How To Combat The "Why Me's"

If you have a chronic illness or suffer from chronic pain, you have no doubt asked yourself “why me?” at least once…or more likely, a hundred times. I know I have. This question usually comes when you are not feeling well, when things aren’t going as you planned, or when you are in pain. It is something that is hard to move past. It can be frustrating and all-consuming at times. It can be depressing and can provoke anxiety. Here are a few tips that I hope will help.

1. Learn to accept that you may never get an answer. For the majority of us, there is no answer to “why me?”. Unfortunately sometimes things just happen. Acceptance doesn’t necessarily mean “it’s okay”. I’m not asking you to say that it is okay that you have an illness or pain. When I talk about acceptance, I mean being able to make necessary adjustments in your life, learning your new normal, and learning that despite your chronic illness or pain you can still be happy. Learning to accept that you may never get an answer to why this happened to you will be a process. It is not something that will happen overnight. You may want to resist it and that’s alright. It is not fair that this happened to you but with some hard work, dedication and a little reorganization of priorities, it is possible to be happy and to accept not having an answer to “why me?”

2. Find meaning. Ask yourself what good could come out of your situation. I guarantee that if you are open to that question, if you take the time to think about it, and if you are honest with yourself, you will likely come up with at least one positive thing that has come out of all the bad. For me, the meaning in my situation is that I am able to counsel others with chronic illness and chronic pain. It is what I love to do and I have been able to take my own experiences and knowledge and help others. For you it doesn’t have to be something as big as a career decision. It may be something as simple as the fact that you now have more compassion for others, you don’t judge people as quickly as you used to, or that your illness or pain has taught you to appreciate the small things in life.

3. Find a passion for something. Try to focus your attention on something other than “why me?”. Find a hobby or a passion that will make you happy and take your mind off of “why me?”. It is okay if the question comes into your mind once in a while. When it is constant or interrupts your quality of life, your focus, or your happiness, that is a problem. Finding something that brings you joy will help you to cope.

4. Find support. You are not alone. As I stated above, the majority of us with a chronic illness or chronic pain have asked ourselves “why me?”. If you find that you are having difficulty with this question, find support, either with friends, family, a support group, or a therapist. Talking about what you are thinking and feeling can help greatly.

My Invisible Illness is Real

Most people who have an invisible illness (a chronic medical condition that shows no outward signs) have experienced these words at one point and time: "But you don't look sick." These words can be extremely frustrating. I often ask my clients, "What is the most difficult thing for you about having (Crohn's Disease, ulcerative colitis, IBS…)?" I can't tell you how many times I have heard the answers "It's hard to talk to people about what I'm going through because they tell me I don't look sick", or "My family doesn't always believe how bad I feel because I don't look sick", or "I've been told it's all in my head". I could go on. This is one of the difficulties those of us with chronic illnesses need to learn to overcome. The idea that people don't believe us because they cannot see our illness like they can see someone in a wheelchair or a like they can hear a chronic cough can feel isolating and depressing. Sometimes it can make us feel like maybe it really is in our heads. Maybe we aren't really as sick as we think. Instead of giving in to this, we need to fight back! Understand that these people aren't saying these things to be insensitive. They just don't get it. So educate them! Explaining to them what you are going through and why you don't look sick will not only educate them on something they are unfamiliar with, it can be empowering for you too. Also, trust yourself. You know how you feel. You know your illness. You know that it is not in your head. It is real.

The Importance of Choosing the Right Doctor

I have been thinking about this topic for quite some time. Not only have I recently had clients question their choice in doctors, I have been thinking about how lucky I am to have the team of doctors I do. I quite literally owe my life to my colorectal surgeon and his team as well as my gastroenterologist. I have complete trust in them and know they have my best interest at heart. That is very comforting.

When you are living with a chronic illness or chronic pain, choosing the right doctor can make all the difference in your treatment. So, with all of the doctors out there, how can you be sure you have chosen the right one for you? Here are some tips:

Do your homework: If you are searching for a doctor, make sure you do your research! Check out healthgrades.com, vitals.com, and other sites where patients can post reviews. Also, don't be afraid to make an appointment to interview potential new doctors. Ask the doctor any and all questions you need answers to in order to make a decision about who would be the best fit for you. If they value you as a potential new patient, they will take the five or ten minutes necessary to answer your questions.

