Flare up

In the afternoon on Saturday, December 5, I started to feel unwell.  I was sore and achy all over.  My hips hurt.  Then I started running to the bathroom - a lot.  Next, I began to run a fever, my head hurt, and my stomach felt like I had eaten ground glass.  Vaguely, my throat didn't feel right.  It came on rather suddenly.

I was trying to figure out how I contracted Covid-19 without coming into contact with anyone outside my immediate family for more than two weeks.  Did I pick it up off a package delivery?  It didn't make sense.

I had a low-grade fever, but my belly was hotter than my forehead.  I took some Tylenol and went to bed, hoping that I hadn't somehow exposed my family to the virus.  My son brought me chicken noodle soup and toast.

Then I felt the familiar pain on the lower left side of the abdomen.  The weird stretching sensation, as if something is pulling at my intestines.  The feeling of needing to go to the restroom even though nothing will happen if I try.  Abdominal pain severe enough to stop all activity, which worsens with movement.  I realized that the diverticulitis was back, after being gone for a year.  I was grateful it wasn't Covid-19. I had no upper respiratory congestion, no loss of smell.  This is a beast, but it's a beast I know how to fight.

I debated whether I should go to a weekend clinic again.  It seems like every time this happens, it's on a weekend and my doctor's office is closed.  The weekend clinic doctor prescribes an antibiotic, an antifungal drug, and if I'm lucky an antispasmodic.  But only if I haven't taken Tylenol because there has to be a fever or they won't prescribe.  Also, it's expensive to go to a weekend clinic, (or any doctor) even with insurance.  My gastroenterologist has told me that next time I get sick I should come and see him so he can see the symptoms himself- - and run tests.   My primary care physician has pretty much the same attitude.  It's frustrating because it sounds like they don't believe what I am telling them.

So instead of going to the doctor, I decided to self-treat.  The next day, I stayed in bed all day.  I took Tylenol and strong probiotics at double the recommended dose.  I ate lightly and gingerly, avoiding all carbs except non-starchy fruit and honey.  Turning over in bed caused excruciating pain.   I spent an hour trying to decide if it was worse to be thirsty or try to get out of bed and get a drink of water. 

Goddess Bless me, I have sinned.  It's been a year since my last confession.  It's been a year since I have been brought to this.  I have eaten all the long-chain carbohydrates without regard for the consequences.  I didn't eat enough fermented food, didn't take my probiotics.  I forgot that my body has different needs, and I neglected those needs.  Damnit what a fool!  I only have myself to blame.

The next day, Monday, I went to work, but it was tough.  I was better but not completely well, able to function - sort of.  I kept debating whether it was better to call out sick for the rest of the day or risk being mediocre.  My son was amazing.  He made me a delicious and filling meal with nothing on the forbidden list.

Today, Tuesday, I'm not 100% back to my old self, and it still hurts to press on my belly, but there is some improvement.  I'm keeping up the probiotics and the diet until things are completely back to normal.  I can have homemade yogurt from the Specific Carbohydrate Diet recipe book, almonds, and applesauce, etc.  I'm taking it easy.  Fortunately, it's already a scheduled day off.  It no longer hurts to move.

I'm recording this because I want to see the pattern over time and try to figure out what works and what doesn't work.  If I keep up the regimen for a few weeks, will it go away?  What brought it on this time?  Why did it feel like the flu at first?   Should I go on an SCD "fast" periodically to keep this from coming back?  I don't care for the diet, but the pain is far worse.  Hopefully, I'll have a handle on this within the next few weeks.  Will I have to deal with this for the rest of my life?

Probiotics and recurrent symptomatic uncomplicated diverticular disease, (SUDD)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3807763/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866096/

Here's something on the effect probiotics has on the bacteria Serratia marcescens:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825935/?fbclid=IwAR35kCq4phPE_7moyNQSoToJNCUisu-Ri9bw073A66KJvw4RM5LweKKiXrc

New Protocol for Diverticulitis

It's baaaaaack!  On Sunday morning, I woke up with the standard symptoms of diverticulitis, and the same familiar sensations that I've had so many times before.  The pain was severe, and I spent most of the day in bed.  I considered going to Quick Care, but frankly I am tired of paying 200 a pop for a doctor to tell me what I already know, and my regular doc isn't in on Sundays.  I thought it might be best to wait until I could get in to see him, since he has only seen the reports from the Quick Care and seems skeptical that the diagnosis is correct if he didn't diagnose it himself.

On Sunday, I took Tylenol for the pain, and then I decided to try something new:  I took a strong pro-biotic.  Not the kind you find in the drug store - I took the live kind that you buy at the health food store and have to store in the refrigerator.  I bought a very strong variety.  The label said to take 1 per day.  I decided to take 1 every 8 hours, for a total of 3 times per day.

