Friday, January 29, 2010

Feeling Better Each Day

I seem to have adjusted to caprylic acid after 3 days. No more headache, nausea or cramping gut pain. Likewise caprylic acid eliminated my longterm diarrhea after only one dose. I finally have 'normal' regularity (2x, rather than 6x daily). However, I still wake up with cramping, gas pains, maybe bacause I take probiotics with dinner. Nevertheless, I prefer feeling bloated after dinner and early morning to taking smaller doses of probiotics during the day, which make me bloated all day long. Great choice! LOL

In my last post I considered taking smaller amounts of caprylic acid spread through the day to decrease the side effects. However, I changed my mind and decided to stick with 2 capsules 2x a day. Then I noticed that my doc had prescribed 2 CA capsules 3x a day when I treated 2 previous bacerial infections. After my experience with his not aggressively treating C-diff (which influenced my multiple recurrences from c-diff spores), I wondered why he had not prescribed more CA to treat achromobacter. So I called his office to inquire about the lesser amount of CA. He reassured me that the current bacteria can be treated with a lesser dose.

All that 'could' be good news, but I haven't emotionally recovered from my 9
month c-diff nightmare. So I can hardly believe I will ever be completely well
again. Nevertheless, I feel better today with no medication side effects and
much less symptoms of the achromobacter infection.

I did have a little pity party after I received my latest diagnosis. After all I've had one gut infection after another since 2006 (klebsiella and enterobacter cloacae bacteria, cryptosporidium parasite, candida fungus, clostridium difficile bacteria, and now this new character 'achromobacter'). I can understand how I contracted those other 'bugs', but achromobacter is rather rare, although usually nosocomial (you get it in hospitals). So I might have gotten it from the Lahaina clinic where I got my vancomycin for c-diff. Still I think "ENOUGH ALREADY". I just want to be well for a few years.

Wednesday, January 27, 2010

Feel Crappy Twice or 4 Times Daily?

I slowly recalled how much I disliked side effects of caprylic acid, when I took that for 2 other intestinal bacterial infections. My doc prescribe 2 CA capsules 2x a day plus probiotics. I vaguely recall that the side effects of nausea, headache, cramping pain and bloating subsided after a few days. However I may be confusing caprylic acid with nystatin, both of which are used for treating candida. (I finally eliminated candida after 5 months of nystatin, which probably made me more susceptible to c-diff.) Nevertheless, I wondered whether I would experience less intense side effects from CA by taking one capsule at equally spaced intervals during the day (like every 5 hours). I also emailed my doc to ask whether that would decrease side effects reactions, help me adjust more quickly to CA and possibly more effectively treat the achromobacter.

I didn't receive a reply from my doc yet. So I tried taking one CA capsule with my morning fruit snack, which is not really breakfast, just a few bites of fruit and 1/2 cup of apple juice, enough to keep me satisfied for about 2 hours. Then I experienced all the usual CA side effects, maybe a bit less intense. I had planned to take the next CA capsule 5 hours later. However, I recalled that yesterday I felt crappy after taking the 2 CA capsules with breakfast and then felt much better before I had to take 2 more capsules with dinner. I actually didn't feel that bad last night.

Then I realized taking one capsule every 5 hours would just make me feel crappy all day long, rather than 4 hours after I take the 2 capsule dose. So I took the other CA capsule with breakfast. I noticed eating higher fat foods (almond butter and hazelnut milk) did reduce the intensity of CA side effects. So I'll return to my original plan of 2 capsules with breakfast, 2 capsules with dinner plus 2 probiotics with dinner for a total of 2 weeks. I hope that treatment plan knocks out this achromobacter. I'm not happy about suffering bloating, cramping pain, nausea and headaches for 2 weeks. Hopefully, the more intense side effects will decrease or even disappear over the next few days.

Tuesday, January 26, 2010

Caprylic Acid Stimulates Ghrelin??

After taking 2 doses of caprylic acid, I'm experiencing all the familiar side effects, including nausea and headache. However, I suspect my ongoing cramping gut pain is caused by the achromobacter infection, rather than the CA treatment. Nevertheless, I wanted to read more about caprylic acid, so that I know what to expect.

After 'googling' several CA topics, I read that CA stimulates the ghrelin hormone which increases appetite. I certainly haven't noticed that yet. However, I look forward to ghrelin stimulation, because right now I hate eating and feel much worse after eating. The CA induced nausea makes me NOT want to eat. So I'm drinking lots of ginger tea to prevent getting so nausea that I throw up.

Nevertheless, I know that my body will adjust to CA in a few days and I will no longer experience nausea, headaches and hopefully no more intestinal cramps. Maybe by then the ghrelin stimulation will kick in. So I can regain whatever weight I lose during the next few days when I'm eating just enough to stop the hunger. Going for long walks to relieve intestinal cramping appeal to me more than eating or sitting here feeling nauseas and having a pity party. LOL So I'm leaving now to walk around my local lake and feed the coots.

Monday, January 25, 2010

Very Sick But Still Hopeful

I'm so glad I talked to my doctor in person, rather than exchanging emails about treating my newly diagnosed Achromobacter infection. I had soooo many questions about that bug, like why I acquired it, how achromobacter could give me symptoms which are similar to my c-diff symptoms, how I can treat achromobacter without getting a c-diff recurrence, how can I trust that caprylic acid (my chosen botanical treatment) won't give me a c-diff recurrence, etc., etc. I booked a short (10-15 minute) consult and ended up needing 30 minutes to feel reassured that I will recover from that new bug.

