Monday, September 17, 2018

Phase 1 to 2, week 2 of treatment: yeast overgrowth to SIBO treatment

I tried to split this post into three sections-background, insights from the last week, and a summary of each day. If you are a friend or family member, I’d recommend sticking with the background and insights. If you’re someone who is having digestive issues, or is wondering what treatment might be like, I’d recommend reading everything.

This post is for informational purposes only and is not intended to treat or diagnose anyone. Go see a doctor for diagnosis and treatment.


Background:
This particular bout of health issues flared in 2015. My job had become extremely stressful and travel intensive, in conjunction with some major life changes: moving in with my boyfriend, becoming a Christian, getting married 2 weeks after being proposed to, becoming a step parent, then planning a wedding reception for the following summer.
In 2016, I was finding I could no longer work full days, and my hair was falling out. When I felt that work was finally slow enough to go to the doctor, I was diagnosed with adrenal fatigue and told to take a month off of work to rest. HA! It didn’t seem possible at that point. However, I did take 2 weeks off then go back at half time in May of 2016. Over the summer I was able to do less and less, and I finally ended up quitting my job in October 2016.
Between October 2016 and June 2018 I had the opportunity to learn how to rest and was able to work on a treatment plan for adrenal fatigue. I was feeling like I was making good progress in the first 3-4 months of 2018. Looking back now, I can see where I was sliding back a bit in April and May. In June, I experienced an extreme energy crash that left me looking for answers, since I didn’t think I had done anything significantly different than I had previously. In the beginning of July 2018, I went and saw a functional medicine doctor who ran a bunch of tests up front to figure out what other things might be wrong with me.
As mentioned in my post about the results from the last visit , my test results show that I have a yeast overgrowth, a parasite, SIBO (small intestinal bacterial overgrowth), and gut dysbiosis.
Previous test results indicated I have low stomach acid, nutritional deficiencies, and hormone imbalances with the adrenal glands, ovaries, and thyroid.
I have been on supplements for the hormone imbalances (previously diagnosed as adrenal fatigue) for a while. They started with my previous doctor. The new doctor is continuing to work on those issues, but with different supplements.

I started the second week of my 4 phase, 10 week treatment plan on September 10th, 2018. Phase 1 will work on the yeast, phase 2 will work on SIBO, phase 3 will work on SIBO and the parasite, and phase 4 will continue with the SIBO. The supplements for everything else will continue through the whole treatment period. This week had a little of phase 1 and 2.
I currently take 11 different supplements throughout the day. Only 1 pill is for the SIBO. Three are for the hormone imbalances, 3 are for nutritional deficiencies, and 4 are for digestive support.


Insights from last week:

I switched treatment phases in the middle of this week. I went from the antifungal nystatin to the antibiotic Xifaxin. I was very pleased to see my bowel movements get back to normal by the time I started the antibiotic. The antibiotic is causing a few minor side effects: trouble sleeping, feeling off balance/lightheaded, and moodiness.

Although trying to blog about what’s going on everyday can sometimes feel like just one more thing to do, there are a few benefits. The first is that the blog acts like a virtual accountability partner. If I write something here and know that at some point someone will read it, it helps me to succeed in doing what I wrote. I’m also finding writing things down helps me to be more strategic about my day. It also helps with tracking how I’m feeling overall so I can get a big picture view of how things are going. With my memory not working well, I don’t always remember how I am feeling week to week.

I’m also processing parts of the treatment in a different way than I might normally. For example, from day 5: The more this week goes on, the more I view the treatment process as a person trying to hold 10 very large non-helium balloons at once. Each balloon has a label- food, sleep, digestion, supplements, kid herding, chores, exercise, spiritual pursuits, social time, etc. I can only hold so many balloons at once before one pops out of my arms, or I bend over to pick one up and I drop 3 more. It’s now painfully obvious I can’t hold 10 balloons at once.

