There and Back Again
When I was finally diagnosed with Crohn’s disease in 2012, it precipitated a crisis, both physical and emotional. The presentation of my flare at that time was one of the worst I had experienced in my life. This disease for me typically came with not only digestive symptoms of various types, but also with major systematic inflammatory responses, the worst of which was erythema nodosum. Erythema nodosum consists of the development of painful red bumps under the surface of the skin. These can spread and enlarge quickly to cover large areas on the legs if the underlying inflammation in the body is not addressed. Unfortunately, I felt that other things in my life were more important and I chose to ignore the signs that something was increasingly out of balance in my body (self-abandonment). By the time I decided to seek help, I was so far gone into a flare that I could barely walk without crying with every movement. The deciding moment came as I lie in bed contemplating the amount of pain I was going to have to deal with if I tried to get up to go to the bathroom. Was I willing to pee the bed to avoid it? No, I guess I was not. I stood, fell to the floor and slowly crawled, dragging myself to the toilet. As I sat there crying, I realized I was not going be able to deal with this on my own. I was humbled. Here I was, a naturopathic doctor, supposedly with all the tools, knowledge and answers available to help me and I couldn’t do it. I couldn’t fix it. I didn’t know what to do. I had to ask for help.
Asking for help was not what I did. I was the one that helped, that listened, that took care of others. Ah, hind sight is 20/20.
This was a pivotal moment for me. Looking back, I realize it was my physical rock bottom. The physical representation of the impact of years of putting my roles, duties, and responsibilities as well as the needs of others over the needs of my own nervous system, body and emotional self. This was my breaking point.
We were getting on a plane in two weeks to head to South America for about a month. I did NOT have time to be sick. This was extremely inconvenient and I could not believe it was happening now. Of course now, looking back, I realize that this was the culmination of months and years of high levels of stress, inadequate self-care and underlying genetic and digestive dysfunctions.
I came out of the hospital with a diagnosis of Crohn’s, an intraluminal steroid and an aminosalicylate medication. I argued and resisted taking medication until my husband sat me down and told me I could not get up until I took something to help me. We had to make a decision about a major trip involving 15 hours of air travel. Could I travel or could I not?
Ultimately I decided that the family trip was important to me and that I would do what I needed to do in order to go. This meant taking a steroid.
I immediately put myself on digestive rest involving bone broth, very simple foods, high doses of probiotics and L-glutamine powder. I started my prescription medications, against my deepest convictions. So be it. I wouldn’t say the results were miraculous, but I did stabilize to the point of being able to travel.
This was the beginning of the Slow and Steady Journey back to health that I began in 2012 and continue walking today. Let me note that although I am sharing the path that I personally chose to walk at that time, I would say that I might choose to do things differently if I knew then what I know now.
I will break down the physical aspects of my healing program in this blog post.
Step 1
STABILIZATION
Nutrition:
Specific Carbohydrate Diet
I started with a Gut And Psychology Syndrome (GAPS) Intro diet and then slowly progressed into full SCD. I remained on this diet for the next year and a half. I no longer solely recommend this option for my patients. I do feel this diet was part of the reason I was able to successfully stabilize my Crohn’s, but it is extremely difficult to stay on that diet for long periods of time and it causes dramatic weight loss. (see link below for more info)
Medication:
Entocort 9 mg
( I started on a 3 month wean, but ultimately ended up on and off this medication at 3 or 6 mg per day for 9 months)
Sulfasalazine
( I started this medication and within 6 weeks discontinued it due to headaches and other reactions)
Supplemental Protocol:
Meriva- 500 mg capsules up to 6 per day during acute inflammation
L glutamine- up to 20 gm per day during acute phase healing
Adrenal glandular
Fish Oil
Probiotic: 80-100 billion per day
Lactobacillus acidophilus (CUL-60 and CUL-21), Bifidobacterium bifidum (CUL-20), Bifidobacterium animalis subsp. lactis (CUL-34), Lactobacillus salivarius (CUL-61)
Step 2
REHABILITATION
Because of the extensive damage to my digestive tract while living in South America, and the extreme antibiotic and antiparasitic medication use that was involved, I developed SIBO (Small Intestine Bacterial Overgrowth)
I treated myself with herbs and antibiotics as well as with Prokinetic herbal supports.
I also followed intensive mucosal healing programs with herbal products and nutritional supplements to help repair the lining of the intestinal wall.
The most important aspect of this part however, was the use of bitter herbs and other lifestyle interventions to build up the strength of my digestive apparatus and to regulate the functioning of the Vagus nerve.
Protocol:
Rifaximin
Metronidazole
Goldenseal/Thyme/Myrrh Tincture
Oregano oil capsules
Vagus Nerve and Bitter Herbal blends (Gentian, Andrographis, Dandelion, Milk Thistle, Ginger, Lemon Balm, Elderberry, Lavender, Skullcap)
Intestinal mucosa healing support:
L glutamine
Quercetin
Marshmallow root
DGL
N acetyl glucosamine
These are the basic parameters of the physical interventions that I made use of over the next 3 years of my life. On their own I do not belief that these would have been sufficient to move me into a space of full healing. Physical layer interventions can be absolutely critical for early phases of healing IBD. I would refer to this as " Stabilization". This is always priority number one with anyone in an acute flare of IBD, especially Crohn's disease. Crohn's can very quickly become a life-threatening or very precarious situation if it is a severe or fulminant onset. Please always remember this when considering natural interventions to help you heal! Step one is to Stabilize. In my opinion, this is often by any means necessary. This includes elemental diets, steroids, biologic medications, or surgery. There needs to be a certain level of available life force energy in order for your system to move into a healing phase. If you are critically ill and experiencing severe weight loss or blood loss, the energy balance in your system is off. Step one is always to re-balance this piece.
Also, once you have created a level of stability, the most crucial next step is to begin evaluating the underlying terrain of your body and constitution.
-What were the triggers in your health history that destabilized your body? Address them systematically on the physical layer.
-What are the imbalances in your mental, emotional and spiritual self? These is the KEY to actually creating the environment in your body that will NO LONGER support the disease process. The way to keep the disease from coming back is to find the parts of your self that facilitated it happening to you in the first place....and CHANGE THEM.
See Part II