Maybe because c-diff was such a long nightmarish infection, with 7? recurrences, I began to believe that I cannot quickly recover from achromobacter. However, my doc's answers to my questions helped me understand what I now have and how I can eliminate it. I want to forget that I blindly trusted him when he first gave me flagyl to treat c-diff. LOL

I took my first caprylic acid dose plus probiotics tonight with dinner. Amazingly I immediately lost that chronic 'fecal urgency' or the 'I have to go all the time' feeling. However, I still had intense stomach and intestinal pain. I suspect I'll need to take CA for a few days to kill enough bacteria to decrease the pain. However, I now understand how this bacteria causes similar, but also different painful symptoms than c-diff caused. So I'm confident I'm experiencing (and treating) a different bacteria.

Although I keep thinking "Here I go AGAIN with yet another gut bug and yet another treatment period", I finally successfully eliminated c-diff. Hopefully I can eradicate achromobacter during a 2 week course of caprylic acid. However, I have enough CA and probiotics to continue for 3 weeks and/or taper treatment if I'm uncertain.

I wish that DNA Microbial testing lab gave 'frequent flier' miles to people who purchase multiple tests from them. I mean after 3 tests, I should get some kind of discount or be allowed to buy tests at the 'bulk rate'. LOL Oh well, maybe I'll recover from achromobacter and actually feel well for awhile. I can always hope, despite my history with gut bugs.

IBSTC Appointment

I felt much worse this morning. I have more intense cramping pain (which woke me up at 3am), nausea, chills and diarrhea. So I decided to make an appointment to see my doctor at his clinic rather than exchange emails. I already planned to buy caprylic acid to treat achromobacter at his clinic, along with more probiotics. However, I read online so many bad reports about achromobacter bacteremia (blood infections) that I want to personally ask my doctor what he knows about treating that bacteria. I hope he knows more about achromobacter than he knew about recurrent c-diff.

Meanwhile I wonder whether I really recovered from c-diff. Maybe my last stool test just reflected no active c-diff bacteria, rather than no c-diff spores. I fear that treating achromobacter with any kind of antibiotic (even botanical caprylic acid) may trigger those c-diff spores to morph into full blown bacteria. I sure don't want to pay $350 for another stool test to determine whether I still have c-diff after I treat achromobacter. SIGH

Saturday, January 23, 2010

Achromobacter/Alcaligenes Species

I never received the emails with attachments of my test results. However, I did receive the paper copy with today's mail delivery.

The good news is that my c-diff level was <0.01 or negative for c-diff. The bad news is that I seemed to have acquired a new opportunistic bacteria (occurs in people with compromised immune systems) called achromobacter or alcaligenes species. I suspect that overwhelmed my good bacteria, after vancomycin destroyed everything in its path while killing c-diff, even though I took probiotics along with vanco. The diagnosis of that new bacteria would explain the cramping pains, bloating, fatigue and nausea which I now experience. Of course the test result reflected what was in my gut (stool sample) 3 weeks ago. Who knows how prevalent that bacteria is now?!

The lab test results provide a list of pharmaceutical AND botanical (herbal) agents which can eliminate that specific bacteria (or to which agents the bacteria is sensitive or resistant). Although the pharmaceuticals include many antibiotics which influence c-diff recurrence (grrr!!), the botanicals include one (caprylic acid derived from coconut oil) which I previously successfully used to eliminate 2 different bacteria (klebsiella and enterobacter cloacae). So hopefully I can just take some caprylic acid plus probiotics and eliminate my most recently diagnosed bacterial infection

Friday, January 22, 2010

Still Waiting ...

This morning I called my doc's office to verify whether they had received my DNA Microbial Stool Test results (which will tell me whether I still have c-diff). The receptionist said that she emailed the results (by email with attachment) at 9:40am this morning. An hour later I still had not received that email. 2 hours later I asked her to send the results with a black/white attachment, which might not take so long. 2+ hours later I still had not received any emails from my doc's office. So I asked his receptionist to snail mail me a paper copy of the results. I probably won't get those until Monday afternoon. At 4:30pm I again called my doc's office and asked the receptionist to try emailing me the test results again before she left.

So when/if I ever get any of her emails, I'll know for sure what 'bugs' were in my 'sample' on January 4 (almost 3 weeks ago now). That's the problem with those tests. If I'm really sick, I get even sicker (as with c-diff) by the time I finally get the results and ask my doc for his 'treatment' recommendation. I suspect I had c-diff last March, because I had symptoms then. However, my doc dismissed my symptoms as 'stress' and recommended I see an accupuncturist. Nevertheless, I persisted and requested that DNA test, but I began to doubt my intuition and delayed picking up the test for a few weeks.

I finally did that test in early May and didn't get the results until the end of May. So I didn't start treatment until June. 7 months later, I retested, because I'm tired of guessing whether I still have c-diff symptoms. Now knowing that the results are available, but I can't see them seems worse than not knowing when the lab will mail the results to my doc. BTW my doc's assistant isn't allowed to read my results and my doc is out of the office today. GRRRRR!

