This is so important to folks with IBD. There are solid, quantifiable reasons that autoimmune disorders are so prevalent in the First World, and particularly in the United States, and there can be little doubt that one of those reasons is our economy’s dependence on GMOs for food. Our bodies have not yet evolved to properly metabolize these proteins, and our immune systems, by their very nature, are designed to respond to and attack invading proteins. Please watch this video, and if you’re not already, consider whether or not it’s worth it to you to buy organic  foods. Yes, they are more expensive… she talks about why. But the more folks buy it, the less expensive it will get.

I’m starting to ramble now, so I’ll close for the time being. Just PLEASE… stop buying GMOs. Feed real food to your self and your family. Our planet depends on it, and so do our lives.

The two most notable characteristics of LDN sleep have been (for me, anyway), a lack of any experience of falling asleep (which is to say that I lay there, wide awake, and the next thing I know, it’s morning. There’s no sense of falling asleep.), and incredibly vivid and complex dreams (which, notably, I actually remember having… not something I generally did before LDN).

Within the last week or so, though, things have begun to shift. It’s difficult to tell when this started happening, but I’m noticing a couple of things now. I’m becoming increasingly aware of being sleepy, for one. The last 3 months have been an interesting time, when falling asleep has been more of an event than a process. I’d be laying in bed, wide awake, feeling definitively NOT sleepy and wondering if I’d be able to fall asleep. Suddenly, in the blink of an eye, it’s morning!

Another interesting development is that my dreams seem to be quieting down. They are still pretty vivid, but I don’t seem to be able to remember them as well. Also, the imagery in them is much less graphic. I’m of mixed feelings about this: One the one hand, I was finding the content of my dreams (and the ability to remember them for a while) to be fascinating and inspiring. On the other hand, they left me feeling exhausted and worn out.

Overall, I’d say that my sleep is getting more restful. I’m waking up more able to function, and I’m hitting the snooze button fewer times before rolling out of bed. Am I getting actual therapeutic benefit from the LDN? I’m leaning towards yes, but not with absolute conviction. My patches of psoriasis have pretty much stabilized and aren’t getting any smaller, but I have noticed that any trace of onycholysis seems to have cleared up, so that’s good. I’d feel a lot more convinced, however, if the inflamed skin on my ears and head went away. In the meantime, I’ll continue to be patient.

Ever since my Crohn’s diagnosis, I’ve had a concern that’s lingered without resolution. I’ve come to think of my disease as a sniper, because it wasn’t until my symptoms were bad enough to require surgery that I knew something was amiss. Oh sure, I knew that my gut wasn’t normal, and I had days that were sometimes uncomfortable, but I never had any of the symptoms that are generally associated with Crohn’s… extreme pain, excessive diarrhea, bloody stool. None of that stuff. So while the surgery effectively eliminated all my active disease, I’ve been left with this lingering thought in the back of my head…. how will I know if it returns? Will I again have to wait until I’m in dire crisis before knowing that I’m flaring? I console myself with reassurances that I’m a lot better informed now, that I’m more in touch with my gut now, that I don’t need to worry since I’ll never allow myself to flare again. But the fear lingers.

This has been especially top-of-mind for me during this last week. I’ve been recognizing some gut behavior patterns that I’ve not seen for a long time…. deep cramping associated with motility, *loud* gurgling, suddenly urgent and explosive BMs. It’s certainly possible that I just ate too many leafy veggies last week. Leafy veggies have always been difficult for me, and part of the lunch food that Diana and I prepared for the week was Saag (Indian creamed spinach). I didn’t think it would be a concern, since it had gone through the blender and was… well…. creamed. I ate it 3 days in a row before things started to get wonky, but by then it was too late. So I stopped eating it and went to eating almost exclusively proteins for a few days. This all started going down last Wednesday and it’s only today that I’ve begun to stop feeling ‘off’. So… was/is that a flare? I don’t know, and I probably never will. Short of being able to just drop everything and go get blood work and a colonoscopy every time things go haywire, I’m left with little to do but to fall back on what I know will work well for me. When in doubt, eat only proteins. (please note: this is advice to myself, not to you. I promise you, your IBD is different from mine… everybody’s is different!).

