A Warning Bowel Movement Before Your "Period"...Who Freakin Knew???!!!

I'm sure this topic may be a bit weird or uncomfortable for many to address, Hoooowever...when it happens to me I'm always concerned about the probability of it happening to another woman, and if she then feels as if she can't express concern or question it because she's the "only one" or its "not proper" to discuss.  If you have been reading my blog AT ALL, you know that my purpose is to discuss and post about such topics because they are natural, normal, they do happen on a daily basis, and we MUST discuss them in order to familiarize ourselves with the anomalies of our body!  And most importantly, not having these discussions enables feelings of isolation, loneliness, insufficiency, and irrelevance that can be harbored as depression and anxiety issues in women, which we ultimately run the risk of passing on to younger women.

I decided to write this post because, over the years I have noticed an obvious relationship between the day I start mensing and horrible crampy bowel movements.  Since I have had a hormone free IUD, I have noticed very difficult, cramping, can't keep still bowel movements the day of mensing (bleeding).  These bowel movements are so painful that I have to use labor breathing techniques, stomach rubbing, and rocking to cope with the pain...afterwards I feel as if my entire bowel tract has been emptied and I'm exhausted and must take a nap.  AND upon waking from my nap... menstrual mensing (bleeding) has begun! Initially, I was thinking that the bowel pain, and discomfort that I was experiencing was related to my Crohn's disease, but in all reality it appears to be related to a non-steroid hormone in our body called prostaglandin!

So What Is Prostaglandin?
Prostaglandins are non-steroid hormones that are very potent and present in very small amounts (Shier, Butler, & Lewis, 2007, p. 495).  They are not stored in cells but are synthesized just before they are released (Shier, Butler, & Lewis, 2007, p. 495).  Different prostaglandins have different functions, but this post is going to focus on one prostaglandin in particular that is named PG4.  This particular prostaglandin has the ability to contract smooth muscle in the walls of the uterus, causing menstrual cramps and labor contractions (Shier, Butler, & Lewis, 2007, p. 495).

Translation to Painful/Urgent BMs at the Start of Menses...
When our endometrium is stimulated by estrogen and progesterone, the production of prostaglandin is increased.  When the endometrium begins to shed or when mensing (bleeding) begins the actual break-down of the endometrium causes the release of prostaglandin (Lewis, Heitkemper, Dirksen, O'Brien, & Bucher, 2007, p. 1386).  The prostaglandin in our reproductive organs causes contractions and constriction of our uterus to expel the complete uterine lining.  In some women, the release and amount of prostaglandin can be very excessive causing the non-steroid hormone to travel to the bowel regions, at which point it causes contractions and constrictions of the bowels...which leads to the urge to have a bowel movement and/or painful, cramping bowel movements within 12-24 hours before the onset of your menses (bleeding).  In addition, this same excessive prostaglandin release is the cause of primary abdominal pain or discomfort (dysmenorrhea) associated with menstrual flow.

Other Symptoms
Other symptoms of excess prostaglandin release can include

• lower abdominal pain that is sharp, radiating to your lower back and upper thighs
• abdominal pain can be accompanied with nausea, diarrhea, loose stools, fatigue, headache, and light headedness (Lewis, Heitkemper, Dirksen, O'Brien, & Bucher, 2007, p. 1386).

How to Feel Better

I'm not sure there is much that can be done about the urgent, very painful, cramping bowel movements.  I just thought it would nice for you to know that those "horribly crampy, smelly bowl movements"  that you may experience between 12 hours and 2 days of your period starting...are not in your head and that there is a legit reason for them...NO REASON TO BE ASHAMED ;)  However, with regards to painful menstrual cramping you can use:

• heat (apply to lower abdomen or back)
• regular exercise (can reduce prostaglandin production),
• proper nutritional habits,
• avoiding constipation,
• eliminating stress and fatigue, 
• drug therapy( such as NSAIDs, Naproxen, Ibuprofen, etc..) - remember that these medications should be started at the first signs of bleeding, and continued for every 4-8 hours to maintain a sufficient amount of the drug in your system to minimize prostaglandin release (Lewis, Heitkemper, Dirksen, O'Brien, & Bucher, 2007, p. 1387).
• lying down for a short period,
• drinking hot beverages (herbal teas), and
• taking warm tub baths.