Wednesday, January 20, 2010

Slow Food Tenets

Now that I'm so close to receiving my DNA Microbial test results (to indicate whether I still have c-diff), I'm freaking out. I need to refocus on eating habits. LOL So I'll discuss some helpful suggestions I found in a chapter from "Can Diets Be Harmful?" That chapter came from a Tufts University Health & Nutrition Letter entitled "Entering a 'Slow Food' State of Mind: Resolutions for Better Eating in the New Year" (January 2003).

The letter begins by briefly describing the 'slow food' movement, which believes that "by snacking less frequently and by preparing one's own meals, individuals will (1) eat less, (2) eat healthier, less processed, foods and (3) enjoy eating more." Then the article explains why unfocused eating (while doing something else) can cause overeating:

"Along with a lack of attention, a lack of enjoyment from quick eating gets people consuming more than they should ... Part of what people seek in a meal is good taste, pleasure, and relaxation. If those elements are missing, eating continues even after hunger is sated in search for the more intangiblesatisfaction food is meant to bestow."

That observation helped me realize why even when I focus on the food and my stomach sensations when I eat standing at the kitchen counter, I don't feel satisfied as easily as when I sit at a table and eat: Standing deprives me of 'relaxation' while I eat! DUUUHHH!!

The best part of the chapter is the 'Slow Food Tenets', which are actually slow food guidelines written by the authors of the Tufts letter, but in keeping with the tenets of the slow food movement. Here's what they suggest:

(1) DON'T EAT UNLESS YOU'RE SITTING AT A TABLE. (You won't feel as satisfied if you eat out of a container standing at the kitchen counter!)

(2) PREPARE MORE OF YOUR OWN MEALS. (Increase the number of meals you currently prepare at home. Use time you would normally spend watching tv or online to prepare food for meals perhaps while you watch tv!)

(3) DON'T EAT WHEN YOU ARE NOT HUNGRY. (When people eat when not hungry, they don't have a clear 'no longer hungry' stopping point, eat more than necessary, feel guilty and eat even more. Although people assume they will just eat less later, an elegant French study showed that snacking unaccompanied by hunger did not reduce the number of calories later consumed when hungry.)

(4) SAVOR WHAT YOU'RE EATING. (When you eat quickly without focus, you miss the food's flavor. What we consider taste is really smell. Taste only includes sweet, salty, sour, bitter. However, slow chewing releases foods' odors to the nose, which can detect subtle flavors.)

(5) DON'T EAT WHAT YOU DON'T LIKE. (Eating food just because it's easily available or on your plate wastes calories AND satisfaction.)

(6) FOLLOW THE SAME PRINCIPLES IN RESTAURANTS THAT YOU WOULD AT HOME. (Expect relaxed atmosphere, great service and granting special requests, like take out boxes from every restaurant you visit.)

(7) PARTICIPATE IN MODERATELY VIGOROUS PHYSICAL EXERCISE EVERY DAY. (Exercise improves appetite control and facilitates digestion.)

I almost always use tenets (2), (6) and (7). I prepare almost all of my own meals, to avoid food allergens. I expect great service and relaxed atmosphere from restaurants, also because I need allergy free preparation of my food. I exercise every day, which improves my sometimes challenged digestive system and also helps me sleep soundly.

HOWEVER, I finally understand why I don't feel satisfied when I eat standing up. I don't like 'snacking' between meals, because I prefer to save my appetite for a relaxed, sit down meal. I've gone back and forth between eat only sit down meals and eat snacks between meals so that I eat less at the meals. I thought I could stop sooner (than uncomfortably full), if I knew I could snack between meals whenever I felt hungry. Instead I allowed myself to snack standing up when I'm not hungry and continue to eat after the meal standing at the kitchen counter, because I didn't feel satisfied by the meal. I'm ready to try eating only at meals for awhile.

I eat when I'm not hungry whenever there is food available as 'free samples (usually fruit because I can't eat most baked goods)' in stores as well as when I have food on my plate, but I'm no longer hungry. I may begin to eat a meal when I'm hungry, but I continue waaay past 'no longer hungry'. So I need to work on eat only when hungry.

I really savor breakfast, because I insist on eating that meal alone every day without distractions. I usually eat lunch without distractions, but I don't often savor every bite at lunch. When I eat that meal with my husband, I'm lucky if I can even chew each bite before I swallow to answer his question or comment on his comment. LOL When we watch a netflix DVD during dinner, I can savor each bite, because I don't talk. However, I often continue to eat past 'no longer hungry', because I don't want to get up to put food away. However, I know I don't enjoy the food when I feel full. When I eat past 'just enough', I can only taste very strong flavors like sweet or salty. I can't really identify subtle flavors at the point. I also leave the table very uncomfortable, when I eat past 'just enough'. So I also want to focus on SAVORING food, rather than just eating.

Unfortunately, I do sometimes eat foods I don't really like. Tonight I ate bland boiled potatoes, only because I covered those with margarine. Without margarine I dislike the flavor and texture of white potatoes (although I LOVE sweet potatoes). I often mix meat with vegetables, because I don't like the texture of dry meat. I love most fish, but I need to add vegies to meats to make them more appetizing. No wonder I love meat soups and casseroles or vegan dishes with grains and legumes or nuts or seeds. If I prepare a specific food which my husband likes but I don't, I can also prepare a food that I like, but he doesn't. Or I can make my favorite vegie and let him make his own favorite vegie. He can cook simple vegies. I've tried to make myself to like his favorites, but I still don't like them. So I won't continue to waste my appetite on foods I dislike.

