Recently I wrote a sensible and neutral-ish description of my DVT issue and how it affects me. I'm now doing the same for the digestive disorder I have because although it is on paper a much less serious issue, it actually affects me and especially my mindstate a lot more regularly and prominently. This is probably even less interesting than the DVTs and I'm writing it partly to clear my head a bit.
What do I have?
Some form of chronic-but-subsiding gastroenteritis. Since the workings of the digestion are a bit mysterious it's only really describable in general terms, such as a gastroenterologist's diagnosis of "Post Viral IBS Of The Upper Digestive Tract" (different to food-sensitive diarrhoea / constipation-prone IBS of the lower digestive tract). Perhaps more pertinent is a stool test result that shows the disorder manifesting as: some inflammation, some difficulty digesting fats, and a lot of bacterial imbalance - this may well be equivalent to SIBO (small intestinal bacterial overgrowth) Blood tests and an endoscopy have shown nothing significant. The crude bicarbonate of soda stomach acid test has indicated I have greatly reduced stomach acid.
Why did it happen?
In 2017 I fell off a route on gritstone and bashed up the side of my leg (no break, just a lot of soft-tissue / muscle damage). I went to Macclesfield A&E for an x-ray, I was careless with my hand hygiene (in particular a minimal rinsing of my fingers after going to the loo, just before eating a pack of nuts), and contracted some form of acute gastroenteritis, probably norovirus. This was an utterly horrendous experience in itself: BUT, my leg was already very swollen, and logically my body was putting all it's healing resources into that mild-but-large trauma, and thus not into healing my gut damage from the norovirus (especially with a few days living off a few hundred calories). So, my gut never healed (in comparison to my partner who caught the norovirus off me, was even more acutely ill, but recovered in a week or so).
What are the symptoms?
Primary
General queasiness - most of the time I feel a little bit mildly nauseous. Not much, but I never really feel 100% (and the few times I do, it's very noticeable how different and "clear" it feels).
Prominent queasiness when hungry - the feeling increases if I haven't eaten enough nor regularly enough (especially after coffee). Instead of just feeling hungry, I can end up feeling quite sick but still having to eat. This is completely different to previously when my digestion was *very* tolerant of long periods of not eating.
Regular indigestion after larger meals - including slightly more queasiness, bloating, and lots of gurgling (the latter okay in itself but not so okay in combination). This includes larger meals as in a normal / smallish evening meal, again this is very different to previously when I could eat massive meals and only feel "stuffed".
Sporadic nausea bouts - these are thankfully getting more sporadic, but are really grim for me when they happen. Often in the middle of the night, constant nausea that I can't sleep through (i.e. feeling too sick to drink water or clean my teeth), followed by at least a day of feeling wasted and only able to eat a tiny amount of bland food. In the early days these were happening every few weeks without fail, thankfully they're much less these days.
Secondary
Low energy - as it says. I don't have as much energy, I'm physically and mentally more tired, and run out of energy quicker in a day (despite healthy balanced regular snacking).
Increased weight gain - no, I'm not sure how the fuck this works either. I'm eating much more healthily, more "little and often" style, much less carb-based etc (see below), and I'm putting on weight quicker than previously. My best guess is a combination of possibly eating a little bit more (because I have to keep eating to stop the hunger-queasiness), and my digestion being worse at processing food (it seems to be processing into fat rather than into energy??).
Lower moods - I've put this in "Secondary" but it has been a massive factor at certain points!! As an example, June 2018 I travelled to the Peaks for The Seaside premier after a nausea bout, with the worst depression I'd had for over a decade - I felt like a hollow shell, a zombie shambling around pretending to be Fiend on the outside, with nothing on the inside. There's a few aspects to this: Firstly I'm mildly emetophobic, so the queasiness and nausea really creeps me out - yes this sucks, yes I'd rather have a lower digestive tract based disorder! Or none at all. Secondly there's a lot made of the gut-brain axis and the vagus nerve connecting them, and for me the nausea bouts result in subsequent bouts of sadness (like actual sorrow, rather than the bleakness of depression afterwards). Thirdly the mild or occasionally prominent debilitation of the queasiness is a constant distraction and inhibition that just gets me down. As I've written previously, I don't feel like a shadow of my former self, but I sometimes feel like a monochrome version.