Educate Yourself

Make sure to keep track of your menstrual symptoms and moods through out your cycle, with some sort of application (I've named a few in a previous post).  This way you can better prepare for rough days, and pick up changes or alterations that can be discussed with your health care providers.  The more aware you are of your body and its responses or lack thereof, the better prepared you can be to address the issue.

I hope this post helps with deciphering between bowel issues related to Crohn's and  bowel issues related to menstruation.  I also hope this post resonates with someone...sometimes all it takes is one person to mention an issue for others to relate.  So, I hope this post is relatable ;)  Feel free to share and comment.  Until next time ;)

References:

Lewis, S., Heitkemper, M., Dirksen, S., O'Brien, P., & Bucher, L. (2007). Medical Surgical Nursing Assessment and Management of Clinical Problems (Seventh ed.). St. Louis, Missouri, USA: Mosby Elsevier.

Shier, D., Butler, J., & Lewis, R. (2007). Hole's Human Anatomy & Physiology (11th ed.). Boston: McGraw-Hill.

Pesticides + Health = What to Buy Organic??!!

I've been purchasing organic produce for close to 9 years now, and this was prompted by pregnancy.  Nine years ago finding organic produce was hard, and I had to travel at least 30 - 45 miles to purchase them.  Fast forward to the present, finding organic goods isn't nearly as hard as being able to pay for them!  So, each time I needed to purchase groceries I would go through this mental process of debating which produce were my favorite, and deciding if it would be worth it to purchase them in their organic form?  After going through this process too many times...I was over it and decided to research which produce were likely to be the most dangerous if eaten in a non-organic form, and I was able to put this list together.

Table 1. Products to buy organic

The pesticides that can be found on our produce affect our overall health in a number of ways.  In many cases when we eat non-organic produce we are digesting approximately 30 different pesticides, and this only takes in to account the number of pesticides that remain on the skin of the item (it does not account for the pesticides that may have seeped into the flesh of the produce).  Those digested pesticides just hang out in your colon until they are released at a very slow pace, slowly damaging your body.  The damage includes, but may not be limited to the items in the table listed below.

Table 2. Affects of Pesticide Digestion

A study conducted on women in 2014, presented that there was no significant evidence that suggested eating organic produce decreased the diagnosis of cancer overall.  However, eating organic produce did show a decrease of Non-Hodgkins Lymphoma diagnoses in women.  This is a very interesting topic, and I'll post more regarding it as information becomes available.  Feel free to check these pages fro additional information:

• The Dangers of Pesticides
• Pesticide-Induced Diseases Database
• Pesticide Injury & Illness Surveillance

In the meantime, choose your produce wisely!  Please feel free to comment, share your thoughts, and follow ;)

Food for Crohn's Flares

I’ve finally had the opportunity to write down the foods and process that works for me during a Crohn’s flare, as well as how I minimize my symptoms on a daily basis.  Anyone exposed to the daily struggle with Crohn’s disease symptoms, can appreciate when any amount of relief can be attained without prescription medications.  I have been working on a few diet changes to reset my gastrointestinal system to a healed and stable state.  After much researching along with trial and error.  I have found that a few almost hard to stick with diet changes ABSOLUTELY make the difference between having a good day and a horrible day.  The diet changes allow my gastrointestinal tract to heal during flares as well as on a daily basis.  The first thing I learned was to simplify my diet, and this was the hardest part to digest mentally.  It’s as if mentally I need sugar and fried foods to enjoy eating...not the case at all...at least not now ;)  

Simplifying my diet...

In simplifying my diet I had to...

• reduce my carbohydrate intake,
• make sure that foods I do eat are very rich in nutrients,
• stay away from processed foods,
• try to eat a majority of foods that MY system can easily digest,
• reduce foods that irritate my stomach (via food diary), and
• eat as many naturally anti-inflammatory foods as possible.

