Patient Journey: Crohn’s

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Despite working with patients for several years now and wanting to share everything I possibly can to make a difference, I have never taken the time to share any stories of patient journeys.  I have never pressured any patients to write testimonials and, quite frankly, I feel like sometimes they can be a little inauthentic.  If you think about it, who is going to agree to write a testimonial and say anything bad?!  However, I have sent my patients a journey worksheet to help me decide what was the most influential, what they believed to be the most impactful moments along the way, and what they would say to those that may be on the same path.  I have used these journey worksheets to help mold my treatment methods, but I feel guilty for not sharing them!  I’m ready.  I hope to share some patient journeys over the next few months so you can understand what healthy looks like through the eyes of patients like yourself.

First up? a Crohn’s patient that will actually be a case study published in my upcoming book on treating immune dysfunction! It’s interesting for me to see how patients perceive our work together, and as you will see, food was a huge part of this autoimmune journey!  I will let you know the question and response, unedited, completely honest and raw…..

  1. What health issues were you struggling with when you began to work with Dr. Angela? I was diagnosed with Crohn’s disease about 5 years ago. I struggled finding the “safe” foods to eat without knowing what was really in food and how it was prepared. So honestly I would usually eat once maybe twice a day because it was just easier than getting sick…I lost about 40lbs within the first 6 months (only weighed 140lbs at lowest weight, so pretty low for a 6’ tall male). I also became very sheltered and was afraid to go out to eat, go to movies or just basically afraid to leave my comfort area “in case I got sick”
  2. What treatment methods had you tried prior to Dr. Angela’s program? The doctor had me taking 3 – 3mg Budesonide (equivalent to Entocort) each morning and then taking 2 Pentasa four times a day…so taking 11 pills a day. Basically tried to stay away from food the doctor told me to avoid. Also took a food allergy test which was 100% waste of my time after spending one short visit with Dr A
  3. What health benefits did you gain from working with Dr. Angela? Where do I start…I can eat without being too worried about getting sick, I can leave the house more often because now I know what I eat and where it came from and I am slowly gaining my weight back. I just finally feel better, but I still have my days but overall I feel better and I am currently taking 3 prescribed pills a day along with my other healthy pills.
  1. What was your biggest struggle during the transition to a healthier lifestyle? The first two weeks were the worst EVER!! I was basically having chicken broth for breakfast, lunch and dinner to clear my system of anything that was bad…it was 100% worth it and yes I would do it again it I had to. Another struggle is making breakfast, lunch and dinner is a chore on some days but when I get to sit down and eat and know that I will feel full and probably not get sick is a great feeling. It’s either all or nothing when choosing this lifestyle so get ready for the ups and downs but once you find some go to meals its fun and worth every penny you are paying.
  2. What did you find most beneficial to you in the program? That I am getting my life back, that I can feed my family good food and stay away from all the processed food. Becoming a better cook is also the fun part because I can cook more meals than I ever thought I could. Also I can eat dessert again and that is always great because Dr A has some amazing recipe’s for any sweet tooth out there.
  3. Did your food options taste good? Sometime they taste too good, like the almond butter chocolate chip cookies are the best thing ever. Its also amazing what you can do with honey, I never liked honey before meeting Dr A but I basically put it in/on everything…and not the fake honey you get in the store, it has to be the real stuff.
  4. Did you have an ah-ha moment that helped you commit to the change? If so, what was it? My moment was when Dr A had us take everything out of the pantry/house that had corn in it and I realized just how much crap we were eating and if I got rid of it. Also was when we learned how some of the cooking oils were made/processed…GROSS!!
  5. If you were going to give a piece of advice to someone on the fence of following a program like Dr. Angela’s, what would you say to them in order to help them decide? Give it time, it is worth it. There will be days that you’re not going to want to get out of bed to make another meal or make another trip to stupid fancy grocery store but I promise you that it does get better, there will be tears and there will be family fights because of what you can and can’t eat but hang in there, my wife also followed along by my side and after all the fights and tears shared we are both better and healthier. When you are addicted to anything, bad food in our case, it tough quitting that habit and you’ll have ups and downs but now we have a lot more ups then downs and love almost every step we are taking….it’s not easy but if I can do it know that anyone can.