As I mentioned above, I’m continuing to use Low Dose Naltrexone as one of the tools in my arsenal. I’ve mentioned in the past some of the effects it’s had on my sleep patterns. Much to my pleasure, I’m finding that the process of falling asleep is  beginning to stabilize a bit, and return to a more gradual one, rather than the more event-based model it’s been following. It’s still not like it was before LDN and I don’t know that it ever will be, but it certainly brings about a lot less panic now, as I’m no longer laying there wondering if I’ll be able to fall asleep. What’s not changed are my dreams. They continue to be epic. Not epic in the colloquial sense, mind you… I mean epic in the Homeric sense! Expansive, huge, complex, and sweepingly epic. Not uncommonly, they are quite violent, which isn’t something I recall experiencing much of before LDN. Interestingly though, I never seem to feel fear during these dreams that would normally qualify as nightmares by any definition of the term. That’s just fine with me! I do sometimes wake up feeling a little worn out by them however.

Overall, I’ve been feeling terrific, and I know beyond any doubt that SCD has been integral to that. Is the LDN helping? It’s difficult to say with absolute certainty. I do have one interesting indicator though. As I’ve mentioned elsewhere on this blog, Crohn’s isn’t my only autoimmune issue. I also have psoriasis, and while it’s been a good long time since I’ve had a flare, I do have several spots of chronic irritation. One of these spots is a large swath on the back of my head, about 2 inches wide and 6 inches long. It’s been in that location and that size for a couple of years. Since starting to take LDN, this spot has begun to shrink. It’s now down to 3/4 inch wide and about 3.5 inches long. So that’s pretty interesting. I’m thinking that I might throw a party when it becomes undetectable! Who’s with me?!?

I’d love to hear from you about how I can make this more useful for you. I write this blog as much for you as I do for me, so please let me know your thoughts. Does the separate page make sense? Or should I just create a new post for each experience?

You see, one does not eat it with a fork. Nor a spoon, or even a knife. Ethiopian food is served with a flat bread made from teff, called injera. One tears off bits of injera, and uses it to grab a bite of food, then the whole handful goes down the hatch. It really is a delightful way of eating… sensual and involved. I love it! Sadly, teff is a grain, therefore SCD-verboten. But, it was Kira’s birthday dinner, so off to Bete Lukas we went!

Their food is outrageously good… there’s just no other way to describe it. Sadly, all of the appetizers are strictly illegal, so my tummy grumbled as I watched folks enjoy their sambusa. When dinner came, it was served family style, as always. A large platter, lined with injera, and all the various dishes arranged on top. I asked the server for a plate and utensils, explaining that I couldn’t eat the injera. She assured me with a smile that teff is gluten free. I thanked her and explained that I was completely grain free. She thought that was odd, but assured me she’d return with a plate and utensils.

I had just began to think that she had forgotten about me, when she finally returned with a small plate. She also placed in front of me some of the saddest, most decrepit looking utensils I’ve ever seen. The fork tines were bent, and the long sundae-style spoon had long had any vestige of shine beaten out of it. They looked remarkably as though they had come off the back shelf of a Goodwill store. It was clear that I had been given the Spoon Of Shame®, reserved as passive-aggressive punishment for those American customers too prudish to eat with their hands. It took a moment for me to get over the insult and to get over the desire to stand up and proudly pronounce my desire to eat all kinds of exotic foods in whatever way was appropriate for that cuisine, to declare that I had known how to handle chopsticks almost as early as I’d known how to handle a fork, to make known that I would love nothing more than to get my hands greasy and stained from the oily, paprika-rich sauces. One deep breath later, I found within myself the ability to stand proud in my dietary choices and in my choices to prioritize my health over my ego. I grasped my wheezy spoon and my arthritic fork and dove in! From then on, the only challenge was leaving food on the platter for everyone else!

If you’re ever in PDX and want some amazing Ethiopian food, I strongly encourage you to check out Bete Lukas. And to bring your own utensils!

Fremont Bridge from the East bank of the Willamette River. Image via Wikipedia

Despite the name of this blog, it’s been a blissfully long time since my gut was actually cranky. Weeks, probably. Praise be to SCD! It’s also been a blissfully long time since there was a traffic jam on my way to work in the morning. I suppose it makes a poetic sort of sense that both of these things should happen at the same time this morning.