I’m not sure how to deal with the balloons. Perhaps hold different balloons on different days? But some, like the treatment medicines and supplements, HAVE to be 3 times a day, everyday. Maybe one arm can hold the every day balloons, and the other can hold a few alternating balloons? Just trying to wrap my head around it at this point is causing me anxiety.

I did some large batch cooking this week and found that having food ready to eat throughout the week was amazing. There were several days I didn’t feel like cooking last week, and it was super helpful to have food that was premade and nutritious. I will try to continue to make big batches of food 1-2 days a week so it’s one less thing to think about.

Day 8
I only slept about 5 hours last night, but am actually feeling decent this morning.
The last few days I’ve really been focusing on getting my digestive system more normal. I feel like it’s finally started to work, because I had a more normal bowel movement this morning!!! Who knew pooping could be so exciting?! Too much info too soon for a Monday?

At the end of week 1, I started ‘eating’ mostly liquids to help give my digestion a bit of a break. This has mostly consisted of pureed soup and a beef sourced protein powder called PurePaleo Protein by designs for health (sounds gross, but not bad in almond milk!) I also increased my fluid intake to 2-3 liters of water a day, and added psyllium husks for fiber.

I had a protein powder/psyillum husk drink and green soup again for breakfast, and still feeling pretty good. I got desperate over the weekend, y’all. The thought of killing things off with the treatment and then having them just hang out in my intestines wasn’t something I could handle, apparently! I did call my doctors office to ask about my liquid ‘eating’. The nurse who answered said it was fine for a few days to get things back on track. She also said everyone kind of struggles at first and that if it helps me to feel better then it’s fine! Given that information, I’m going to try and make 1 or 2 pureed soups with different veggies for some variety. If I can manage to make 2 soups today, it should last me most of the week.

I don’t even really have to cook much for my family this week because we have a ton of left overs for breakfast, lunches, and dinners. WINNING!

I have been on the computer all morning finishing up the post for phase 1/week 1 of my treatment plan, and starting the post for the 2nd week, so at this point (about noon) I need to stop and figure out what the rest of my day is going to look like. I have a tendency to prioritize poorly sometimes. For example, I’ll make it a really big deal that laundry needs to be done but neglect the actual important thing for the day, like making soup.

I did good on prioritizing, although sometimes unexpected things come up. Take the broth I needed for the soups. I took the jars out of the freezer and this is what I saw:



I was super tired the night I put the broth in jars, and I forgot them on the counter and then went upstairs to take a bath. My husband happened by a while later, and I asked him to put them in the fridge for me. Normally I leave the lids on really loose until the broth cools and before I put them in the freezer. I think he tightened them a bit more than I usually do, because the jars were not overfilled.
So I did what anyone who spent hours making bone broth would do….I put the jars upside down in a glass bowl and microwaved them to get my broth!




After a few minutes in the microwave, all the glass pieces fell off, and the frozen broth chunks were left. I extracted the broth chunks with some tongs, dumped the glass into the trash and rinsed the bowl, then returned the broth chucks to the bowl to microwave them some more.

I realized that the broth needed to be totally liquid so I could strain it through a sieve and coffee filter to make sure all the glass pieces were out. Fun fact: broth does not go through a coffee filter that well. I think the fat clogs up the filter. So I had to use several filters. I’m not even making this up.


So the ‘simple’ task of thawing broth to make soup later in the day took about 30 times longer than I anticipated.
Because the broth thawing took longer than planned, I made a poor food choice for lunch. Since I was out of green soup, I had some left over gluten free waffles I found in the fridge. So much for going all liquid.
After lunch, I went out to run a bunch of errands, including getting ingredients for the soups I would be making:
Here are the recipes I tried today:
Garlic infused olive oil: https://www.fodmapeveryday.com/recipes/garlic-infused-oil/
Low FODMAP Silky Zucchini Soup: https://www.gatheredtable.com/recipes/965123
The zuchinni soup called for the garlic infused olive oil, which I was excited to try since I haven’t been able to have garlic recently. Apparently, the fructans in onions and garlic are water soluble, but not oil soluble, which is why the garlic infused olive oil is considered low FODMAP. It wasn’t as strongly flavored I had hoped, but I still used it in the soup recipe.