The 'slow food tenets' helped me understand why I prefer meals to snacks and how to enjoy those meals so much that I don't want food before I sit down and after I leave the table. SAVORING is the key to eating 'just enough' and leaving the table satisfied.

Sugar Cane Fiber Reaction??

When I picked up my DNA Microbial Stool test (for c-diff and other 'bugs') at my doc's office, I also picked up a free sample of a high fiber gluten free bread. That bread previously was very low fiber. So I was pleased to discover that Ener-G Foods had reformulated the ingredients to make it high fiber. Ironically I didn't even look at the ingredients, because I assumed they were the same as the previous version.

I tried the bread sample and loved it. So we bought a loaf. I've eaten 3-4 sandwiches with that bread during the past month. I ALSO had more nausea, headaches, irregularity (which surprised me when I still have c-diff) and palpitations during the past few weeks. I attributed all those symptoms to c-diff recurrence.

However, last night I decided to check the price of that bread in the Ener-G Foods catalog. At the top of the catalog entry were the ingredients which listed: "filtered water, SUGAR CANE FIBER ... (and many other ingredients)" I have a diagnosed cane sugar allergy which causes reactions of nausea, palpitations (or tachycardia). Now I wonder whether eating that bread so often (about twice a week) caused the headaches and other symptoms which I attributed to c-diff recurrence????

I emailed my doc and asked whether sugar cane fiber would cause a reaction, given my cane sugar allergy. He said, "cane sugar fiber (is) part of the plant, so it should be avoided. A related example would be allergies to psyllium. Those people need to avoid psyllium fiber." WOW! That could have caused the symptoms I believed were caused by c-diff recurrence. Maybe my stool test will be negative for c-diff!!

Meanwhile I still await those DNA Microbial stool test results. The good news is my results should arrive sometime this week. I would LOVE to see a 'negative' result. So I could blame my recent symptoms on sugar cane allergy reactions. However, that won't explain the gut pain I had before I took vanco the last 3 times (2, 5 and 10 days ago). I can recover from an allergy reaction more quickly than from c-diff.

Saturday, January 16, 2010

Short Pulse Dose Cycles

I talked to my husband today about my c-diff fears. So much depends on my naturopath's reaction to my test results. Of course, I assume those results will be positive. I felt pretty sick by the time I did the sample, which I shipped to the lab. I'll be very surprised if I get a negative (for c-diff) result. So I'll email my naturopath doc early next week about my recent treatment history and the imminent arrival of my DNA microbial test results.

I also counted my remaining vanco capsules and realized I could take one every 3rd day and still have enough for 10 weeks of pulse dose treatment. That reassures me a bit. If my doc refuses to renew my vanco prescription or if my test results are delayed, I'll still be covered for awhile. So I plan to take a vanco every 3rd or 4th day to prevent full-blown recurrence by killing off recently morphed bacteria (from spores).

I felt pretty well (no c-diff symptoms) when I did the every 3rd day pulse dose for 2weeks awhile back. When I tried to extend the pulse period longer than 3 days, I began to experience more symptoms. Then I read more online recurrent c-diff treatment articles which suggested using higher doses with longer pulse periods. So when I experienced obvious symptoms after 5-6 days without vanco, I took a higher dose on the treatment day. That seemed to work well. However, in order to take the DNA microbial test, I went off vanco for 8 days, longer than any previous period. On the day I did the test, I had obvious cramping pain, nausea, headache and fatigue, which made me certain that the test will show positive c-diff.

Most recently, I began to experience nonstop cramping intestinal pain after only 5 days. That intense pain did not diminish until I took 3 vanco to treat the bacteria. I followed that with high dose probiotics. However, I learned that I can't wait that long between pulse doses. So I will return to the every 3rd day cycle, which requires only one vanco to kill c-diff bacteria.

Friday, January 15, 2010

My Designated (Eating) Issue

Before I even read Martha Beck's article about 'designated issues', which I described in my previous post, I began to wonder what eating issue I should resolve this year. After 9+ months without bingeing during 2009, I wondered (and even blogged about) resolving my 'overeating' problem, now that I had eliminated my binge/purge habit. Rather than just continue doing whatever I needed to maintain freedom from bingeing, I needed to 'improve' my eating habits even more. I discounted that I already abstain from 7 food allergens, eat a fairly healthy diet and maintain a low (but healthy for me) weight. I thought I needed to improve my eating habits even more. I commmited to eat only to the exact point when I felt comfortably full or 'just enough' ... until I binged on January 6.

After that binge, I described the incident in a blog post, which I later deleted. Then I did a 'post lapse analysis' (ala 'Appetite Awareness Workbook') which I also described in another blog post, which I also deleted. I didn't really understand why I chose to binge after resisting bingeing for so long. However I suspected that I binged, because I had resumed restricting sweets, by putting the Christmas cookies in the downstairs freezer, purportedly to make more room in the upstairs side by side frig/freezer. So I brought the sweets back upstairs and did 'antideprivation' eating of cookies at lunch each day until 6 days after the binge. Then I consumed too many sweets standing at the kitchen counter, but stopped eating when I felt moderately full.