I also went on a modified version of the SCC diet.  It was more like Paleo with some exceptions for things like the rice flour that was added to the antibiotic.  But I stopped all breads, beans and lentils, pasta, and starchy vegetables.

I continued to monitor my temperature, but the fever came and went.  I didn't want to go into the doctor's office without a fever, because the doc has already said that he can't diagnose diverticulitis without an elevated temperature.  Each day in the afternoon after work, I didn't have a fever, possibly because I was taking Tylenol for the pain.

I continued to feel some pain after that, but it wasn't so bad that I couldn't sleep, and by Wednesday, the only remaining pain was a tender and sore feeling in the abdominal, which is understandable after days of strong spasms.

By Thursday, my body was starting to release the infection.  I'm not going to describe that in any more detail than that.  I did need to take some time off from work.

I'm cautiously optimistic that I'll be able to eat normally by Christmas.

I've been thinking about what triggered it.  The Friday before, I had a huge, devastating blow in my personal life involving a family member.  The next day, I spent a good part of the day cooking, and I remember that my entire body was starting to hurt - all the muscle and joints hurt like I had the flu, even though I had no other flu symptoms.  It felt like what I imagine a full body autoimmune disease would feel like.  Also, in the weeks leading up to the flare, we had been moving to a more plant based diet, and I had been eating more legumes than normal, and had also introduced some meat substitutes like the Impossible Burger.  I think the dietary changes and stress triggered it, but I still want to be able to eat a plant based diet, so I'm hoping that if I continue the pro-biotic, I may have a good result.

Protocols for a Diverticulitis flare

To be clear, this is my personal strategy for dealing with my gastrointestinal issues.  This is not intended as advise for anyone else.

When going to the doctor, remember to ask for Dicyclomine with the antibiotics.  Consider bringing an old bottle to show the doctor.

Directly after visiting the doctor, while picking up the prescriptions, obtain the following items if they aren't on hand:

OTC pain relievers
MiroLAX if needed
plenty of fluids with no sugar, sugar alcohols or milk
apple sauce with no sugar added
deglycyrrhizinated licorice  (not SCD legal)
slippery elm  (not SCD legal)
marshmallow root  (not SCD legal)
5 HTP
probiotics to be taken at the end of the course of antibiotics


Pull out the SCD books, particularly Ending the Vicious Cycle.

Diverticulitis Flare 03/23/2019

Yesterday I went to urgent care with a low grade fever, abdominal pain, and intestinal spasms.  The doctor put me on Cefdinir 300 mg and Metronidazole 500 mg.  He did not offer Dicyclomine for the pain and spasms, and I was in so much pain that I forgot to ask, but I have some on hand from a prior flare.

What was interesting to me is that the doctor told me to take the antibiotics with food and did not prescribe a clear fluid diet for the next few days.  I'm going to stick with fresh fruits and cooked non starchy vegetables with lots of clear fluids for the next few days.

I don't remember when the last flare happened, but it's been at least 3 years.  It's probably in my medical records but they aren't accessible right now.  And yes, the Dicyclomine is expired, but it's still working.  That stuff is like gold when you are in so much pain that you can't think or breathe.

I do remember that I went on the SC diet for a prolonged period, (I think it was about 3 months,) and then I eased off the diet.  I think the SC diet was pretty effective, because the infection was coming back regularly up until then.

It's been so long that I have forgotten the protocols that worked for me the last time.  I'm going to create a separate blog post, name it "protocols," so that I have something to refer to next time this happens.

Last week, I went on the Nutrisystem diet in order to lose some weight, and I'm wondering if that was a contributing factor.  There are a lot of sugar alcohols in their food.  I've been drinking plenty of water and taking in enough fiber.  I have been taking Motrin and Advil, so perhaps that was a contributing factor.  At this point I have no idea.  I'm going to be going back on the SC diet for a while now, to keep this from flaring again.

But for now, I'm going to spend the day in bed.

Recipes to Try

It's been over two weeks since I switched completely to SCD.  I had originally thought everything would return to normal in two weeks, but it hasn't.  While the diverticulitis is cleared up, and I have been taking a daily probiotic and avoiding sugars and starches, I can tell by the way my body is functioning that it's too soon to return to a standard diet.  My husband and I have talked it over, and for the time being, my plan is to continue to use diet to heal for the foreseeable future.  Diverticulosis is not reversible, but frequent diverticulitis flares are not going to lead to a good long-term prognosis.

After things have improved enough, it also might be a good idea to investigate the FODMAPS diet.  It's similar to SCD, but it may be a better alternative.  Right now it's too soon to tell.  Here is a link to information about that diet:  http://www.scdkat.com/2013/11/the-fodmaps-diet/

Here is a link to some additional interesting information:  http://gutharmony.net/index.php/category/diet-navigator/

The biggest challenge right now is arranging a varied diet.  I've made a few SCD recipes in larger quantities, freezing them in single portions.  It's become monotonous, rotating the same few meals with salads and fresh fruit.  On my days off, I try to make at least one recipe that I can add to the freezer.

