Notes on AIP Business Trips

file5111243186814

Restaurants. Conference lunches. Continental Breakfasts. Those words are enough to strike terror in the hearts of anyone on a restricted diet, let alone the autoimmune protocol (AIP).

In the past six months I’ve traveled twice for work to conferences/trainings – the first to Disney and the second to St. Louis. I managed to remain 100% committed to the AIP on both occasions. Here are a few tips and tricks I learned along the way:

Be assertive. With my first trip, I felt a little ridiculous sending the list of my food restrictions to the organizers at Disney, which is where the conference was held. Little did I know that Disney prides itself on accommodating food restrictions. They assured me that it was not a problem, and even had the chef who would be working our conference call me ahead of time. I ended up getting steak and some amazing sweet potato fries every day for breakfast. So despite my fear of sounding like a high-maintenance food snob, simply asserting my needs paid off and most importantly, no one made me feel bad for doing so. So when the second conference rolled around, I didn’t feel the same fear of expressing my needs. I contacted who I needed to, and the catering staff was happy to make me a “special” lunch each day.

Plan ahead. By asking through various email channels, I was able to see the menu for the meals included in the price of the conference. Right away, I saw that the conference venue’s breakfast was not going to cut it – pastries and fruit every day. I checked the breakfast menu of the hotel we’d be staying at, and found a source of non-egg protein I could eat – bacon. So every day I got up a little earlier and ordered breakfast up to my hotel room.

Just Ask. Speaking of that room service breakfast, I got creative and asked for a bowl of avocado, which was not on the menu. The kitchen was happy to comply, making up a price and bringing me a full bowl of avocado every day. I broke up the bacon and mixed it in with the avocado and bon appetit!

Pack snacks. I brought along Trader Joe’s plantain chips, two cans of salmon, and a bag of my Paleo Cheezits. I never had to use the salmon, and used the other two for mid-afternoon snacks.

Embrace fruit. Normally I try not to eat a bunch of fruit (even though I might want to, too much fructose is not recommended on AIP), but at the two conferences, both offered fruit in the mid-morning and mid-afternoon, along with pastries. So for a week I embraced bananas, waxy looking apples, and sliced melons. You can also usually find bananas and apples in the airport once past security, so this was a good way to keep up my energy during travel.

Look at menus ahead of time. Before even boarding the plane to Disney, I wrote down one or two restaurants near the resort where we were staying that I knew would fit my restrictions (with a few modifications to the menu items, of course!) and then casually suggested them while walking around Epcot with my coworkers. At the French restaurant, the French chef even came out of the kitchen in his tall white hat to discuss my meal with me. He made me duck confit and a special side of sweet potato. It was delicious!

Be adaptable, but stick to your guns. In St. Louis, every night a huge group of colleagues would walk down the street near our hotel and choose somewhere that looked good. I didn’t want to miss out on being part of the group, so I went along even though the spontaneity freaked me out a little. One night, they chose a Spanish tapas restaurant. The menu was divine, but there were unlisted tomatoes hiding everywhere. I got an order of saffron roasted cauliflower that ended up having little tomato chunks all over it. I was tempted just to eat it to avoid a fuss, but when the server came back, I asked for a replacement with no tomatoes. They were happy to do so. While eating out, I understood it was likely that I consumed oils I normally wouldn’t, but I decided not to stress about it. I did the absolute best I could.

Learn how to paraphrase. This ended up being the most important lesson I learned. In a busy restaurant setting, at first I felt completely self conscious about disrupting the flow by asking the server to ask a bunch of questions and listing off what I couldn’t have. After a little practice, I had it down pat. This is what worked for me:

  • I asked for a gluten free menu. Many places had one. If not, no biggie.
  • I picked out a few possibilities on the menu that I could modify to fit my restrictions. That often ended up being an entrée of fish or steak. I’d look for a veggie side to sub for white potatoes, and be ready when the server got to me.
  • When they did, I’d say, “I have some food restrictions. First of all, I need to be completely gluten and dairy free. I’m looking at the (insert entrée title here) – would this be safe for those restrictions?” After we got that determined, I would add “No spices except salt, sub the potatoes for a side of green beans, and add a lemon wedge”  (because let’s be honest plain restaurant white fish is not the most flavorful of all).

Embrace questions. This final point is necessary because it is inevitable that if you’re traveling with people, they’re going to notice that you eat differently. Imagine no one noticing that I was eating a plate of steak every morning at Disney while they were having pastries! When asked, I found simply saying, “I eat a special diet for health reasons,” usually did the trick. Those who were interested would press further and then I’d tell them a little more. By being open to those who asked, I connected with another conference goer with Crohn’s Disease who was interested in the Paleo diet. Another time, I got into a great conversation with a colleague in which I learned that her husband has myasthena gravis, an autoimmune neuromuscular disease. So, even though it was at times disconcerting to have unwanted attention due to my dietary choices, it also allowed me to make these connections.