I began that 'almost' binge to prove to myself that I could eat sweets standing up at my usual binge location without bingeing. I consciously chose to eat and stayed aware of my body sensations as I ate. Nevertheless, when I stopped eating I felt nauseas after eating so many sweets and continued to feel ill for several hours afterwards. I just ate too many sweet foods without throwing up afterwards. That experience totally changed my beliefs about sweet foods. As long as I ate tiny portions, I obsessed about the great taste of sweets. However, eating mostly sweets as a meal just made me nauseas for hours afterwards. I did not purposely restrict sweets after that 'almost binge', but I just have not wanted anything sweet for the past few days.

After reading the 'designated issue' article, I recalled that I initially binged (breaking my 9+ month abstinence period) 2 days after I shipped my DNA microbial stool test sample to the lab to test for c-diff (or anything else). The morning of that binge, I verified via Fed Ex tracking that my test sample arrived at the lab. However, I had very mixed feelings about that test. If the results were positive for c-diff, I'm not sure my doc will continue to prescribe vanco for treatment. If the results are negative, I don't know how to explain the recurrent cramping and nausea symptoms I have between pulse doses of vanco. Either way I lose. I feel very out of control about c-diff.

The next 'almost binge' occurred after a phone conversation with my husband about his job. He worries about his job stability now. I can support and encourage him, but I feel powerless about his job situation. However, I CAN obsess about my eating habits, rather than worry about my husband's job or my c-diff infection.

In her 'designated issue' article Marth Beck's 'basic process' for resolving that issue really spoke to me. When she said "Imagine ... that your designated issue is gone ... Not even a memory", I thought "One binge in over 9 months does not mean I went back to square one. I could easily be a 'normal eater' now. I know how to eat according to my body cues. I'm thin. I really don't have to worry about how much I eat, because I don't like feeling too full. I really could just wake up tomorrow morning and not have an 'eating problem'. I did that for over 9 months already. Normal eating is MY norm now. I just have to focus on the real 'scary' issue."

So I asked myself (per the 'designated issue' article): "Now that I've fixed that, what problems do I still have to face?" My immediate answer was unmistakedly "C-DIFF!!!!" I'm scared I still have that bacteria, but my doc doesn't understand how c-diff recurs. He thinks I'm 'vancomycin resistant' (which only occurs with intravenous vanco). So I'm worried that he won't prescribe more vanco, but might want to try some other less effective drug, even though vanco worked for me. I'm even more scared that the test will be negative for c-diff, even though I still have c-diff symptoms. So I talked to my husband about my fears. He reassured me that my GHC doc would prescribe more vanco, if I just showed her the DNA microbial stool test results and told her my history.

Then I took my one step toward resolving my c-diff fears: I drafted a letter to my naturopath doc. I'll ask my husband to read that letter before I email that early next week. I've had more c-diff recurrence symptoms during the past few days. So I'm more focussed on that problem. Ironically, I haven't weighed or overeaten or let myself get too hungry between meals during the past 3 days. I'm more focussed on eating what makes me feel comfortable, because I have enough c-diff symptom pain without making myself uncomfortable with overeating or eating foods that taste good in my mouth, but don't feel good in my stomach.

I'm amazed at how easily I stopped eating when I felt moderately full since I read that article. I didn't obsess over needing a between meal snack when I ate a light lunch. I also didn't worry about 'antideprivation' eating. I'm just not interested in sweet foods (other than fruit) right now. However, I won't restrict those if/when I want them again. Now I just want to relish stomach comfort, because my intestines don't feel so great.

Designated Issues

I recently discovered a thought provoking article entitled "What's Wrong With This Picture?" by Martha Beck in my October 2009 O Magazine. I usually review old issues before giving them away. However, that article totally changed my perspective about 'eating issues'. So I want to share what the author said and then describe my insights (in my next post).

Ms. Beck says "designated issues aren't just problems; they're also solutions. Like toxic-waste receptacles, they serve the useful function of containing some nasty, scary material. Your so-called worst problem may be sparing you even greater distress." She then describes several women who have problems with weight or finances or depression. Then the author states: "from the outside, it's obvious these women were using their 'worst' problems as distractions from much worse ones. Yet each (women) claimed, "If I could only fix this one thing, I'd be so happy!'

The author then lists "certain characteristics (which) distinquish these issues from everyday problems:

(1) Designated issues command inordinate mindshare. With ordinary challenges, we can relax our attention after taking reasonable action. However, if we obsess about a problem, which our efforts don't resolve, we may have a 'designated issue'. Consciously we want to get rid of the problem. Subconsciously we need that problem.

(2) Designated issues dodge permanent solutions. No matter what we try, we continue to struggle with that problem.

(3) Designated issues synchronize with seemingly unrelated events. The problem seems to escalate or worsen during certain situations or events. Actually the 'designated issue' helps us contain our worries about those other situations or events.

I'll describe in more detail how those ideas about designated issues relate to one of my 'ongoing problems' in my next post. However, I want to first describe the author's suggestions for identifying and dealing with those seemingly unrelated situations which may scare us more than our 'designated issue'. Here's her suggested process:

Sit down in a peaceful space. Vividly imagine that your designated issue is gone. You don't even remember having it. Now ask yourself, "Now that I've fixed that, what problems do I still have to face?" Then choose one of those problems and take at least one step toward resolving it. After taking that step, go back to obsessing about your designated issue.