I’m sure the list above is very overwhelming, and it may only work for me.  However, in my opinion it’s worth sharing with everyone, just in case there’s a possibility that it can improve anyone’s symptoms associated with inflammatory bowel disease.  When I started the journey of developing my diet during flares...it was HORRIBLE!  It has taken me almost 4 years to understand my body, digestion, and how EVERYTHING we eat is an accumulation that presents itself as our daily health or “feel good” status.  

Bone broth...

So, at my very worst...when I’m nauseous, vomiting, can’t keep anything down = FLARE ALERT!  I instantly seek refuge in homemade bone broth.  Making bone broth consists of

1. Simmering water, 2 tbsp of apple cider vinegar, and fresh organic grass fed chicken bones or carcass.  I usually run to Whole Foods and purchase about 4 of their organic grass fed bone-in chicken breasts. 
2. I cut the meat and skin off the bones, and plop the bones and skin in the simmering vinegar water for 6-24 hours. 

Bone broth

This broth has been a total Godsend as it is rich in amino acids, gelatin, glucosamine, and chondroitin.  These nutrients from the chicken bone helps with

• strengthening the stomach lining (balances stomach acids),
• joint and skin health, and
• teeth and bone health.

I eat just this broth for all meals with Rooibos tea as my beverage until I am confident that my stomach is stable.  

Rooibos Tea...

The brand of Rooibos tea I use.

Rooibos tea has a very earthy smell and taste, but its feels so refreshing and soothing to my stomach.  In fact, I have a cup or two of Rooibos tea every morning (it has replaced coffee...completely) before eating or drinking anything.  It’s hands down the best start to my day!  Rooibos tea or sometimes-called Red tea is...

• caffeine free
• has very powerful antioxidants (cancer fighters)
• high in minerals
• magnesium – essential for nervous system
• calcium and manganese – creates strong teeth and bones
• zinc –  strengthens metabolisms
• iron – helps blood and muscles distribute oxygen
• prevents the enzyme that triggers cardiovascular disease
• lowers blood pressure and cholesterol
• relieves abdominal cramps, diarrhea, indigestion
• reduces abdominal spasms and inflammation
•  supports the body in absorbing iron, and
• prevents lipid peroxidation that can ultimately lead to Parkinson’s and Alzheimer’s diseases.

Advancing my diet to the next phase...

When my stomach feels stable, I advance my diet by eating...

•  organic chicken breasts and/or salmon,
• homemade bone broth (as a seasoning, or alone)
• cold-pressed coconut oil for cooking,
• cooked organic carrots and zucchini (I really call them green squash),
• plenty of water (with lemon or lime added), and
• salt and pepper.

I usually stick with this restricted menu for approximately 4-6 weeks.  My symptoms usually lessen within the first 2-3 days of bone broth consumption.  However, the length of time before symptom relief is experienced is directly related to the degree of internal inflammation.  Please make note that I don’t eat fruit, sweets, dairy, or grains during this phase of reestablishing gastrointestinal stability.  It’s very important to only eat foods that will assist in the healing of the gastrointestinal tract.  Also be sure to keep a food diary that includes a list of any and all symptoms you may be experiencing on a daily basis.

Next post I will discuss my approach to advancing my diet options to the next phase, as well as my approach to fulfilling my daily nutrient needs without compromising my gastrointestinal tract stability.  As with any diet or health changes, please seek advice from your physician regularly, and understand that this content is provided for educational purposes only.  My intentions are not to treat, diagnose, cure, or prevent any disease including digestive problems.  I hope this post has been helpful.  Feel free to comment and follow ;)

Food Choices for Crohn's Disease

Having to figure out the foods that work for your body after a Crohn's disease diagnosis can be very time consuming and painful.  Fortunately, I have already completed some trial and error research for you ;)  The list below contains a few items that I have found to work for my body during a flare as well as on non-flare days.  The list includes:

• Yogurt with active Lactobacillus strains
• chemically broken down milk or fermented milk
• during the fermentation process, the good bacteria digests a majority of the lactose found in milk, giving yogurt the ability to avoid the element of lactose, while still being nutritional
• the good bacteria found in yogurt reside in our stomachs and over-crowd the bad bacteria in our stomachs, leading to a very healthy equilibrium for our stomach lining and immune system
• ultimately, it provides the body with much needed calories and calcium that may be lacking due to the Crohn's disease process, along with aiding in intestinal recovery
• Salmon, Tuna, and Herring
• contains Omega-3 fatty acids
• have anti-inflammatory properties
• help reduce inflammation
• Cooked carrots (should be cooked until soft and tender)
• contain antioxidants
• nutrient filled (excellent source of fiber, vitamin A, vitamin K, and manganese)
• easily digested
• Unsweetened apple sauce
• can serve as a substitute for fresh fruits and vegetables, as fresh produce can prove to be troublesome for some
• Cheese, specifically Swiss and Cheddar
• great source of calcium
• Potatoes and bananas
• exclude the potato skins (can be too high in fiber)
• great source of potassium
• helps maintain fluid body balance
• Refined cereals
• such as Cream of Wheat, Special K, Corn Flakes, or Rice Krispies
• has a small amount of fiber
• helps maintain nutritional balance
• Liquid meals
• such as Ensure
• large amount of calories in a very digestible form
• helps boost energy level, and immune system
• available in numerous flavors for the fickle taste palettes
• available for multiple nutritional needs, such as high protein or weight gain formulas
• contains dairy, so it can aggravate Crohn's symptoms in some

I have also compiled a list of items to avoid, which include:

• Spicy foods
• mild herbs and citrus juice can be substituted for spicy seasonings
• Fried and greasy foods
• the fat in these foods are not absorbed properly by the small intestine, which causes cramping and loose stools
• try foods that are baked, broiled, or steamed
• High-fiber foods
• not digested completely by the small intestine
• substitute with refined breads and pastas
• Foods with gluten
• labeled "whole-grain" or "whole-wheat"
• some with Crohn's may also be "gluten intolerant" or "gluten sensitive"
• Caffeine
• avoid if you are experiencing diarrhea, as it stimulates the intestine increasing diarrhea
• to get needed fluids try drinking water, sport drinks, and fruit juice (may need to be diluted with water)
• sip your drinks instead of gulping, as gulping can lead to excess gas
• Alcohol
• may exacerbate diarrhea
• has the potential to dry out your body (cause dehydration) and prevent proper rehydration
• has the potential to negatively interact with Crohn's medication
• Raw fruits and vegetables
• in their pure form are loaded with fiber
• not completely digested in the small intestine, causing diarrhea
• switch to cooked vegetables and fruit without skin
• broccoli, cauliflower, and beans may never make the "ok to eat" category

The key to developing a diet that helps your Crohn's disease symptoms is to keep a food diary.  This will enable you to look back at your meals to pinpoint the causes of flares or pain occurrences.  It is very important to take supplements (Omega-3s, multi-vitamin, etc.) in order to make up for the nutrients missed by removing certain foods from your diet.  Also keep an eye out for your body's response to dairy products, as they can be hard to digest and they contain lactose (causes additional aggravation for those that are also lactose intolerant).  Please keep in mind that food tolerability as it pertains to Crohn's disease is different for everyone.  So, this is just a foundation for you to try in order to discover what will work for you.  This is all I have compiled to date, so feel free to comment or ask questions.  Also, make sure you stay updated with new blog postings by selecting one of the methods located on the right menu bar.  Hope to hear from you ;)

Remicade Infusion Change

Good Evening Everyone,

I am proud to announce that my Remicade infusions have been prescribed more frequently instead of increasing my actual dose, and they will continue this way through July of this year ;)  So, instead of going every 8 weeks, now I go every 4 weeks, and it has made a huge difference health and lifestyle wise.  Even my level of functionality after the infusions has improved.  I still take my pre-meds for potential allergic reactions, possible body aches, and nausea.  Even still, the pre-meds don't have the same "put me to sleep" effect as it did initially.