The zucchini soup I liked, and it was written to be low FODMAP. This is going to sound weird, but it kind of tasted like a breadstick dipped in a pesto/spaghetti tasting sauce. I think the macadamia nuts in the recipe are what give it the unique flavor. This soup made a big batch, which is awesome! I’m going to leave one big jar out for this week, and freeze the smaller ones so that I have some available for days I don’t feel like cooking.

The carrot soup was a normal recipe, so I had to modify a few things to get it to be low FODMAP. The result was ok. I think it would be amazing with the garlic and onions in the recipe for those who can eat them. I added some paprika, chipotle chili powder, some additional cayenne, and about ¾ tsp salt and that seemed to help. This soup made about 5 cups less than the other soup, so I still have lots of leftovers
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I’m glad I made two soups today. That will help me feel like I have choices for my liquid ‘eating’ the rest of the week. I also made a few cups of brown rice to go with the soups for an easy grain for the rest of the week.



As you may have already surmised, my energy levels have been surprisingly good for how little I slept last night. While I was able to keep myself motivated to keep going with my to-do list, I did find I was super irritable today.

One other thing to note about today- cortisol manager had been recommended to me by my new doc, but they were out of stock when they recommended it. The supplement came in today, so it’s the first night that I’ve taken it. It should help with the hormone imbalances. I had some adrenal building herbs given to me by my previous doc, and I had been taking those while I waited.

Tomorrow I’ll have a lot fewer errands to run, and I’m hoping to get to the gym to work out a bit and sit in the sauna. I’m also hoping to do some laundry and do some general cleaning around the house (which I have been terrible at since the energy crash in June).

Overall, I can say I did feel noticeably better today, with obvious GI distress or pill side effects. YAY!

Day 9
I didn’t sleep well again last night, and I’m feeling kind of lethargic. I also noticed when I woke up that my sinuses were super dry. I’ve been purposely pounding water, so I don’t think I’m dehydrated. It might be time to start up the humidifier!

 I think not sleeping well the last few nights might be due to lack of exercise. I think I only made it to the gym once last week. Most of the time I go I only do 30 minutes on an elliptical, but it seems to help with sleep quite a bit.

I had the carrot soup for breakfast this morning, and was brave with the psyllium husk and went from a half to a whole teaspoon.

I ran several errands before heading to the gym for an hour long gentle yoga class. I was gone for about 4 hours, then came home and started some laundry.  I also had to pick up my step daughter and her friends from school later in the afternoon, fix them a snack, make them dinner, and then take them to a tumbling class. I realized a little too late that the location of the tumbling class had been moved from last year, and instead of being 5 minutes from our house it was 15 minutes away. I hate running late to things like that; it tends to trigger my anxiety. Between all the errands, house chores, and kid herding I was feeling really anxious for about an hour. When I got home I went and walked the dogs to help calm myself a little.

This is the first Tuesday we’ve had my step daughter where she had tumbling classes instead of regular cheer practice.  In future weeks, I will make sure not to plan much for Tuesdays and focus on crockpot meals!

Even though I did quite a bit today I didn’t feel great while doing it. I’m still thinking it’s due to lack of sleep.

I ‘ate’ mostly soups today, with a muffin, some grapes, and a protein bar being the only ‘solid’ things I ate. Surprisingly, I’m not that hungry if I eat enough soup. I’ve been trying to put extra garlic infused olive oil in the soup after I heat it up to help with satiety.

I did have a bowel movement today, but it was a 1 on the Bristol scale, which indicates constipation.  I guess I should just be happy I had movement 2 days in a row!

I’m drinking my magnesium supplement as I’m writing (9:45 pm) and starting to get tired. Since I ran around frequently today and got some exercise I’m hopeful that I will sleep better tonight!

