On Swallowing 57 Pills a Day

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Or, “What to Expect When You Visit a Functional Medicine Doctor.”

Well, I did it. I finally made an appointment with a local Functional Medicine Doctor (www.funcionalmedicine.org) to help me work out my persistent issues with inflammation despite almost a year on the Autoimmune Protocol.

For a long time, I’ve had a sort of fairy tale fantasy of what visiting a functional medicine doctor would be like. In my mind, the doctor would sit and listen for hours about every pain I’d ever experienced, every round of antibiotics, every digestive anomaly. They would pat me on the back for all the work I’ve been doing to heal with diet and who would provide a clear answer as to the reason I am still struggling with rheumatoid arthritis symptoms. The reality was a little different.

The Initial Appointment
I met with Dr. M to discuss my current symptoms, medical history, and lifestyle factors. He did indeed want to talk in detail about my medical history. He was quiet, yet knowledgeable and decisive about where to go from there. 

Test Results
Dr. M suggested I order two tests – one blood test for zonulin (which would tell us if I have leaky gut – read more about that here) and an organic acids test that looks for yeast/bacteria in an effort to solve my digestive mystery (which involved FedExing my pee to Kansas!). It was so helpful to be given a narrow list of tests to get, since I’ve often gotten lost down the Google rabbit-hole researching the multitude of tests I should get.

I tested positive for zonulin, indicating that I, after 9 months on a gut healing diet, STILL have a leaky gut, and I had elevated yeast presence as well. While frustrated that my gut hadn’t healed after all this time on my diet, I reasoned that I was still on hormonal birth control for 7 of those 11 months. Before that, I was on daily NSAIDS for 2 years and several rounds of Prednisone. As those medications likely contribute to leaky gut, then I can understand why it might be a problem. I can’t help but wonder if my current remaining medication, Plaquenil, is contributing as well but there is no research on it that I can find.

Diet
His recommended diet was basically exactly what I’ve been doing: healthy fats such as olive and coconut oil, pasture-raised meats and fish, and 9-12 cups of vegetables per day, with an emphasis on eating a variety of colors to ensure a variety of micronutrients. He recommended keeping carbs at 100 grams per day (to help fight yeast overgrowth), which I naturally tend to fall right around. He recommended adding back nuts and seeds (which I’ve successfully reintroduced some varieties of), and he is a big proponent of juicing and smoothies, which I incorporate occasionally. 

Supplements
Doctors prescribe medicine, functional medicine doctors prescribe further testing and LOTS of supplements. I was somewhat prepared for this, but nothing could be prepare me for being told to take 57 pills a day, plus a powder and two liquid supplements. These supplements include: herbal anti-fungals to kill off the yeast overgrowth in my gut; digestive support in the form of probiotics and digestive enzymes; gut healing supplements like L-Glutamine, MSM, and others; and key vitamins and anti-oxidants to help support my body’s ability to detoxify. The financial cost is enormous, and I can’t yet tell you how far into the future it will be financially sustainable for me. However, it helped to have someone knowledgeable about supplement quality recommend certain brands and look at my specific health history to recommend dosage. It took the guesswork out of buying and taking supplements helter-skelter.

Next Steps
The beauty of functional medicine is that you dig deep in search of the root cause of your illness. However, there seems to be no end to the depths which to dig to. One round of tests provides some answers that call for another round of tests. You can test for this gene defect (MTHFR) and these food sensitivities (IgG test) … but oh, if you have toxic levels of these heavy metals, then you’ll likely not improve even if you address those other factors. It’s really frustrating to start on the path for answers, learn which way you could take to get them, and then have to choose from a list of tests because you can’t afford all of them. Also, it’s hard to get good information about which tests are truly effective. I am still trying to research and prioritize what (if any) further testing I would like to do.

Results So Far
Though the doctor said it might take months to see real progress, since starting this supplement regimen three weeks ago, I have seen a number of improvements. My digestion has been the best it’s been since starting the AIP last August (though I have been experiencing some nausea and lack of appetite after taking my pills in the AM) and I’ve felt a surge of energy and a lightening of my mood.  My acne has calmed down.  My joint pain and inflammation has decreased quite a bit since my recent flare, and pain/stiffness is much improved.

The improvements so far are encouraging – especially that of my emotional wellbeing, which makes such a difference in the way life looks. So, though the reality of following this functional medicine plan means swallowing my weight in supplements, I’ll continue to pursue it and look forward to further improvement.

Feel free to ask me anything about this experience in the comments!

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Easy Fermenting: Beet Kvass

Getting into fermenting foods can be intimidating. I’d read about how important it was to regularly consume fermented foods as a way to improve the flora in your gut. I thought about it and waffled on it for months before finally taking the Big Leap. Only to find that the Leap wasn’t that big at all – fermenting stuff is easy! It’s fun! And it’s tasty!

My favorite ferment so far is beet kvass. It takes minimal preparation, a week or so on the shelf, and the result is an earthy, salty, slightly sweet fizzy drink that’s great with a squeeze of lime. If you’re waffling on taking the Leap, try kvass as a first step.

