Food! Glorious Food!….. Sorry I couldn’t help it! :-)

So… food.
I haven’t posted for a while as initially I was in charge of the household whilst Andrew went off on a stag do. So I was busy busy keeping the pooches fed and walked!! So my pacing had to eliminate the bike rides and take on the morning and evening walks. But that’s pacing!
However, following that weekend I was unable to conjure up the energy to post as I was struck down by diarrhea and vomiting….. Nice, I know. But interestingly, over the few days I had off work recovering, my RA was a lot easier (not better, but easier). So what was the cause? Coincidence? Lack of work? Or change in food intake?
Now I have looked into food and RA before, but I have been reluctant to massively change my diet for a few reasons. 1) I eat well and healthily, but I do enjoy my food, and the odd treat. 2) I personally feel that once you start with ‘intolerance to this’ and ‘intolerance to that’ you open up more problems (perhaps I’m wrong!), but I have always believed that a little of everything healthily balanced is what maintains and prevents intolerances/allergies. And perhaps I’m way off (or not, but looking at this point from the wrong angle) and it is just my one opinion from observation, but 3) people I’ve met with intolerances/IBS/ulcers often have chronic pain illnesses** and often suffer with low mood. Big sweeping statement I know, and I will be happy to retract it at any time, but currently, from my experience those patterns have come up time and time again ***.
Now, as I say I am happy to retract my third point, well, both my points regarding intolerances (obviously not the one about me loving food… as I do!! A Lot!!), and I am looking into the whole thing with a little more purpose now. Because having not eaten for 2 days during my illness, I was soooo much better (not a totally scientific start – as it could have easily been the extra days off work, I know work adds to my pain as Saturday is generally my worst day of the week)!! Unfortunately, going on a volitional fast and slowly re-introducing foods gradually keeping the worst offenders off the list for the time being….. Not exactly what I want to be doing whilst busy growing a baby!
It’s a really difficult decision to make, especially since I don’t really think that anyone in the world knows the answer, is it better to provide the unborn developing foetus with vitamins and minerals from a wide variety of foods from all food groups, but risk the fact that some of these foods may be making my rheumatoid pains worse, or do I eliminate vast food groups, possibly depriving my baby from certain vitamins/minerals (I just don’t know) during some of the most important months of its newly formed life… but at the possibility of helping rid myself of some sever and debilitating pain… (Which may help the foetus in different ways, e.g. less pained/stressed mum to be) I don’t think anyone knows the answer, I don’t really think anyone knows really what our recommended daily/weekly/yearly allowances actually are? Especially at such vastly different times of our lives such as during pregnancy and during disease?
Plus… Food makes me happy!! Especially all the foods that I consistently see as bad for RA… Dairy, meat products, sugar and gluten – although I think I could manage without gluten without too much heart ache, and I’d like to live without sugar… but dairy…. Meat… especially the badly thought of red meat… oh steak, how could I live a life without another steak? Or cheese? Oh it makes me sad just thinking about it! I could go on about how food makes me happy all night long, but I could also go on about how sad RA makes me (even had a little cry last night)…
If the food issue is indeed adding to my pain (which I won’t know until I cut it out) then I’d have to make a decision, a very difficult decision… what do I want more, and I guess I would have to choose health (but can you believe how uncommitted that sounds!! That is how much I love my food!).
I feel a little bit like I am in the ‘evening stages’ of a bad relationship, coming to terms with the idea of separation, but not yet able to cut all the ties… but in some way I can see it coming. I’m just not sure when yet…
So, any thoughts from any of you out there regarding diet and pain? I’d love to hear of the changes you’ve seen, and what has helped? I know lots of people will have taken these steps, and had different results, please tell me about your experiences! It might help me make my decision…

 

 

 

**(I know, I know… RA is a chronic pain problem! But I have never viewed it in the same bracket as ‘Chronic Pain’, patients with RA don’t have the same pain behaviours as ‘Chronic Pain’ patients – maybe it’s because with RA the patient has a diagnosis, and therefore, can accept the pain and cope/manage better than someone who is continually looking for a diagnosis and no practitioner or consultant can give them a name for their diagnosis apart from ‘Chronic Pain’.)
***Perhaps my snap shot of the population is skewed as those that are out there managing and living with their intolerances/IBS/chronic pain, are the people that I don’t see!! And it is the people that need help with their management that are suffering with depression, understandably in many cases when you hear their stories.

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Peaks and Troughs of Activity

As a physiotherapist I always prided myself on my ability to empathise with the patient. To be able to talk on a level about chronic pain and pacing, the do’s and don’ts, the reasoning behind it, and the need to avoid peaks of activity followed by troughs of inactivity and pain and the downward cycle of deconditioning.

I felt able to use myself as an example of it working, and of pacing’s benefits. But perhaps I never appreciated how much of a pivotal role my pain management played in my being able to achieve appropriate pacing.

Of course, I knew how important pain medication and pain management was with pacing. I regularly encouraged patients to go back to their doctors and consultants to discuss better pain management. But I think I lost sight of how much my medication was helping me! Until I had to stop taking it!

Over the last year, since stopping the methotrexate and just being on the Etanercept (Enbrel) my pacing has been POOR! My lifestyle and my pain levels don’t match well at present, and it has taken me a whole year to be able to look back and appreciate this… I am a rubbish patient, I have always been a rubbish patient, I have never taken my advice well, but now I wonder, if it’s about time I started to listen to myself.

In the past year my activity levels have plummeted due to the pain and exhaustion of a full day at work. I have managed little more than two dog walks a day, and that has now dropped to one more often than not. I have deconditioned. I am now feeling the effects of the deconditioning – Right Achilles tendinopathy, Right anterior knee pain, the list could go on – hills and steps have become my nemesis…. I’m 29!!!

For the last two months I have been giving myself exercises to combat these secondary problems… but like a bad patient I have done them infrequently, and therefore they are useless.

I feel that at the moment, work is my peak of activity, I have exhausted all I have by 4.30pm, and my trough of inactivity is the evening. My feet throb from being stood up all day – I want to sit down, then I seize up and struggle from the chair, my hands scream from holding, supporting and facilitating people all day – I don’t want to hold or touch anything in the evening. And the rest of me aches and feels heavy and difficult to move.

I know however, I have to start doing something to break up the inactivity of the evenings, I have loads of options easily to hand… cycling, swimming, rowing – all low impact, with the benefit of strength and cardiovascular fitness. Of course I know this! I’ve suggested those and many other activities to hundreds of patients… I’ve just got to listen to my own advice!!

So… the plan is… well, the plan is still forming! But I’m going to, I have to, get more active in the evenings… Ideally I’d get to rest a little in the day, but that’s not going to be possible, so instead I have to manage my time in the evenings better, relaxation can’t be on the settee… as I can’t get up again, and going up stairs to bed becomes a 10 minute ordeal. Perhaps going swimming, or pregnant yoga, or out on the bike… my problem is, I’ll miss my pooches, I have to cook dinner at some point… and will I burn myself out? People keep telling me that as a pregnant woman I should be getting some rest… it’s going to be a work in progress!

In the meantime, I’m waiting for an appointment with a colleague, so I have someone else telling me this stuff!! It’s a lot harder to ignore someone else, it’s very easy to talk myself out of doing things! Although that’s a trait I am working on.

And finally, what better motivation to stay in shape and find ways of pacing myself now… because in six months’ time, I’m going to be looking after someone else too, time management is going to become imperative!! And I know myself, if my muscles weaken, and my joints don’t get their support, on top of additional weight (both baby and the odd cake!) it’s only going to make my life harder!!

 

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