stress and gut issues has become a cliche -- the stereotypical crime drama lead actor downing glasses of milk or rolls of Tums to quiet their ulcer.

In my case, maybe it's the "New York City syndrome."  The fast pace, small space, overall excitement of life in the big city may be pushing my GI tract to its limit.  My GI doctor told me many of his patients are not native New Yorkers and their symptoms recede once they leave the city.    Maybe it's also the death of my cat last year -- one of the most stressful periods for me, ever.

Can you pinpoint your gut issues to a particular period of your life?

I was interested to read there seems to be a direct correlation of GERD and World Trade Center rescue workers.