My commute is not very long. When traffic is favorable, it’s about 12 minutes door-to-door. This morning, traffic was the opposite of favorable. Traffic slowed to a crawl as I was entering the Fremont Bridge. Not a big deal. But about 1/3 of the way across the bridge (moving at about walking speed!), it happened… a wave of crampy, nausea-inducing pain and urgency rolled across my midsection. From my vantage point, I could see the next half mile of traffic, but whatever was causing the traffic was beyond that. It was obvious I was going to be stuck in this traffic for a while.

I must confess that I was starting to feel some panic at this point. The loud gurgling and intense pain was not helping. As I slowly creeped forward, a few feet at a time, I began to wonder which would be worse… to pull over and poo all over the roadside with hundreds of people watching and no TP? Or to just lose it in the car? Yes, folks… these are the kinds of things IBD-ers think about!

As I neared the far end of the bridge, I was able to see the obstacle causing the backup. That mangled car looked about how my colon felt. I knew that once I got past the wreckage, it would be less than 5 minutes before I was in the office and would have a bathroom available. And so began a conversation with my colon. I spoke to her, displaying compassion and empathy, and encouraging patience and soothing relaxation. I decided at this point that perhaps my colon needs a name. I’ve not yet decided on one. Suggestions?

Finally, we crept past the wrecked car and I saw wide open highway ahead of me. With no hesitation, I brought the hammer down, hurling 4000 lbs of oversized car down the highway at barely legal speed. It was with no small amount of joy that I pulled into the parking lot and all but ran into the office building to find that the restroom was not occupied! After 20 minutes of turning myself inside-out into the toilet bowl, I emerged victorious, with a smile of relief and satisfaction on my face.

Today is our office holiday party, with lunch at some local place followed by a couple of hours at the local bowling alley. I may skip lunch, that I might continue to enjoy my currently delightful sense of emptiness!

I’m not at all certain that I experienced a 3-month crisis, but that’s hardly surprising since I started the diet while in post-surgery remission. I don’t recommend a bowel resection as a terrific way to have a few days off work, but I gotta say, it’s sure made my life a lot easier!!

SCD Legal Pulled Pork in the Crock Pot

• 1 boneless pork shoulder roast, about 4 lbs.
• 2 onions, sliced into half-rounds
• 1 batch SCD-Legal Ketchup
• 1/2 cup stock (chicken or beef)
• 1/4 cup apple cider vinegar
• 1/4 cup honey
• 1 tsp Tabasco (adjust to taste)
• 1/2 tsp kosher salt

Like all good BBQ, you’ll also need a rub for the pork. For that, you’ll need:

• 4 Tblsp Paprika (smoked, if you can get it…. Penzy’s has a really nice one)
• 2 Tblsp Cumin
• 2 Tblsp Chili Powder (see note below!)
• 1 Tblsp ground Black Pepper
• 1 tsp Cinnamon
• 1 tsp Cayenne
• 1 Tblsp Salt
• 2 Tblsp Honey

Combine all the rub ingredients. Rub into all surfaces of the pork roast (leave the roast tied!). Wrap the roast in plastic wrap and allow to rest in the fridge for a few hours or overnight. While it’s resting, it’s a good time to make the ketchup.

In large pan, sear roast on all sides over medium high heat, 2-3 mins per side.  Place in crock pot.  Add onions to pan and carmelize, 15 minutes.  Add garlic, sauté for 1-2 mins.  Deglaze pan with stock and vinegar, being sure to scrape all the goodness off the bottom of the pan, and bring to a boil.  Add to crock pot.  Add remaining ingredients and cover.  Cook 6-8 hours on low, until pork falls apart.

Now, here’s where the magic happens. Carefully lift the roast out of the pot, leaving as many onions and as much sauce in the pot as possible. If you have a hand blender, use it to puree all the onions. This give the sauce a rich, velvety texture. If you don’t have a hand blender, GET ONE! It’s such a useful tool! But until you do, you can dump all the sauce into a blender or food processor and puree, then return to the pot. Remove the ties from the roast and pull the meat apart with two forks (be ready…. this could be messy!). Return the meat to the pot and stir to combine with the sauce. Voila! BBQ deliciousness with none of the outside inconvenience or particulate air pollution!