Dr. Angela’s perspective:

This patient had evidence of intestinal permeability, some underlying infections that needed addressed, excessive stress in certain areas of life, and a list of about 50 foods that “he wasn’t supposed to eat.”  Thank goodness for that list of foods, because his wife contacted me (after hearing from one of you about me) at a complete loss as to how to cook for him with such restrictions.  This is often how it starts.  I get contacted with an intention, and after a short consult, we have a completely different direction that focuses are correcting the underlying cause of disease.  This patient has since removed all his meds and had a COMPLETELY CLEAR colonoscopy.  Every patient has a different journey, but especially with autoimmunity, I insist on the education component because the children of that patient inherent the DNA.  While DNA doesn’t cause the disease, it sets the stage for it.  So, the process he mentions about removing corn was a random idea I came up to get the kids involved in understanding just how many foods may contain things that make dad (and many others) sick.  Like I said, no two patients are the same, and therefore, I don’t think I’ve ever done exactly the same thing with any of them.  You are unique, your body is unique, your lifestyle is unique, and the things that matter to you are unique.  That means you need a plan that fits your unique circumstances.

 

Stress and Autoimmunity (Part IX)

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Stress is something that is unavoidable.  We will all experience stress on a daily basis in some way shape or form.  Stress can be anything from mental and emotional stress to exercise and food sensitivities.  All of these things have a breakdown mechanism in the body that elicits the the same physiological response.  Stress activates the autonomic nervous system and you can’t control this.  It’s very difficult to recognize that is happening and actually stop it.  For example, when you lie, your body has a stress response.  This is the reason people say “Secrets keep you sick.  Or Secrets kill.”  This is the exact reason we use lie detector tests!  You can tell your conscious brain to settle down or you’re not nervous all day long, but most of the time, if it is stressful, you still express stress physiologically.  Your palms get sweaty, your voice may waver, your heartbeat increases, and you breathe a little more rapidly. We use those to our advantage to detect stress but what about the hormonal response?  The release of cortisol, the decrease in immune cell production, the disruption in hormones and catecholamines?

The more you experience stress, the more your body runs on sympathetic (fight or flight) dominance.  This leaves you feeling like you wish you could just disappear tomorrow.  Maybe disappear to an island far far away where you could be in silence.  This is often why most people cry at the thought of coming back from vacation.  You body is exhausted from living in this state and if you fall asleep on the couch an hour after coming home from work, you know what that exhaustion feels like.  This is probably hitting home for a lot of you right now in a very doom and gloom way.  Why? Because heaven forbid you have an autoimmune disease, feel there’s no way to get away from stress, you are slowly killing yourself, and there’s nothing you can do about it.  I’m here to tell you that without changing your situation at all, you can reduce stress.

The most important thing you have control over is your thoughts.  They will creep in and try to dictate, but simply recognizing that and repeating what’s really happening in that moment, you won’t get carried away by “what ifs. ”  I see this a lot with people when it comes to work relationships.  A boss said something the wrong way so the employee gets instantly freaked out that they may lose their job, and if they lose their job they will have no money, if they have no money they will lose their home, if they lose their home then their kids will get taken away, then they will have no insurance and they’ll just die because they won’t have any healthcare options for their illness.  STOP!  If this is the type of road your mind takes you down, get good at recognizing when you start down the path.  Bring yourself back to present.  Close your eyes and breathe deeply in one nostril and out the other.  Do not let yourself entertain ideas of things that may or may not happen UNTIL THEY HAPPEN.  The funniest part is that I have asked every single person whether any of these things have actually happened and not a single one has lived this story.  All that time slowly killing our cells over something that has no real likelihood of happening!

Step one is controlling your thoughts from spiraling down a path of worst case scenarios.  The second step is to smile and laugh.  EVEN FAKE ONES.  You heard me right.  There’s also a proverb that laughter is the best medicine because it REVERSES the physiology of the stress response.   You could say that it’s impossible to be stressed and joyous simultaneously.  Go to a funny movie, watch a hilarious youtube video, talk to your friend about old time shenanigans, go to a comedy show.  Smile at everyone you see.  When they are real, they have a huge impact.  When they are fake, they STILL have the same impact.  Laughing reduces cortisol, soothes the nervous system, and improves hormone regulation.  In our society, we tend to become more and more isolated by technology and busy schedules.  Keeping your social connections is so important.  It is not a luxury.  It’s actually good for your health!  I may even dare to say that having a beer with a good friend has more positive effects on your physiology than negative despite the fact that your consuming glutinous alcohol!  That’s how important these things are to your health.  Even a tough love doctor is telling you laughing with friends is possibly more important than what you eat in some instances!