Those are my experiences so far. What have been yours traveling while on a special diet? Do you have any tips and tricks?

Advertisements

On Reclaiming My Energy

DSC_0419_2

Last summer, I lost my energy to prednisone—that tiny white pill that works like magic to diminish RA symptoms but causes a whole host of other issues, such as a depressed immune system, weight gain, and insomnia, among other things. Personally, I felt great on prednisone – it took care of my joint pain and didn’t bother me otherwise. This allowed me to enjoy a risky, blissful ignorance: I didn’t realize the power of the pill until I tried to stop taking it.

About Prednisone
Prednisone acts similar to cortisol, a hormone naturally produced by our adrenal glands. Cortisol completes many functions, including keeping inflammation at bay – which is why prednisone is used in treating symptoms of inflammatory conditions like rheumatoid arthritis and other autoimmune diseases.

While taking prednisone, the adrenal glands don’t have to work as hard to produce cortisol since prednisone is doing all the work. If the prednisone is suddenly taken away, the adrenal glands have trouble learning how to function again. For this reason, prednisone must be weaned off of very slowly so that the adrenal glands can re-learn how to produce cortisol on their own.

The Crash
At the recommendation of my rheumatologist, I began weaning off prednisone, stepping down 2.5 mg per week, from 10 mg which I had been taking for about 6 months. At that point in time, my symptoms were well managed using a combination of prednisone, plaquenil and sulfasalazine (which are Disease Modifying Anti-Rheumatic Drugs – DMARDs). I felt fine until about a week after my final dose. I went to work in the morning and started to feel clammy and lightheaded sitting at my desk, so headed home to rest.

The next day, I couldn’t get out of bed. Every time I sat up, I got a horrible head rush and my heart started racing. I knew I should get up and get something to eat, so I laid there and thought about it for 3 hours before actually being able to. I tried sitting in a chair to eat some strawberries, but ended up taking them back to bed because sitting up was too exhausting.

I called my rheumatologist, whose nurse told me that I was experiencing prednisone withdrawal and I could a) power through it or b) go back on a smaller dose and wean more slowly. She gave no real explanation as to what was happening in my body. Being somewhat stubborn, I decided to push through. I spent about a week in bed, too weak to do much. The simple act of folding a shirt necessitated a few hours napping. My boyfriend didn’t understand why trying to sit up and play a game of Boggle was nearly impossible. I slept for 11-12 hours a day.

After about a week, I slowly recovered my strength. I could stand and walk normally so that I was able to go back to work. At this time, I finally connected with some more helpful information and was able to give a name to what I was going through – adrenal fatigue (I highly recommend this post for more details on adrenal fatigue). With my racing heart, exhaustion, low blood pressure, dizziness upon standing, and emotional rollercoaster, I was your classic case of adrenal fatigue.

Getting Back on My Feet
The really severe symptoms lasted about a week, but over the next several months, I never regained my energy. Exercise was out of the picture, and I had lost a significant amount of weight from not eating well while I was sick. My blood pressure was consistently on the low side. I had a deep craving for salt – another sign of adrenal fatigue. I canceled my gym membership and left my bike locked up until summer was over. For a previously very active person, this felt like a defeat.

So what did I do? I researched and learned as much as I could. I knew I had to commit to healing if I wanted to get my energy back and feel like myself again. I started the autoimmune protocol. Sleep became my highest priority, and I gave myself 9 or 10 hours a night. I supplemented with B-vitamins and bought high quality Celtic Sea Salt to help with the sodium balance in my body. I looked at sources of stress in my life, the biggest being my (fairly new) relationship. I made the impossible decision to let him go so that I could seek health more fully.

It took about six months for things to turn around. A few weeks before Thanksgiving (4 months post-Prednisone), I sighed to my mom, “I just want my energy back.” It was around New Years before I felt that it was coming back to me. At that time, I was able to go for longer walks again. In January, I dusted off my hand weights. I started waking up after 9 hours of sleep actually feeling rested. Healing didn’t come all at once, or proceed in a linear fashion – at times it was very frustrating, with the triumphs seeming few and far between.

Looking back on those months, I am able to see where I could’ve done a few things differently to speed up my recovery. I was probably eating far too few carbohydrates, throwing my hormones even more out of whack.  If I could go back now I’d be sure to eat plenty of starchy vegetables. Also, I never forked over the cash to get a cortisol saliva test to confirm my diagnosis. It was pretty obvious what I was dealing with, as prednisone withdrawal is directly connected to  adrenal crisis, but would have been a good idea to know for sure.

I’m happy to say that after months of sticking to an AIP diet and managing sleep and stress faithfully, I’ve reclaimed my energy once more. I am back at the gym, lifting weights and feeling strong. I bought a new bike and took a long ride with a friend on Sunday, enjoying the first spring-like day in Minnesota. Feeling fatigued for months on end affected how I felt about everything. The healing process is far from over, but with my energy back, I am able to focus more on the good things happening in my life and feel capable of continuing the challenging road to recovery.