Day 10

I didn’t sleep well again last night. Part of that was I had a hard time falling asleep due to the anxiety I experienced from yesterday evening, and some of it was waking up early and not being able to go back to sleep.

I was able to do some laundry and cleaning this morning, but after lunch I could barely keep my eyes open. I tried to take a nap, but not sure I actually slept much. I mostly just laid down and rested for a few hours.

I pushed myself to go to the gym later in the afternoon to see if that would help with sleep.
On my way to the gym I think I experienced a prolonged hot flash. I only experienced hot flashes with the antifungal the first day or so, and then sporadically when I didn’t eat enough.

My bowels were moving again today, which makes it 3 days in a row! Still a Bristol scale 1, but at least things are moving.

I was hoping to have normal bowel movements by the time I started the antibiotic for SIBO tomorrow. While I have been more regular the last few days, I wouldn’t say things are back to normal.

Speaking of tomorrow, I’m a little nervous starting the new medication. The pharmacist had mentioned that many people experience lightheadedness the first day or two they start taking Xifaxin. I intentionally did not plan anything for tomorrow in the event I experienced any side effects. With other prescription drugs I’ve taken, I don’t often experience side effects.

I think I’m going to try an Epsom salt bath tonight and see if it helps with sleep at all.

Day 11

I slept a little better last night, but still not long enough. I had the wired/tired feeling when trying to go to bed, which is related to the adrenal fatigue. I woke up early again for no particular reason.
I was super irritable this morning, and generally pretty sluggish. I did have a normal bowel movement, though! So that was exciting.

At this point in the day I’ve taken 2 Xifaxin doses. I noticed a little bit of lightheadedness at lunch, but it wasn’t pronounced.

I do feel pretty ‘spacey’ today…I’m having a difficult time tracking with one thing, and am getting easily distracted.

The last two days I’ve been in my Pjs until late afternoon. The last few months I had been doing a good job of getting dressed right after breakfast and feeling prepared for the day. The last two days I just haven’t felt like it. Taking a shower and getting dressed just seems like more energy than it’s worth. Sometimes it’s those types of details that let me know how tired I actually am.

I’m also noticing a higher level of resistance to starting tasks. For example, I need to go check the mail and drop off a package at the post office. Most days, that’s an easy task. Today, getting the gumption to put on normal clothes and leave the house just isn’t happening.

My guess is that the tiredness and lack of motivation is related to not sleeping the last few days.
Later in the afternoon, and a few hours after taking my dinner dose of Xifaxin I did start to notice that I felt off balance, which could be related to the light headed symptom I was warned about. I also noticed I was significantly more hungry than normal. I wonder if it’s related to the gut bacteria dying off…maybe they’re sending signals for food because they’re dying off?

The wired/tired feeling was present again before bed. It was likely exacerbated by being out of the house too late. I haven’t seen my husband much this week, so I rode with him to go pick up our daughter from cheering at a volleyball game, which would have been a short trip. Except for the last game had just started, so we stayed to watch since we were already there. Then we ended up taking another one of the cheer girls home after the game was over. What would have been a 40 minute excursion turned into a 2.5 hour excursion and not getting home until 10:30pm. Next time I’ll just stay home.

Day 12

Between staying out late yesterday, not falling asleep til midnight, and being woken up at 6:15 this morning, I didn’t sleep well or long enough. Oddly enough, I don’t feel as tired as I did yesterday.

The more this week goes on, the more I view the treatment process as a person trying to hold 10 very large non-helium balloons at once. Each balloon has a label- food, sleep, digestion, supplements, kid herding, chores, exercise, spiritual pursuits, social time, etc. I can only hold so many balloons at once before one pops out of my arms, or I bend over to pick one up and I drop 3 more. It’s now painfully obvious I can’t hold 10 balloons at once.