That brings me to the third thing that you can do to reduce stress.  Exercise outside.  We can make this life scenario even more appealing by saying “Go for a walk with a friend, tell stories, laugh, and “touch” goodbye.”  I say “touch” because anything from a hug, a high five, a kiss, whatever, it all has a positive impact.  Movement helps distract the nervous system from obsessive behavior.  It likes to move forward.  You see this with dogs, too.  They are much more behaved in a pack, walking because it is calming to their nervous system.  We are animals, too.  Going to a group fitness class is the same thing.  Moving with friends, laughing, and making connections.  Doing some of this outside is that much better because of the air quality and restorative nature of nature.  No pun intended. ;)

The last and final thing you can do is engage in physical touch.  In my profession, I would be touching people all day long.  However, sometimes patients would come in and that would be the first touch they experienced all day.  I am not a touchy feely person, but that doesn’t mean I don’t experience the same physiological effects of touch.  I’m just more choosy about who I touch! hehe, I couldn’t resist.  Back on track.  Hug your child or spouse goodbye, hug a friend when you see them, get a massage, go to the chiropractor, hire a professional cuddler (that really does exist), have sex or kiss your partner.  These things are not luxuries either!  They are hugely necessary to our well-being as humans.  They counteract stress.  We are hardwired to need touch.  Think about yourself as a child.  Everyone wanted to hold you, give you kisses, touched you constantly to help you maneuver the world.  Then you became a little more developed and touch can be misconstrued as sexual so it happens a little less.  That is until you go looking for it from a teenage boy/girl.  What if you find yourself as a single adult.  You may literally go days without touch.  Heck, the way we greet people in ANY country has to do with TOUCH.  Maybe its a handshake or a kiss on the cheek.  May it’s a hug.  It has and always will be imperative to normal nervous system function.

These are simple, free, yet hard things for some people.  For those less expressive, it may be good to start with the thoughts and movement.  From there start planning social activities to get out there and connect with friends and family!  If you are a single person with an autoimmune disease, even seeing a massage therapist can gain you touch benefits.  Hope you guys are enjoying the series as it is coming to an end!  I will have one final article to address a few questions people had for me.  If you have a question you would like answered in that article, please let me know!

 

Intestinal Permeability and Autoimmune Disease (Part II)

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I have written several articles about our bodies being hotels for bacteria, and when the bacteria levels are balanced and the microorganisms are happy, we are healthy.  These bacteria make up so much of our immune system, its hard for me to fathom why we haven’t placed more focus on their role in studying disease.  It’s gaining traction, and therefore most people have heard the buzz phrase “leaky gut” thrown around somewhere.  In this article, we are going to discuss what it actually is, and how it has to do with autoimmunity.

Let’s start with the basics.  From your mouth to your anus, you have one long tube with stops along the way.  The mucosal barrier that keeps food in the tube, and not in your tissue, it technically ON THE OUTSIDE!  I know it sounds crazy, but that tube running down the middle of your body is an exterior surface. It’s comprised of a single layer of cells; that’s it!  Pretty amazing if you think about how food goes in one and end and comes out the other.  After food goes in your mouth, it has stops along the way and one of them is in the small intestines.  The small intestines is where most of your nutrients are absorbed into the body. The way nutrients get into the body through the section of tubing we call the small intestine is by specific breakdown that occurs via acid, enzymes, bile salts, and bacteria.  Proteins are broken down into their lego parts, amino acids.  Fats are broken down into fatty acids, and carbs are broken down into simple sugars. Once food is broken down into its simplest form, it’s ready for transport into the body.