Since moving into our new house in November, planning and chaperoning our son's 6th birthday party, along with preparing our first Thanksgiving and Christmas dinners, a lot of new topics have evolved.  So, stay tuned for new posts and be sure to check out my new page dedicated to our dry skin journey!

Second Remicade Infusion Completed...

Well Everyone,

My second Remicade infusion has been completed, and I was absolutely exhausted immediately afterwards.  However, I would rather be exhausted than in pain ANY day ;)  The process was the same as the first infusion, but this time I had a lot riding on my reaction to this particular infusion...this weekend happens to be our 6th wedding anniversary, and my over-achieving husband always takes me away to one of our two favorite hotels to shop, relax, eat, and have together time!  I was praying the entire time to have more energy after this infusion than the last, and it worked ;)  I will say that since I have started Remicade, my blood pressure has been elevated, so I'm not sure it that is a side effect, but I plan on mentioning it to my PCP this week.

I also had a chance to workout on thursday morning, I used my Zumba Rush game for Xbox 360 Kinect for 1 hour and 14 minutes, and I burned 872 calories...INSANE!  My heart rate stayed within my zone 3 (180-197)  for 53 minutes.  I definitely felt my heart rate begin to increase during the warm-up phase, and during the warm-up portion my heart rate was at 155.  I think it is so amazing how our bodies compensate and work like a well oiled machines.  Supposedly you can calculate your target heart rate zone for workouts by using the following:

Maximum Heart Rate

• Subtract your age from 220, 220 - 30 = 190 (This should be my maximum heart rate)

Lower End of your Heart Rate Workout Zone

• Multiply your Maximum Heart Rate by 0.7, 190 x 0.7 = 133 (This should be my lower limit)

Upper End of your Heart Rate Workout Zone

• Multiply your Maximum Heart Rate by 0.85, 190 x 0.85 = 161.5 (This should be my upper limit)

My target heart rate zone = 133bpm - 161.5bpm
My maximum heart rate during any workout should not exceed 190bpm

According to my actual measured (as opposed to the calculated) heart rate mentioned above, I was exercising outside of my maximum heart rate for a long period of time on thursday, as I spent at least 53 minutes with my heart rate between 188 - 195bpm.  I'm sure the calculation is just that, "a calculation", meaning it can be off by a few numbers in either direction.  However, I did use the Polar FT60 heart monitor watch to measure my heart rate during the entire 1hr and 14min workout, and I'm very happy with my calorie burn of 872 as measured by thewatch :)  This watch comes in handy when you are really serious about getting the most burn for your workout time.  Here are a few pictures of the Polar FT60 heart rate monitor watch.  They come in a few different colors, but I chose purple for Crohn's Disease, and it matched my workout shoes!

This watch is AWESOME, and I would definitely recommend it, not just for show, but for health reasons so you never over work your heart while exercising.

First Remicade Infusion

My first Remicade infusion was great!  There were no complications, and my husband was there to hold my hand the entire time!  When we arrived, I was greeted with financial documents to sign as each Remicade infusion costs close to $6,500...WOW!  Thank God for health insurance, and also the new RemiStart program where you complete an application and become approved for the usage of a discounted infusion rate.  With RemiStart approval, each infusion will cost you $50, instead of what ever your insurance company states is your responsibility to pay.  In my case, I would have owed my infusion center $650 for my first infusion.  However, with RemiStart I will only pay $50 for each infusion for the next year.  At the end of each year, you have to re-apply for the program.

After paperwork and bracelet placement, we were escorted back to our room, where the infusion would take place.  I was given pre-medication, an IV was started, and the Remicade began simultaneously with fluids.  All together the process may have taken 3 hours, but I was very tired and exhausted towards the end of the infusion, and almost achy.  By the time we made it home, I was clearly exhausted and wanted nothing more than sleep!

My second infusion is approaching, and it has been said that the second infusion is the point where difficulties are encountered if there will be any to encounter.  So we shall see :)

If there is anyone you know that may need or happen to know someone else who is taking or thinking about taking Remicade for an illness, please share this RemiStart link with them.  This website will give them the information they need in order to apply for the discount program.