General queasiness - most of the time I feel a little bit mildly nauseous. Not much, but I never really feel 100% (and the few times I do, it's very noticeable how different and "clear" it feels).
Prominent queasiness when hungry - the feeling increases if I haven't eaten enough nor regularly enough (especially after coffee). Instead of just feeling hungry, I can end up feeling quite sick but still having to eat. This is completely different to previously when my digestion was *very* tolerant of long periods of not eating.
Regular indigestion after larger meals - including slightly more queasiness, bloating, and lots of gurgling (the latter okay in itself but not so okay in combination). This includes larger meals as in a normal / smallish evening meal, again this is very different to previously when I could eat massive meals and only feel "stuffed".
Sporadic nausea bouts - these are thankfully getting more sporadic, but are really grim for me when they happen. Often in the middle of the night, constant nausea that I can't sleep through (i.e. feeling too sick to drink water or clean my teeth), followed by at least a day of feeling wasted and only able to eat a tiny amount of bland food. In the early days these were happening every few weeks without fail, thankfully they're much less these days.
Secondary
Low energy - as it says. I don't have as much energy, I'm physically and mentally more tired, and run out of energy quicker in a day (despite healthy balanced regular snacking).
Increased weight gain - no, I'm not sure how the fuck this works either. I'm eating much more healthily, more "little and often" style, much less carb-based etc (see below), and I'm putting on weight quicker than previously. My best guess is a combination of possibly eating a little bit more (because I have to keep eating to stop the hunger-queasiness), and my digestion being worse at processing food (it seems to be processing into fat rather than into energy??).
Lower moods - I've put this in "Secondary" but it has been a massive factor at certain points!! As an example, June 2018 I travelled to the Peaks for The Seaside premier after a nausea bout, with the worst depression I'd had for over a decade - I felt like a hollow shell, a zombie shambling around pretending to be Fiend on the outside, with nothing on the inside. There's a few aspects to this: Firstly I'm mildly emetophobic, so the queasiness and nausea really creeps me out - yes this sucks, yes I'd rather have a lower digestive tract based disorder! Or none at all. Secondly there's a lot made of the gut-brain axis and the vagus nerve connecting them, and for me the nausea bouts result in subsequent bouts of sadness (like actual sorrow, rather than the bleakness of depression afterwards). Thirdly the mild or occasionally prominent debilitation of the queasiness is a constant distraction and inhibition that just gets me down. As I've written previously, I don't feel like a shadow of my former self, but I sometimes feel like a monochrome version.
What it doesn't affect:
No excrementary disorder - okay I shit like a fucking cow but am pretty regular and generally have little diarrhoea and no constipation.
No actual vomiting - thank fuck.
No particular triggering due to particular foods - my cooking is quite spicy and flavoured, and occasionally I'll have a curry treat, and there's generally little response unless I eat too much (or pulses, which give me gas).
Treatment?
No actual vomiting - thank fuck.
No particular triggering due to particular foods - my cooking is quite spicy and flavoured, and occasionally I'll have a curry treat, and there's generally little response unless I eat too much (or pulses, which give me gas).
Treatment?
The general treatment after consultation with several different specialists / nutritionists is: A restricted diet to reduce stress / work for the gut, combined with better nutrition and digestive supplements.
Diet: greatly reduced: wheat, gluten, dairy (some main stressors for digestion), processed foods, excess sugar, alcohol, pulses (the latter mostly to avoid bloating / gas).
Increased: lean proteins, leafy greens, berry fruits, oats.
Supplements: pro-biotics, pre-biotics, omega oils, l-glutamine (strengthen small intestine lining), gi-sol (attempting to crowd out excess bacteria), ox bile (assists fat digestion), digestive enzymes with HCL (I accidentally had one of these break whilst dry swallowing and yes fuck me they definitely have some acid in them!!)