Choose a doctor who specializes in your condition: If you have gastrointestinal issues, choose a gastroenterologist. If you have chronic pain, choose a doctor who specializes in pain management. You get the idea. I cannot express how important it is to have a doctor who specializes in the specific illness you are struggling with. General practitioners can be great for common colds, flu's and that sort of thing, but when you are dealing with something specific, such as Crohn's Disease, arthritis, chronic pain, etc. you need a doctor who knows everything possible about your condition.

Trust your instincts: If you have been seeing a doctor you are not happy or comfortable with, find another doctor! I know this sounds like common sense but I can't tell you how many clients I have seen who have stayed with a doctor they are unhappy with. To some degree I understand. Doctors are seen as authority figures so sometimes we question our own instincts when we feel uncomfortable with a doctor. We think it must be something within ourselves, not something with the doctor. Please know that if you feel that something isn't right or you are not getting the treatment you deserve or need, you are probably correct. Trust your instincts. Your health and happiness are on the line.

If you aren't sure, get a second opinion: If you have received a diagnosis you are unsure of or your doctor is recommending a procedure or surgery you are not sure you need, get a second opinion. The worst that is going to happen is that the second doctor will agree with your doctor. At least you will then have the peace of mind you need to move forward.

Ask your peers: If you are looking for a doctor, don't hesitate to ask people you know for a recommendation. You can also research Facebook groups or other online forums dedicated to people with your illness and ask individuals there for recommendations. Hearing the good, the bad, and the ugly from actual patients can be the best way to find a new doctor.

The Psychological Epidemic in Patients with Gastrointestinal Diseases: Help is Needed for Patients Suffering from Suicidal Thoughts, Depression, Stress and Anxiety

I don't know how many of you have read about the suicide of Aaron Swartz. While their may have been many factors that lead to his decision to take his life, many of the articles written about him mentioned the fact that he had ulcerative colitis and that this may have contributed to his depression. After I read some of these articles I couldn't stop thinking about it. I decided to put my thoughts into words. Below is the link to an article I wrote about the psychological problems many people with gastrointestinal problems face. While suicide is a drastic measure, it is not unheard of.

If you cannot open the link directly, please copy and paste it into your browser.

http://voices.yahoo.com/the-psychological-epidemic-patients-gastrointestinal-12196127.html?cat=5

J-Pouch Surgery and Getting Pregnant

When I was told I would only have an 80-85% chance of conceiving on my own after the J-pouch surgeries, I was devastated. I cried for three days. My husband and I had only been married for six months and we both wanted children. I couldn’t believe this was happening to me and questioned what I had done to deserve this.

It took me the three days of crying to come to terms with the fact that I didn’t have any other choice. I was so sick that it was either I had these surgeries or I died. I had to realize that whatever was in store for me I could handle. Whether or not I could conceive on my own or through in vitro fertilization, I was going to have a child. The most important thing was to get healthy first.

I think that for most women facing this surgery, the idea that they may not be able to have children without help is one of the most difficult parts. Also, the decision of whether or not to try to get pregnant with the ostomy before the final take down surgery is a big one as well.

It is important to go into this situation as informed as you can. Know your options. Talk to other women who have tried getting pregnant after the surgeries and find out what their experience was. Talk to your partner about what you will do if you are not able to get pregnant on your own so you are prepared. As scary as the statistics are, it doesn’t mean it’s not possible. Our bodies are made to bounce back. It is important to remain positive and remain hopeful.

Just to prove that it is possible, here is a picture of my beautiful 16 week old baby boy.

Relaxation Techniques and IBD

We all know that stress does not cause IBD, but that stress, along with anxiety and depression, can make symptoms worse. It is really important to find a way to cope with the psychological aspects associated with IBD. One way is to use relaxation techniques to calm your mind and body. So, next time you are feeling stressed, anxious or depressed try one of these...they really can help:

1. Slow breathing: This is probably the simplest thing you can do, but it really does work and the best part…you can do it anywhere. If you are by yourself, close your eyes. Then, relax your body. Take a deep inhale in, slowly counting to four or five. Hold the breath for a second, and then slowly exhale over four or five seconds. Rest for a second, and then repeat. While you are breathing, concentrate either on counting the seconds while you are inhaling and exhaling, or think of something peaceful, like the ocean. This works great if you are by yourself and can lay down and close your eyes, but it also works if you are out in public and start feeling some anxiety because it will make you concentrate on something other than what you are anxious about.
2. Progressive Relaxation: This is a great technique that works best if when you are alone. Start by either lying down or sitting in a comfortable chair and closing your eyes. Take a couple deep breaths. Then, tense the muscles in your feet. Hold the tension for a few seconds and then let it out. Move to your calf muscles. Tense the muscles and hold for a few seconds. Then release. Move to your quadriceps muscles. Tense your quadriceps muscles and hold for a few seconds before you release. You are going to repeat this procedure, moving all the way up your body including your buttocks, hands, lower arms, upper arms, whole arms, abdomen, chest, and facial muscles. After you have finished, tense your whole body, hold for a few seconds and release. Then take a few deep breaths.
3. Guided Imagery: Start by either laying down or sitting in a comfortable chair. Close your eyes and picture yourself in a peaceful, relaxing place. This could be either at the beach, lying in a hammock…anywhere you like. Look at your surroundings. Notice the colors and textures around you. Hear the sounds, smell the ocean or the flowers, feel the sun. Notice any other sensations. Relax and enjoy. The more you do this, the easier it becomes.

There are many other relaxation techniques, but these are the three I like the best. Remember, the less stressed, anxious and depressed you are, the better you will feel. Enjoy and remember they all take practice. I hope these help!

8 Things to Avoid When You Have IBD

There are so many things to do and not to do when you have IBD (inflammatory bowel disease). In my experience, these are the top 8 things to avoid when you have IBD:

1. Stress - While there is no known cause of IBD stress can definitely be a trigger. Now you are probably thinking "How in the heck am I supposed to avoid stress? That's impossible!" While I know it's hard to avoid stress completely, reducing stress can be a great benefit to you. Everyone has different ways of reducing stress. For some, including myself, it's by exercise. Others reduce stress by reading or watching TV. Find something that works for you.

2. NSAIDS (Non-Steroidal Anti-Inflammatory Drugs) - This is a big one. Many gastro's advise their patients to avoid long-term NSAID use because they can cause serious adverse affects in people with IBD. They can cause ulcers in the stomach and first part of the small intestine, and they can worsen bleeding and inflammation. I have firsthand experienc with this, and let me tell you, it's not fun.

3. Certain Foods - Now this varies from person to person. While certain foods don't cause IBD they can trigger a flare or cause discomfort and worsen diarhea. It's important to find what foods work for you and what don't. While you are trying to figure this out, keep a food journal to help you out.

4. Dehydration - It is so important to be aware of dehydration when you have IBD. Because of all the lovely bathroom trips that come along with flares, it's essential to make sure you are getting enough liquid every day.

5. A sedentary lifestyle - This is going to vary from person to person, and it's also going to depend on whether you're having a flare or not. For me, before I had surgery, I was very active. I went to the gym 3-4 times a week and also did yoga. When I had a flare though, I couldn't do as much and cut back on most of my exercise until I felt better. Find what works for you. Some sort of exercise is important though, not only because it's good for your body, but because it's good for your mind too. When you exercise, your body releases endorphins which not only put you in a better mood, but help with stress as well.

6. Malnutrition - When you have IBD and are having a flare, it is really easy to become malnourished. You don't have an appetite. You are in pain. You are constantly running to the bathroom. Because it is so easy to become malnourished it is essential to get the nutrients you need in some way. It helps to eat small meals throughout the day. Find nutritional food you can tolerate. Drink protein drinks. Take supplements in pill form.

7. Isolation - Having a disease like Crohn's Disease or Ulcerative Colitis can be very isolating. People who haven't experienced these diseases just simply don't understand what it's like. Not only that, quite frankly, it can be embarrassing! However, isolating yourself will only make things worse. Find an IBD, J-pouch, or Chronic Illness support group. I go to one, and let me tell you, it is so helpful to talk to other people who understand what you are going through!

8. Smoking - Especially if you have Crohn's. People who smoke, or who have smoked in the past, have a higher risk of developing Crohn's than those who don't smoke. Crohn's disease patients have a higher risk of relapses and repeat surgeries. Interestingly enough, in patients with ulcerative colitis, nicotine has been shown to have a positive short-term effect on those having a flare. I AM NOT TELLING YOU TO SMOKE PEOPLE! I'm just saying, there is research going on now on the effectiveness of nicotine patches in controlling flares in patients with UC.

Well, that's all I've got for now...stay tuned for more.