Health & Wealth
ModelMomMD

Awaiting Remicade

Hey Everyone,

I am still Remicade free!  Due to a few set backs I 'm not scheduled to get my first infusion until Friday, and I'm scared shitless.  Luckily we have an appointment scheduled with my PCP an hour prior to my infusion.  So, I will be able to ask him any last minute questions pertaining to the infusion.  I'm most concerned about my systemic reaction during the infusion, and getting home afterwards with additional pain or headaches not knowing which medication to take for it or having not having that certain medication in my possession.  I would hope that my PCP has included pre-medication medication to avoid nausea and head aches during and after the infusion.  I will say that the side effect a fear the most is a migraine exacerbation.

Random question, but did anyone know that the cost of one Remicade infusion costs $5,000.00, which is why my prescription for it had to pre-authorized by mt prescription company.  I have heard so many stories regarding patients first infusion reactions starting from the infusion and leading to the next infusion appointment.  I have a personal nurse through my health insurance that specializes in Crohn's disease and her recommendations were to rest tremendously for the next two days after an infusion, as I will be extremely tired.  She also mentioned achy joints, and numerous flu-like symptoms.  I also hear that the infusion can run from 2-4 hours depending on the patients reaction.

After my infusion I will post my reaction to it and how I am responding afterwards.

Health and Wealth :)

Embarking on the usage of Remicade

Hey Everyone,

If you couldn't tell from the title, my husband and I have decided to give Remicade a chance at placing my Crohn's disease in remission, as I have been battling my symptoms for the past year and 11 months. So, it will be 2 years in July that I have been actively battling Crohn's with multiple trips to the hospital and different specialists.  My diagnosis was given in July of 2011, but numerous GI doctors after that time "are not impressed", as they say with the information provided to them through my symptoms, blood tests, stool tests, etc that I actually have Crohn's disease.  My initial GI doctor that diagnosed me is a world re-knowned GI physician that works with Johns Hopkins.  Now, just for clarification just because he works for and with Johns Hopkins that does mean that I automatically believe everything he says.  After much research of his background and independent projects he has initiated regarding GI diseases, along with his bedside manner, and unending dedication to my health and wellness, my family and I have decided that he is the GI doctor for us.  He is always available, and he has an AWESOME assistant that I can contact at any time, and she responds to my emails ASAP, usually within 10 minutes!

My symptoms have ranged from vomiting/diarrhea, nausea, migraines, achy joints, fever, extreme fatigue, abdominal pain, no appetite, weight loss, weight gain, rectal pain and pressure, bloody stools, etc.  My blood work has shown numerous things ranging from very low vitamin D, and higher than usual ASCA levels (which is usually indicative of Crohn's disease).  My biopsy showed Crohn's ileitis of the terminal ileum.  You would think that such a biopsy would be enough for other physicians to rely on for a diagnosis.  However, I went to a near by hospital for emergency care pertaining to my Crohn's disease, and the GI doctors on staff told my husband and I that I did not have Crohn's disease according to the blood work they had run during my visit.  They definitely did not take my word for it or the fact that my GI doctor from Hopkins had already diagnosed me!  This sent my husband and I fro a second opinion, and needless to say the second opinion doctor thought I had Crohn's disease from the information he was provided, but he wanted his pathologist to re-read my biopsy report...we never heard back from that GI doctor!

We re-entered the treatment conversation with my original GI doctor, and here we are...ready to begin Remicade treatment on the 10th of June!  I am very happy about our decision to try Remicade, as I have been suffering for almost 2 years now.  Yes, there are many dangerous side effects and adverse reactions, but these days all medications come with these issues.  However, Remicade and other TNF drugs have been linked to a deadly Lymphoma.  This deadly Lymphoma has been seen in a some children, and elderly that have received TNFs.  We are a point in my illness where we have to weigh our options, and to us my quality of life is more important than my quantity of life, if and when we have to choose.  I will be posting after my first infusion, and through out my journey with Crohn's disease.  I want to continue to remind everyone that Crohn's is a chronic disease, but it does not define you.  the manner in which you combat the illness and your daily stressors defines you ;)

Health and Wealth,
ModelMomMD