That last suggestion may sound ridiculous, unless we realize that we need our designated issues to spare us worry about the other problems. However, the author then advises that we 'repeat the process outlined ... and you will find your designated issue getting smaller, lighter, less compulseive ... If you have a designated issue, addressing other problems will eventually make it (designated issue) dry up and blow away."

Martha Beck's analysis and suggestions for dealing with designated problems totally oppose my direct (name it, claim it, resolve it) approach to dealing with problems. However, her definition of 'designated problems' and suggested resolution process questions pointed to my longterm eating issue, especially after I binged once last week and 'almost' binged again this week, after 9+ months of abstaining from bingeing. I'll describe what Martha Beck's article taught me about my 'eating problem' in my next post.

Recurrent C-diff with Pulse Dose

In my last post I described my confusion about whether I had an allergy reaction or food born bacteria from the deli salads or actually had another c-diff recurrence. I'm fairly certain that my symptoms were just another c-diff recurrence. I had used the pulse dose method (skipping days between vancomycin doses). That allows the antibiotic resistant spores to morph into bacteria, which I can then kill with the new antibiotic dose. However, I seemed to get recurrent c-diff symptoms from those newly morphed bacteria, after only 4 days. If I wait 6 days between doses, I really feel awful with cramping intestinal pain and nausea.

So this week I planned to space doses apart 5 days. However, by today (5 days after my last vanco dose), I had really obvious colitis pain but not much diarrhea. So I took one vanco at breakfast and another one at lunch. I planned to just take probiotics with dinner to replenish the 'good bacteria' killed by the vanco. Nevertheless, I still have slight cramping. So I wonder whether I need to another vanco before bed. I hope my test results come earlier than the usual 3 weeks after sending the sample.

Sunday, January 10, 2010

Cross-Contamination or Bacteria?

For the second time in 2 months, I experienced excruciating gut pain and diarrhea after eating a salad from 2 different deli dishes from our local PCC. I had eaten one dish ('emerald salad') many previous times and had no reaction. So I suspect the 'black bean and corn' salad which I added to the 'Emerald salad' to create a complete protein (beans plus corn and wild rice) dish. I still have that pain today even though I ate the deli salads at last night's dinner.

However, I also planned to take another vanco for recurrent morphing c-diff spores (if I still have any) either today or tomorrow. So MAYBE the symptoms are recurrent c-diff?? I have nausea, cramping pain, but not much fatigue. Either c-diff or another bacteria or 'bug' from the deli food could cause those symptoms.

I don't think an allergy reaction caused my symptoms, because I don't have sharp pains like allergens cause. The 2 deli dishes did not contain any allergen ingredients, according to their labels. However, I could have gotten cross-contamination from another deli dish, which may have contained one of my allergens.

So I decided to take a vancomycin with lunch today, NOT eat the rest of the deli salads, but also take some lower dose probiotics. Then I can assess how I feel tomorrow morning.

Friday, January 8, 2010

Another DNA Microbial Stool Test

On Monday morning (01/04/10) I shippped via Fed Ex my 'sample' from a DNA Microbial Stool Test back to the lab for analysis. The lab which will examine my 'sample' to determine whether I still have c-diff or any other bad bugs (bacteria, fungus or parasites) which cause intestinal pain and damage. Before I took the test I had to abstain from probiotics, antibiotics and digestive supplements for 3 days. I had already abstained from vancomycin (antibiotic) for a week before taking that test.

Two days before the test, I began to experience cramping pain, nausea and passing mucous, which seemed very much like my previous c-diff recurrence symptoms. So after doing the test on Monday morning, I took a vancomycin with breakfast, another vancomycin with lunch and a high dose probiotic packet with dinner that night. All during the next day I felt WONDERFUL (no bloating, cramping, fecal frequency or urges).

Unfortunately, I didn't feel as well the next day. However, I hesitated to take more high dose probiotic packets, because I only have 2 left. If I need to take vanco again, I want to follow that with the high dose probiotic treatment. As I accumulate more days since my last vanco dose, I wonder whether those last symptoms meant 'recurrence'. So perhaps I need to take another vanco sooner than a week after the last. However, I really don't know at this point.

I'm sooooo tired of guessing. Do I or don't I still have c-diff? Do I have something else which causes these symptoms? Am I just taking too much magnesium, eating too much fiber, not drinking enough water, etc., etc.??? (All the questions I asked myself when I had cramping pain and irregularity before diagnoses of food allergies and each of my previous intestinal bugs.) ENOUGH ALREADY!!

I tracked the Fed Ex medical lab package containing my 'sample' all the way to the lab in Georgia. It arrived in less than 48 hours. So I wonder: why I usually don't see test results until 3 weeks after I mail the sample?? Whatever ... I'll certainly call my doc's office exactly 3 weeks from the date I sent the sample and tell them to call me or email the results as soon as they receive the 'analysis' from the lab. I don't need my doc's interpretation. I've done that test 3x now and other stool tests 3x before that. Will this intestinal infection nightmare ever end???