For future reference, here are some SCD recipes I'd like to try:

"Apricot Slice" Bars:

https://glutenfreescdandveggie.blogspot.co.uk/2011/08/apricot-slice-gf-scd.html

Ghostly Meringues:
(just in case it's too hard to get through Halloween without a little something sweet)

http://comfybelly.com/2010/10/ghostly-meringues/#.WAZMpIWcGUk

Grandma's Apple Pie:

http://myhoneypie66.blogspot.com/

Chili Cheese Pumpkin Seed Crackers

http://www.cestleterrain.com/blog/chili-cheese-pumpkin-seed-crackers-scd-nut-free

Cranberry Crumb Bars With Pecans and Rosemary

This will need to be adapted for SCD:

http://www.realfoodkosher.com/cranberry-crumb-bars-with-pecans-and-rosemary/

Bombay Beef:

https://eatingscd.com/2008/03/31/bombay-beef/

SCD Friendly Naan:

http://wellnow.co.za/scd-naan-bread-indian-flatbread/

One Dish Paleo Cottage Pie:

http://scdgirl.tumblr.com/

Pancake Balls:

http://www.nomorecrohns.com/aebleskiver-pancake-balls.html

Salt and Vinegar Zucchini Chips

http://www.sugarfreemom.com/recipes/salt-and-vinegar-zucchini-chips/#_a5y_p=3114418

Cauliflower Rice

https://glutenfreescdandveggie.blogspot.com/2013/08/cauliflower-rice-gf-scd.html

Halloween Witch's Finger Cookies

http://www.livinglavidamama.com/search?updated-min=2012-01-01T00:00:00-05:00&updated-max=2013-01-01T00:00:00-05:00&max-results=6

Hot Cereal for Breakfast

http://www.saltedpaleo.com/2011/10/scd-hot-cereal-for-breakfast.html

Homemade Coconut Yogurt

http://www.thishouseofjoy.com/2014/05/01/how-to-make-fresh-coconut-yogurt/

SCD Friendly Saltines

http://www.saltedpaleo.com/2012/02/recipe-review-saltine-crackers-scd.html

Snickerdoodle Snack Bites

http://detoxinista.com/2015/11/snickerdoodle-larabar-bites/

Mediterranean Kidney Bean Burgers

https://glutenfreescdandveggie.blogspot.com/2012/04/mediterranean-kidney-bean-burgers-gf.html

SCD Lasagna

http://againstallgrain.com/2011/12/02/scd-grain-free-lasagna-2-0/

Tomato and Black Bean Soup

http://www.scdrecipe.com/recipes-soup/tomato-and-black-bean-soup/

Pumpkin and Apple Veggie Turkey Meatballs

http://thetastyalternative.com/2013/11/pumpkin-apple-veggie-turkey-meatballs-with-sauteed-spaghetti-squash-scdpaleo/

Carrot Pancakes

http://www.scdandme.com/intro-diet/carrot-pancakes.html

This ought to keep me busy for a while!

Diverticular Disease, The Specific Carbohydrate Diet, and Gluten

About six or so years ago, I began to notice that I was feeling mildly unwell.  It didn't seem serious enough to see a doctor, and our family didn't have health insurance at the time.  We couldn't afford  thousands of dollars in medical tests.  I was nearly always fatigued, experiencing "brain fog," and having digestive issues.  The decline in health was so gradual that I scarcely noticed it until it could no longer be ignored.

After discovering the raw vegan diet in early 2012, my family and I gave it a try.  It was amazing - I was full of energy, free of "brain fog," and felt ten years younger.  My symptoms disappeared.  I stayed on the diet for around two years, blogging about it enthusiastically.  I still love raw food and eat it often, but one thing I learned from that experience is that as beneficial and healthy as the diet is, staying on a strictly limited diet for longer than two years just doesn't work for me.  For example, if I ever go to New Orleans, I will want to be able to enjoy a good, memorable bowl of authentic jambalaya.  This might be treasonous in the vegan and raw vegan communities, but that's how it is for me. 

Also, for me at least, keeping high-raw vegan was almost a full-time occupation that paid in health dividends but wasn't very helpful to our financial state.  I grew weary of it, and as my attention turned to other interests, I simply had less time for it.