In order to get into the body, digested nutrients have to cross that single layer of cells called enterocytes.  On the other side of the wall lives blood vessels, lymph vessels, and immune cells of the gut.  The amino acids, simple sugars, minerals, and water soluble vitamins (like B vitamins) are transported via blood and the fatty acids and fat soluble vitamins (like A, D, E, and K) are transported through the lymph. A leaky gut occurs when there is damage to that single layer of cells and things that shouldn’t be able to cross over, do.  This damage can occur by sections of cells themselves being damaged, or the bonds between them being broken. When this happens, now we have things like pathogens, incompletely digested proteins, bacteria, and toxic substances entering the territory where immune cells live.  The immune cells immediately recognize them as foreign and plan an attack.  However, if any of them get through that line of defense, now we have them floating in the bloodstream. The body frantically tries to clean it all up, and this produces a fairly global inflammatory state.

I think it’s worth mentioning that those undigested proteins stimulate a part of the immune system that produce IgE antibodies.  Food allergies that cause difficulty breathing, swelling, ER visits…those are due to this IgE response.  This is a TRUE allergy.  However, when antibodies such as IgGs are produced, this is what we call a food sensitivity. The reason we call it a sensitivity is because the immune response produces symptoms of allergies for example, fatigue, mucus drainage, inflamed sinuses, and possibly even things like eczema.  This is what doctors are testing for when they do a blood panel for food allergies!  If you have ever had a food allergy/sensitivity test and it came back with a list of crazy amounts of foods like chicken, spinach, strawberries, etc., you are most likely NOT allergic to those foods.  This is nothing more than a IgG production because food proteins got into spaces they don’t belong.  Once you heal the gut and keep those foods from crossing the gut lining, your body will QUIT producing antibodies against them.  I see this all the time when I work with food allergies.  You can absolutely resume eating most of those foods without issue as long as appropriate care has taken place.  I got off track….back to the antibodies. Of those antibodies being produced, some can be autoantibodies.  When cytokines (chemical messengers) are released, it stimulates both the innate and the adaptive immune system.  This pokes the bear of the adaptive immune system that can result in an autoimmune disease.  If you remember from the previous article, this is where amino acid sequencing can get confused for our own tissues.

I hope I didn’t lose anyone with crazy words, but I think this connection between how the food we eat gets to places it shouldn’t, and the immune response that results is an important one to know!! Why? Because autoimmune diseases live in about 50 million DIAGNOSED people and cancer is only 12 million.  Heck, heart disease is 25 million!  Needless to say, this costs our country more than just $100 billion dollars in direct care costs, it is costing us our quality of life!  Anytime I have a patient that is able to go about their day without worrying about the symptoms of an autoimmune disease, I do a happy dance.  It gives them their life back!  This is priceless.  In the upcoming articles, I will talk about which foods can create the perfect storm, and other lifestyle factors that damage that single layer of cells that keep the good stuff in and the bad stuff out.  These are things you CAN CONTROL!  I’m getting pumped up…can you tell…welcome to what it feels like to be in the audience when I give a talk.  I just can’t help myself….

How does an Autoimmune Disease Actually Happen?

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Without the audience having an in depth knowledge of the body, this can be a confusing process to explain.  However, I’m going to put on my teacher hat and try my best to explain how your body could ever be so confused that it begins to attack it’s own tissues resulting in diseases such as Multiple Sclerosis, Rheumatoid Arthritis, Crohn’s, Psoriasis, Hashimoto’s, etc.  Even though these diseases are present in different systems within the body, the same mechanism of trigger initiates the cascade.  Every autoimmune disease is an IMMUNE SYSTEM disorder.  However, most people focus on the system involved by taking thyroid medication for Hashimoto’s, creams for psoriasis, digestive aids for Crohn’s, and the list goes on.  Most of the heavy duty medications on the market for these problems are immunosuppressants.  That means their entire job is to dampen the ability of the immune system to function in hopes it will quit attacking itself.  This has a nasty side effect of also leaving patients vulnerable to sickness because their immune system is being shut down (hence the fine print in commercials saying not to take them if you are sick, in contact with the sick, etc.)  Many patients will say “Isn’t there a way to help this WITHOUT shutting down my immune system?!”  The answer is “absolutely,” but you will not find those methods in medication.  I hope now you are asking “HOW?!”  Let’s look at how it happens to try to address that question later…

Proteins: Proteins are the building blocks of life.  They are made up of things called amino acids and we use about 20 different amino acids to build every single kind of protein that we need.  Based on how you put the amino acids in sequence, you can create different kinds of proteins.  These creations make up the cells of your organs, your hormones, and the antibodies we call immunoglobins.  You may have heard of some of these amino acids without even knowing it!  We have all heard of tryptophan around Thanksgiving because people blame the sleepiness on it’s presence in turkey.  Maybe you’ve heard of Glutamine if you are in the fitness industry.  Perhaps phenylalanine has popped up as you search the risks of artificial sweeteners?  These amino acids are essentially the legos that make up parts of your structure.