Is this all helping?? I don't know. Find me the control Fiend who can still eat pizza and have a pastry-based breakfast, not eat for 8 hours, have a massive evening meal and still feel fine, and compare us?? The treatments make logical sense and mostly correlate with each other and, despite being sometimes infuriating and expensive, are manageable. I am slowly getting better, but I have no idea if I'd be getting better regardless or whether I'd still be significantly ill without any of the changes. It's taking fucking ages but the more I look into it, the more complex and obscure the digestion is - and you can't just isolate it and give it a rest like you would with a broken limb. Fixing the digestion is like trying to fix a car engine.....whilst you're still constantly driving.
Symptomatic alleviation with: Prochlorperazine (this stuff is a fucking miracle and the only thing that can touch the nausea bouts), ginger (helps a little bit with queasiness), heat pack on torso (reclining with one of these and some ginger when I have indigestion does help a bit).
Diet: greatly reduced: wheat, gluten, dairy (some main stressors for digestion), processed foods, excess sugar, alcohol, pulses (the latter mostly to avoid bloating / gas).
Increased: lean proteins, leafy greens, berry fruits, oats.
Supplements: pro-biotics, pre-biotics, omega oils, l-glutamine (strengthen small intestine lining), gi-sol (attempting to crowd out excess bacteria), ox bile (assists fat digestion), digestive enzymes with HCL (I accidentally had one of these break whilst dry swallowing and yes fuck me they definitely have some acid in them!!)
Is this all helping?? I don't know. Find me the control Fiend who can still eat pizza and have a pastry-based breakfast, not eat for 8 hours, have a massive evening meal and still feel fine, and compare us?? The treatments make logical sense and mostly correlate with each other and, despite being sometimes infuriating and expensive, are manageable. I am slowly getting better, but I have no idea if I'd be getting better regardless or whether I'd still be significantly ill without any of the changes. It's taking fucking ages but the more I look into it, the more complex and obscure the digestion is - and you can't just isolate it and give it a rest like you would with a broken limb. Fixing the digestion is like trying to fix a car engine.....whilst you're still constantly driving.
Symptomatic alleviation with: Prochlorperazine (this stuff is a fucking miracle and the only thing that can touch the nausea bouts), ginger (helps a little bit with queasiness), heat pack on torso (reclining with one of these and some ginger when I have indigestion does help a bit).
The climbing lifestyle: impinged by the issue:
See the secondary effects above - these quite clearly impact on me as a climber. Being heavy and tired and depressed isn't great. Neither are the nausea bouts and although they're sporadic they can still fuck things up: As an example, I was in North Wales bouldering in early October, staying in a charming and thankfully mostly empty mini-hostel in Blaenau. The first day out I felt a bit queasy in the day due to hunger. I had an okay evening meal, went to bed, and woke about 2-ish feeling really sick. Took two prochloroperazine, but even with those and a middle-of-the-night shit, ended up propped up in bed drifting in and out of nausea until I finally got to sleep about 5-ish. Somehow I managed to summon enough energy for a bit of bouldering the next day, had a very mild and early evening meal, went to bed and had a second nausea bout and didn't get to sleep till past 2.... Distinctly sub-optimal.
There's a few subtleties too: It's harder to feel motivated and fired up and to visual climbing because I've realised that a lot of that comes from feeling strong all over, and a lot of that comes from the core. Imagine pulling any sort of hard move....it will almost always involve some power through the core. Now imagine sitting in a car heading out somewhere, trying to get psyched by visualising those hard moves....and when it comes to the core it's all just wobbly and delicate and out-of-sorts - it's surprising how inhibitive it is!
Logistically it's harder to plan things and be a reliable partner (although I've only had to let people down a few times), it takes me a lot longer to get going and feel ready for action, it's harder to get easy snacking and nutrition out and about in climbing areas, I have to pay more attention to eating and also comfortable accommodation. I'm becoming even more of a fussy fanny, not through choice but necessity.
As I say, things are improving over time. I had hoped to eat a celebratory pizza in November 2018 because surely I'd feel better enough then. That was pushed back to 2019. Now it's pushed back to 2020....I've forgotten what fucking pizza tastes like now!!
Anyway, next time - I talk about climbing, and choss :).
No comments:
Post a Comment