Beets

Beet Kvass

2-3 Beets
1 Tbsp Sea Salt
Filtered Water

Instructions:

Scrub (but don’t peel) beets and chop into inch-sized cubes.

Drop into a jar. I use an empty Bubbies jar, which is about 25 fl. oz. If you use a bigger jar, add a second Tbsp of sea salt.

Add sea salt and filtered water over the beets. Leave about an inch of space at the top of the jar and seal it tightly.

Put it on a shelf in a warm room and forget about it for a week. After a week, it should be ready to be put in the fridge and enjoyed.

*Economical Tip: Re-use the same beets for another batch!*

 

Field Notes on A Typical Week

The title of this post is a little misleading, because in my experience, a healing diet and lifestyle doesn’t usually follow a “typical” course. Each new week comes with its new hurdles, new food reactions, new questions, and new triumphs. But after doing this for a while, I’ve fallen into a pattern of food prep that makes being on a healing diet simpler.

Lately, I’ve figured out a good routine that involves making two dishes on the weekend, which will serve as my breakfasts and lunches for the entire week. Yes. I eat the same thing every day for five days in a row. As someone who cooks for myself and works a full time job, that’s what works for me. Each evening meal is usually baked fish with a roasted vegetable. 

Hash with words

I make this all the time for breakfasts and lunches. Two pounds of grass-fed ground beef plus what ever kind of spices and vegetables I feel like adding. I use this to get my sulfurous veggies in – broccoli, cauliflower, and Brussels Sprouts are the usual suspects. I add garlic, ginger, and turmeric. This is where I might hide some liver to get my dose of organ meats.

Soup

Chicken soup has become a regular feature this winter. I make it with homemade bone broth and add whatever veggies and herbs sound good. I will eat this for any meal. Always with a side of greens!

Salad

I have gotten to the point where I can digest raw vegetables again. Lately my go-to lunch is a cabbage-based salad with broccoli slaw, green onion, cilantro, and a generous pour each of olive oil, apple cider vinegar, and coconut aminos. So simple, and so good. I wash and mix up the vegetables and herbs at the beginning of the week and add my protein and dressing in the morning before work.

 

Cakes

Blurry picture of nori, roasted carrot fries and fennel, spinach, and my salmon cakes.

fish

Tilapia with a drizzle of olive oil and roasted cabbage.

Finding into this routine took me months of practice.  It took a while to figure out how much food I really needed each week and when I should do my cooking.  I also eat a piece of fruit every day, usually an orange with lunch. I am newly working on incorporating more starch – like yucca, taro root, and plantain – into my diet since I’ve started working out again (yay!).

What does your typical week on a healing diet look like?

On The First Blog Post

A year ago, I was diagnosed with an autoimmune disease called rheumatoid arthritis. A few months ago, I began to use food as medicine to manage my disease and begin to heal my body.

Rheumatoid arthritis (RA, or “Toidis” as I like to call it) is not osteoarthritis, like what elderly people get. As I said, RA is an autoimmune disease, meaning that your body begins to attack its own healthy tissue. Multiple sclerosis, Crohn’s disease, Celiac disease, and Systemic lupus erythematosus are also autoimmune diseases.

In RA, the healthy body parts that get attacked are your joints. This leads to pain, swelling, stiffness, and eventually permanent joint damage. Other effects of the disease include fatigue, dry eyes, and a host of other ailments. Add the side effects from the multitude of medications it takes to manage this condition, and you’re looking at one big, scary diagnosis.

The doctors help by telling you that you’ll be sick and in pain for the rest of your days, followed up by a list of scary-sounding medications to try. I was given very little information about the disease itself, my prognosis, or anything I could proactively do to help myself.

I discovered the idea of managing inflammation with food from my mom, who had taken a class that empowered people to go gluten- and dairy- free to improve a range of health issues. I was reluctant at first – the idea of cutting out entire food groups, not drinking beer any more, and changing my eating habits seemed too overwhelming. But I made the decision to give it a try.

Over the past year, I went from loosely avoiding gluten and dairy to dabbling in the Paleo diet to strictly adhering to the Paleo “Autoimmune Protocol” (AIP) for the past three months. The past year also saw me trying a couple of medications in a variety of combinations that landed me with horrible withdrawal that I am still struggling with (prednisone) and diminished kidney function (sulfasalazine).

I start this blog still very much a work in progress. It is a challenge to see the daily ups and downs as an overall healing process. The very idea of healing autoimmune disease is brushed aside by the medical community, but after just a few months of focusing my energy on healing through food, sleep, stress management, and light exercise (and not being perfect or very consistent with any of these aspects!) I am happily on one remaining medication and managing some residual joint inflammation in my hands. There are a ton of great resources on the web and in my local library that have helped me start and continue on this journey.

A lot of people doing Paleo diets take up blogging. I think it’s because you spend so much time cooking, eating, and cleaning up after those activities that it makes sense to document it all in the hope that someone else will benefit from what you learn.