Well, these proteins tend to have a lot of similarities to the proteins in other life forms such as animals, plants, and even viruses.  For heaven’s sake, we have 67% DNA similarity to an earth worm!  Like I’ve said before, this is why biological principles are important to know; we all exist under the same fundamentals!  Small sections of these proteins are recognized by antibodies.  This is the recognition system for our immune system to be able to ID, tag, and get rid of foreign invaders by recognizing specific amino acid sequences present on the protein structure.  When the antibody binds to one protein, it’s common that it will also attach to other proteins containing a similar sequence. This is a good thing if those other proteins are also foreign invaders, but it’s a bad thing if the other protein happens to be our own tissue.

Don’t worry though, we have a quality control system.  Because of so much shared DNA sequencing, this happens all the time!  It happens in everyone really.  However, we have a process called “selection,” that allows T and B cells to recognize self and they are destroyed.  This is all happening in the bone marrow and the thymus gland (hence T and B cells, haha…ok, not funny).   It can also happen via suppression where certain T cells shut down autoantibody production from any cells that may have escaped the first check.  In a healthy individual, this system of checks and balances works beautifully!  However, for those with autoimmune conditions, the body has a breakdown in the second process and simply can’t keep up with the quality control process of destruction.  Let’s just say your employee came in drunk and is no longer paying attention to the bad specimens rolling through!   So, it’s not really a problem with the body making antibodies against itself, because everyone does that.  It’s more about a faulty system in the ability to keep them at a minimum.

Once this breakdown occurs, it’s much easier for the body to then create another autoantibody to a different tissue, which is why so many autoimmune patients can then get another autoimmune disease fairly easily.  When enough damage has occurred to the tissue being targeted, you will start to express systems of the disease.  This is when you show up at the doctor with digestive distress due to Crohn’s, or unbearable joint pain due to Rheumatoid, or heaven forbid the neurologic symptoms of MS.  Here is where the fork in the road happens.  How do you treat it?  You can take medication to address the symptoms presenting, you can take an immunosuppressant to try and shut down your body’s ability to produce antibodies (to itself or to foreign invaders), or you can eliminate the triggers that cause the immune system to attack in the first place.

The environmental triggers for immune system attack can include anything from vitamin D deficiency, bacterial infections, silicone implants, chemical exposures, and yes, intestinal permeability (aka leaky gut).  Even though genes may create the perfect recipe for an autoimmune disease, the environmental triggers are really what start the cascade of events.  This is the reason why many people will say that genes load the gun, but lifestyle pulls the trigger.  This is why it is so important to be testing for underlying infections, nutrient deficiency, eliminating chemical exposure, and doing all we can to correct leaky gut.  If you correct intestinal permeability, you can reverse an autoimmune disease.  I have done this over and over with patients, and the changes in their quality of life and thought of such a different future makes me overwhelmed sometimes.  THERE IS ANOTHER WAY.  If you don’t believe that, then I can only imagine the thoughts that run through someone’s mind knowing it will only progress and get worse.  That part of my job breaks my heart.

The silver lining is that even though you can’t control your genes, you CAN control your lifestyle.  I will be writing a number of articles focusing on different aspects of this including the story of gluten, dairy, nightshades, and eggs in addition to the powerhouses I utilize with patients including ferments, broths, and organs.  I never know much to simplify my explanations to help someone understand the connection, so I have decided to go a little bit more in depth on the blog.  That way I have the easiest answer possible “Go take a look at the articles on the blog and let me know if you still have questions!”  For a professor, it’s like trying to teach 8 years of physiology in 30 seconds (because that’s how long you have until people tune you out if they aren’t understanding).  Good luck with that one!  I hope you enjoy, and if you have any questions you would like to make sure I touch on along the way, feel free to shoot me a comment!