Shortly after going back to eating regular food more often, (mostly whole, and much of it cooked vegan,) my health issues returned with a vengeance.  One day in the spring of 2014, (shortly after reintroducing more standard foods such as cooked grains and starches,)  I experienced such excruciating pain that I had no choice but to visit an urgent care clinic.  I was diagnosed with diverticulitis.  Eventually we procured health insurance, I saw a gastroenterologist, and came to realize that I also have some sort of a non-celiac sensitivity to wheat and/or gluten.  I asked the gastroenterologist how to find the cause, since it isn't celiac, and he said, "Why go to all the expense?  If wheat bothers you, don't eat it!"  Of course I've had to put up with people saying derogatory things about non-celiac people who avoid gluten, but that's not nearly as irritating as the reaction to wheat.

People have asked if I think the raw vegan diet contributed to my current condition, and the answer is "no."  The symptoms began long before I changed diets.  I realize now that the raw vegan diet was less a cure and more a "Band-Aid," but it certainly helped while I stayed on it.  And it's not nearly as harmful as other types of eating habits, as long as a person pays attention to their nutritional requirements, including using supplements as needed.  But it's not for everyone.

Today, I'm recovering from a third severe bout of diverticulitis in as many years.  I've been using the Specific Carbohydrate Diet to manage mild flare-ups, and mostly (not always) avoiding gluten.

Coincidentally, (or perhaps not,) this flare up occurred a week after finishing a course of Amoxicillin prescribed by a dentist.  In my case, it seems the infection that causes diverticulitis laughs at Amoxicillin, although Ciprofloxacin combined with Metronidazole does do a good job of knocking it out.  Hopefully, there won't be a next time, but if there is, I'm going to ask about Rifaximin instead of Cipro.

In addition to the antibiotics, the doctor also prescribed Dicyclomine for the cramping, and Ondansetron Hcl for nausea and vomiting.  I didn't need much of the Ondansetron Hcl.  I also took Motrin for pain, which probably wasn't the best choice, but it was all that was available.

The doctor disagrees that the Amoxicillin killed off the healthy intestinal flora, creating optimal conditions for the toxic biofilm that causes diverticulitis.  But the doctor, as much as I appreciate and respect him, also thinks that the diverticulitis is caused by eating popcorn.  Popcorn, and it's evil cohorts "nuts and seeds," did not factor in on any of the flare-ups I've had.  Perhaps it does for some.  For me, it seems that too much starch in general, especially wheat and/or gluten seems to have more of a deleterious effect than popcorn, nuts and seeds.  A diet that is proportionally high in sugars and starches leads to disaster.  Fiber helps a little, but it's not enough on its own. 

The current flare-up has led me to believe that in my case, any course of antibiotics should be followed by a course of  SCD approved probiotics.  Also the Specific Carbohydrate Diet should be followed strictly during and for about two weeks after any course of antibiotics.  It would make sense to do everything possible to create an environment that is not friendly to the bacteria that causes the infection.  The war in my gut is a battle between "good" bacteria and "bad" bacteria.  It really is that simple.

I try to eat healthfully, and use the Specific Carbohydrate diet when I notice the minor symptoms that tend to lead to a full blown flare-up.  In my case it seems to be a good idea to use mild green juice cleanses on a fairly regular basis, (no wheatgrass or barley grass juice,) even without symptoms.

I believe that every person who has some sort of a chronic condition may benefit from observing which foods seem to aggravate the condition,  while consuming more of the foods that do not.  As long as nutritional needs are being met, the worst thing that could happen is - nothing.  But it might help a person feel better.  For some, red meat may aggravate a chronic condition, and for others, it may be raw broccoli.  Nothing I post here is intended to be advice for anyone, because everyone is different. 

At this time, my intention is to stay on the SCD for about two weeks, longer if the symptoms don't abate.  I plan to take probiotics.   Upon returning to a more standard diet, I plan to keep the percentage of complex carbs, starches and sugars whole and low, meaning that small amounts of brown rice and quinoa are okay, but table sugars and junk foods are not.  Monosaccharides are fine, but should not make up the major percentage of the diet.

Thinking of any illness as a war between one's health and that which impedes health is helpful for me, because when at war, we strap on our armor, we deploy resources towards the defeat of our enemies, and we simply do what must be done.

The purpose of this blog will be to track my progress with the condition, noting things that seem to cause flare-ups, and posting links to sources.  I don't intend to post often.  People with similar concerns are free to comment, especially with more helpful sources.  Spam will be deleted.

https://chriskresser.com/how-to-prevent-diverticulitis-naturally/

http://www.breakingtheviciouscycle.info/home/

http://www.diverticulitisdiet.us/

https://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/diverticulosis-diverticulitis/Pages/overview.a

http://www.everylastbite.com/

http://pecanbread.com/

http://www.westonaprice.org/

http://www.beth-spencer.com/

http://bethsblog.typepad.com/turtle_soup_scd_cookbook_/turtle-soup-reci

http://www.gastrochef.org/

http://www.siboinfo.com/uploads/5/4/8/4/5484269/scd_food-list.pdf

http://scdsuccess.com/Steps_to_SCD_Success/Steps_to_SCD_Success.html