Important note on chili powder and SCD legality! As pointed out by fellow blogger, Paul Stocker, of Eating SCD, I should mention that chili powder is not just ground chili. It is a blend of spices, and depending on the brand, may contain illegal anti-caking agents or other ingredients not listed on the label. I can’t possibly confirm the legality of every brand out there, so it’s on you to check up on it. I *CAN* tell you that I have confirmed that the chili powder I use, from Penzey’s Spices, is free of illegal ingredients and therefore SCD compliant.

http://crohnsjustsucks.wordpress.com/2011/12/04/crohns-and-the-stick

Depending on the scope of your imagination, fecal transplant may or may not be exactly what it sounds like, but it is a procedure that is trending upwards in terms of its ‘discussability’.

It’s no secret to the IBD world that gut flora, the vast colonies of bacteria that live in our colons, play a significant role in overall systemic health. More specifically, imbalances within the gut flora are believed to be one of the defining characteristics of Crohn’s disease, and one of the foundations behind the Specific Carbohydrate Diet.

If you’re reading this blog, there’s a good chance you’ve already read Breaking The Vicious Cycle, by Elaine Gotschall, but for the benefit of all, I’ll summarize the thought behind SCD and gut flora. It goes something like this: At some point, for reasons that aren’t entirely understood, the immune system begins to characterize certain species of bacteria as invasive rather than symbiotic. As a result, it sets to work attempting to eradicate colonies of that type. One of the immune system’s most powerful tools is inflammation. It uses that tool in the gut, attempting to make it an inhospitable place. An unintended consequence of this is that the gut’s ability to process carbohydrates is reduced. Those carbohydrates then become available as food for the very colonies that the immune system is fighting. These colonies then grow thanks to the surplus of food. The immune system increases inflammation in response to the growing ‘attack’, making more carbs available to the bacteria.  This is the essence of the vicious cycle…. a spiral of inflammation, gut injury, and out of control colonies of specific bacteria (and reduced colonies of others). The goal of SCD is to starve those out-of-control colonies by removing most carbohydrates from the diet. The thought is that by eliminating these colonies, the immune system will no longer see them as a threat.

Obviously, there are myriad ways of changing the makeup of gut flora beyond just diet. Antibiotics are a popular tool among allopathic providers. Many people (including myself) take probiotic supplements to introduce greater numbers of beneficial bacteria to the gut. Colonic irrigation, enemas, and laxatives are other ways that people attempt to flush out and reset the gut flora.

But what if these don’t work? What if the colony you’re trying to eliminate is so virulent that antibiotics and starvation don’t kill it? What if it’s so aggressive that other colonies aren’t able to establish themselves? What if the undesired colonies always re-establish themselves before anything else can take hold? What then?

This is when most allopathic doctors start shrugging and shooing you out of their office. More and more often (or perhaps less and less infrequently?), people are turning to fecal transplantation as a method for restoring their gut flora to a healthy and diverse population. The process is pretty simple, really. The transplant recipient chooses and recruits a healthy person to be the donor. The recipient goes through the same prep as for a colonoscopy, flushing out their gut and eliminating as much of the current population as possible. The donor takes a laxative to assist with producing a donation. The doctor facilitating the procedure makes a solution from the donation and, using some of the same equipment as for a colonoscopy, injects that solution deep into the colon. The hope is that this will serve as a ready-made population of gut flora that is already established, thereby crowding out the undesired colonies before they can regrow.

Let’s be clear: This is not an FDA-sanctioned procedure! In fact, there are a variety of reasons that the FDA may not even be able to review it, much less approve it. An interesting article discussing some of the regulatory hurdles related to fecal transplantation is here. If this is a therapy you’d like to consider, then your first challenge is going to be finding a doctor that’s willing to perform it.

Another significant hurdle to mainstream acceptance is the obvious ‘ick factor’.  I mean, it just sounds gross. This technique, like helminthic therapy, violates some serious social taboos. But I give you this for your consideration: If you are so sick that this therapy sounds intriguing to you, you are probably past the point of being grossed out by poo.

Not surprisingly, there have been no controlled, double-blind clinical trials into the efficacy of fecal transplantation as a treatment for anything. Not only would it be difficult to recruit participants, but who’s going to pay for it? It’s not as if Big Pharma could make money off selling poo. That said, there have been several very interesting studies and loads of anecdotal evidence that point to extraordinarily high cure rates.

A google search yields a surprising amount of information, which I won’t duplicate here.

Are you familiar with this procedure? Have you used it? What were your results? Any other thoughts? I’d love to hear them!