Sunday, January 3, 2010

Reinforcing Small Successes

When I committed to stop bingeing, anytime I stopped short of saying 'Oh what the heck, I might as well binge' was a 'success'. However, I also clearly knew what constituted a binge for me. I 'binged' when I felt overly full (after a meal or during between meal snacks), realized I could easily reflux and throw up if I continued to eat, and decided to eat all the foods I didn't regularly eat, but loved and had deprived myself from eating. I knew EXACTLY what constituted a binge.

However, in order to eliminate binges, I had to learn to endure 'overly full' sensations without guilt or fear, because those overly full cues led me to think 'oh what the heck' and proceed to binge. Now that I'm learning to stop at 'comfortably full', rather than overly full, I want to clarify and reinforce every instance when I stop before overly full. Last night I gave to my husband food left on my plate. So I easily stopped when I felt comfortable. If I can 'give it away', I can put it away in the refrigerator or freezer.

Today at lunch I felt slight fullness cues while I was finishing my peanut butter and mango wrap. I still had some pineapple slices sitting on the table. However, I knew that eating pineapple, after finishing my wrap, would take me from comfortably full to uncomfortably full. I knew just one bite could make that difference. So I wrapped up the pineapple and put it away.

Dinner tonight was as bowl of butternut squash (with vegies and turkey) soup and one medjool date. After eating that, I did not feel full, but I no longer felt 'hungry'. Previously I would have wanted to eat more until I felt obviously full. However, I now understand that 'nothing' (not hungry, not full) is that comfortable midpoint when I can stop eating and let my body digest the food, which will bring me to 'comfortably full' in a short while.

In order to keep my commitment to stop at comfortable I decided to mentally note (or blog about) each instance I succeed with stopping, while ignoring the instances where I feel more than comfortably full. I want to do more of what works and remembmer why that worked and do less of what didn't work and not dwell on that.

Success with Positive Goals

Amazingly I stopped eating during dinner with my husband when I was comfortably full. Despite distractions of talking during the meal, despite serving myself more than I comfortably needed, despite a snack 1-1/2 hours before the meal, I found a way to STOP eating when I felt satisfied. I had prepared honey mustard glazed baked chicken, green beans, and roasted Yukon Gold potatoes. So the meal was delicious!

I started eating green beans, but before I finished those, I moved onto the chicken, but saved the potato (my least favorite) for when I felt almost full. When I first began to feel full, I really slowed down to savor each bite, because I knew I would be comfortably full very soon. After savoring a few bites of the potato with Earth Balance margarine (an allergy free treat, because I didn't have any 'safe' margarine for over 4 years), I realized I was comfortably full. So I didn't need to make my self uncomfortable by eating more. So I offtered my husband the last part of my potato and he gladly ate that. That allowed me to 'clean my plate' without eating more.

What worked? I wasn't famished, because I had a fruit (pineapple spear) snack before I started preparing the meal. Every item of food was delicious. However, I 'rated my plate' and ate first what I knew would feel good in my body. Nevertheless, I didn't completely finish any food before I tasted everything on my plate. So I could reassess my taste rating and eat more of what I liked before I began to feel full. The food was really warm, because my plate was warm and the room was warm enough. So I could eat slowly and not suffer through cold food. Also I recently listed and considered all my 'irrationalizations' for overeating and realized none of those reasons were worth making myself uncomfortable.

Above all, in my mind I replaced a negative intention (stop eating past comfortably full) with a positive goal (eat enough to feel comfortably full). So my goal focussed on comfort, rather than avoiding a behavior. Focussing on something I want helps me avoid rebellious resistance to abstaining from something I don't want.

Maybe having 3 different foods on my plate helped me 'dequantify' the amount I ate. So I didn't let the amount on my plate dictate how much I ate. Instead I let my stomach tell me when I ate enough. I usually try to guess how much food I need, when I serve my meal. Then I eat that amount no matter how my stomach feels. However, I recently reread the section in 'When Women Stop Hating Their Bodies' about dequantifying food. That helped me focus on what was going on in my stomach more than what was left on my plate.

I had also recently reviewed in Karen Koenig's "Rules of Normal Eating" guidelines for stopping when full or satisfied. She suggested asking yourself after every couple of bites whether you still feel hungry and if you are still enjoying your food. I didn't exactly do that, but I was aware that my hunger sensations and my enjoyment level change as I progress through the meal. So I actually noticed when I felt hungry, less hungry, not hungry, slightly full and comfortably full. Slowing down when I felt slightly full allowed me to digest the food and still have room for a tiny dessert (one medjool date) and still feel comfortable immediately after and an hour after the meal. I didn't take any digestive enzymes, because I'm abstaining from digestive aids to prepare for a stool test for c-diff on Monday.

Overall that 'successful dinner experience taught me to focus on what I wanted, rather than what I don't want, check in with my stomach every few bites, and consider what's in my plate or bowl just available food, not exactly how much I should eat. That seems similar to considering all food (including sweets and treats) 'just food', rather than good/bad foods. So I can let my stomach, not the serving, dictate the quantity I eat. I suspect that's why I seldom overeat in restaurants, because I believe that I will only need to eat part of what I'm served. At home sometimes I'm hungry for all that I serve and sometimes I'm not. I intend to let my stomach decide.

Challenging Irrationalizations

After reviewing my list of 'rationalizations' for not stopping eating when I felt comfortably full, I realized how irrational most of those excuses are. So I decided to call them IRrationalizations. Here's how I challenge each of those excuses and replace them with more logical, helpful self-talk:

EXCUSE: "I don't want to waste so little food. So what, if I feel a little more than comfortably full?"