I’m not sure how to deal with the balloons. Perhaps hold different balloons on different days? But some, like the treatment medicines and supplements, HAVE to be 3 times a day, everyday. Maybe one arm can hold the every day balloons, and the other can hold a few alternating balloons? Just trying to wrap my head around it at this point is causing me anxiety.

So, I’ll move to other topics.

Soup update: Yes, I ‘ate’ liquids most of the rest of the week. I did have a burger patty and a brat last night for dinner and felt fine, so there have been some solid foods here and there.

 Remember on day 1 of this week where I was saying I had so much left over soup that I was going to freeze some? Well, that didn’t happen. When you eat soup for 3 meals a day on most days, those jars get used up really fast. I think I’m down to one serving of carrot soup and 2-3 servings of zuchinni soup. I loved having a quick, nutrient dense meal ready when I needed it. I will try and continue making a large batch of soup a week just for when I don’t feel like cooking.

Digestion Update: I had a normal bowel movement AGAIN this morning! That’s a few days in a row now. I can’t tell you how excited I am that my digestion is back to normal now that I’m in the antibiotic phase!

 I do think the soup helped with this, as well as adding the psyllium husks to my routine. I’m going to try and go back to eating mostly solid foods and see what happens.

I’ve mentioned feeling wired/tired before bed the past few evenings. Tonight was a little different. For lack of a better word, I felt caffeinated. After about 9pm I was feeling pretty restless and decided to go shopping at Ross since they close at 11pm. I figured I had been going to bed later than that the past few nights and figured it wouldn’t be a big deal. It took me a long time to start to feel tired- probably around 1 am.

Day 13

I probably slept 6-7 hours last night. Not enough, but I didn’t feel terrible when I woke up.
My digestive tract continues to move normally.

Today my husband helped a girl from out church move. I didn’t ‘move’ so much as fetch forgotten items and tried to make sure people were staying hydrated. I carried a few things here and there, but nothing heavy.

I discovered when I arrived at the apartment that if I moved quickly I was really off balance, and that I was pretty irritable. I also discovered stairs don’t help with feeling off balance.

I was probably out of the house 4-5 hours. When I got back I had some lunch and then could barely keep my eyes open. I slept for about 2.5 hours in the afternoon, and woke up in time for dinner.

It’s about 8pm currently, and I’m still feeling tired and off balance. I’m wondering if I’ll be able to go to bed at a normal time tonight, or if I’ll start feeling caffeinated again in few hours.

I wondered if the caffeinated feeling was related to the Xifaxin, so I spent some time trying to see what other people’s experiences with Xifaxin were and stumbled across this forum thread.
It looks like other people have experienced increased hunger and moodiness, but I haven’t yet found where other people feel caffeinated. I did, however, find that trouble sleeping is a common side effect of Xifaxin. I’m going to assume that my feeling caffeinated is related to the trouble sleeping side effect.

After thinking about the forum thread I read where people experienced increased hunger, I recalled that when I quit gluten in the summer of 2016 that I was RAVENOUS for about a week. It didn’t matter how much I ate, I was starving 10 minutes later.

In relation to FODMAPs, I know I have big reactions with onions and garlic, both of which belong to the fructan category. Wheat also falls into the fructan category, and I wonder if the hunger I had when I stopped eating it was related to SIBO bacteria versus an allergy or sensitivity.

Day 14

I didn’t sleep well again. We went to church this morning and I noticed I couldn’t quite catch my breath. This is a new symptom, and not sure what it's related to.

I spent much of the afternoon lying in bed and binge watching a show on Amazon. I was too wired to sleep, but too tired to do anything upright.

I managed to drag myself to the store in the early evening to get a few things for dinner this week.
I noticed after dinner that I was craving carbs. My cycle should be starting in a few days so I’m going to assume that’s PMS related.

I took an epsom salt and lavender essential oil bath hoping it would help make me tired. It did help me to relax, but I didn’t fall asleep until midnight.

As am editing this blog post I'm noticing how I write less on the days I'm tired. I'm going to assume that the post for week 3 is going to be relatively short...lol.






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