REPLACEMENT: "Eating more than I need is wasting food. The goal of eating is to feel more comfortable by resolving hunger. Overeating causes DISCOMFORT."

EXCUSE: "Okay, I could get up and store these last 3 bites in the refrigerator. However, I wonder how much food born bacteria has developed on this food while it sat on my plate?"

REPLACEMENT: "I've never had a problem with bringing home leftovers from a restaurant. That takes longer to get from my plate to the refrigerator than leftovers on my plate at home. Besides thorough reheating those leftovers should eliminate the bacteria."

EXCUSE: "How could I possible reuse 3 bites of vegies (or meat) or casserole or soup? This is too little for a meal and I don't like to snack on vegies or casserole or soup. I might just as well eat this."

REPLACEMENT: "I add little bits of meat and vegies all the time to salads, soups and casseroles. Those little bits come in handy when I want to make a hot lunch."

EXCUSE: "I know I'll feel too full, if I eat all this food, but I don't feel comfortable getting up and leaving the table (or living room while watching Netflix) to put away this extra food, before my husband is finished."

REPLACEMENT: "I often get up to get a condiment or dessert. I can certainly interrupt the movie to put away my leftovers. That's why we have the 'pause' button."

EXCUSE: "I can't waste this food after spending so long preparing this meal."

REPLACEMENT: "I'll waste more food by eating it, than by saving it for another meal."

EXCUSE: "If I stop eating now, even though I'm comfortably full, I'll get too hungry before the next meal and just grab anyting while preparing the next meal. So I prefer to eat until I feel obviously full."

REPLACEMENT: "If I feel hungry before my next planned meal I can either eat the meal then or enjoy a snack of fruit I saved when I felt full at a previous meal."

EXCUSE: "Of course I feel full. I took a probiotic before dinner."

REPLACEMENT: "If bloating from probiotics makes me feel uncomfortable, then I will feel more comfortable if I don't overeat."

EXCUSE: "I can afford to overeat a little. I'm not overweight. It all balances out, even if I feel uncomfortably full occasionally."

REPLACEMENT: "Do I have to be overweight to treat my body with respect? I deserve to feel comfortable after eating at any weight."

EXCUSE: "I really didn't get what I wanted to eat before I got full. I still need a sweet taste or some dessert to feel satisfied."

REPLACEMENT: "Before the next meal I will carefully consider what I want to eat, so that I save room for sweets or a dessert. Those foods will still be there the next time I feel hungry. I don't need to make myself uncomfortable to eat them now."

Saturday, January 2, 2010

Stopping with Food on My Plate

I consistently stop eating when I feel comfortably full, when I serve myself just enough to satisfy myself and comfortably fill my stomach. When I eat the exact food that both feels good in my stomach and satisfies my taste cravings, I can more easily stop when my stomach says 'enough'. When I focus on the tastes and textures of the meal, without distractions like tv, reading or conversation, I feel happy to stop when I finish my meal.

However, when I serve myself too much food, when I don't choose satisfying foods, or when I'm distracted by mealtime conversation, I don't want to stop eating when I feel full. I need to feel satisfied AND full. So more recently I began to seriously consider what food would satisfy my cravings and hunger, before I prepared my meal. I also eat at least one meal a day (usually breakfast) totally free of distractions. After focussing on tastes, textures and stomach sensations during the entire meal, I'm happy to stop eating.

Nevertheless, I continue to struggle with stopping at 'comfortably full', when I serve myself more food that I can comfortably eat or foods that really don't satisfy my body or my cravings. I consistently want to 'clean my plate' at home. At restaurants I can more easily stop and leave food for the 'take home box', because I assume my meal will be much more than I need. However, at home I usually know and serve myself just enough food for comfortable fullness. Nevertheless, I sometimes overestimate how much I need or I feel less hungry than usual or I try to 'fill the plate', rather than guestimate how much food my stomach needs.

Here's what I hear myself saying when I feel comfortably full, but want to continue eating, because food remains on my late:

"I don't want to waste so little food. So what, if I feel a little more than comfortably full?"

"Okay, I could get up and store these last 3 bites in the refrigerator. However, I wonder how much food born bacteria has developed on this food while it sat on my plate?"

"How could I possible reuse 3 bites of vegies (or meat) or casserole or soup? This is too little for a meal and I don't like to snack on vegies or casserole or soup. I might just as well eat this\."

"I know I'll feel too full, if I eat all this food, but I don't feel comfortable getting up and leaving the table (or living room while watching Netflix) to put away this extra food, before my husband is finished."

"I can't waste this food after spending so long preparing this meal."

"If I stop eating now, even though I'm comfortably full, I'll get too hungry before the next meal and just grab anyting while preparing the next meal. So I prefer to eat until I feel obviously full."

"Of course I feel full. I took a probiotic before dinner."

"I can afford to overeat a little. I'm not overweight. It all balances out, even if I feel uncomfortably full occasionally."

"I really didn't get what I wanted to eat before I got full. I still need a sweet taste or some dessert to feel satisfied."

WOW! That's quite a list of rationalizations for overeating!! I'll challenge and 'talk back' to each of those rationalizations in my next post.