No Guts, No Glory
After 20 years of mostly trying to ignore the reality that I have a chronic gut condition, I finally decided to be more proactive in trying to take care of myself. Typically, I’d suffer a flare-up — sometimes landing in the ER, or getting a new prescription for antibiotics — and then when symptoms subsided, pretty much forgetting about it. Until the next time. In the first few years of the diagnosis, I had flare-ups fairly regularly but since 2017 I had been symptom-free, except for what I often dubbed a “bad morning.”
Then this February, March and April I had four episodes in a row, every couple of weeks. I managed without antibiotics by going to a liquid diet for a couple of days (except during the March episode when I went into an almost complete denial and had chicken tenders for dinner, causing symptoms to persist for another couple of days.)
I scheduled a virtual appointment with my primary care doctor, followed by an in-person visit with her physician’s assistant about a month later. I decided to ask for a referral to a nutritionist with expertise in digestive issues. I assumed such common ailments — from the occasional stomach distress that anyone can experience, to IBS, Chron’s disease and (my favorite) diverticulitis — would be on any nutritionist’s radar. The PA gave me two recommendations: one, an in-house (George Washington University Medical Faculty Associates) nutritionist; the other an outside person she knew well from her own training.
I also joined an on-line diverticulitis support group and committed myself to talking openly with my two adult daughters about how I was doing rather than keeping my symptoms hidden. I understand myself well enough to know that there are good reasons why I haven’t been more disclosing about my gut issues: I grew up with a father who was terminally ill with emphysema for my entire adolescence and died when I was 16. I never wanted my children to have parental sickness as a backdrop to their life story as it was for me. Also, I choose to be a vital, active, usually optimistic — or at least, realistic — person; I don’t want my life taken over with preoccupations with aches and pains, illness or fears about mortality. But I think I had over-corrected. So I’ve been working on putting things in better balance.
Yoga practice, walking, being deeply involved in work that I love as a psychotherapist, spending time with my adult children, grandchildren and a small group of friends when possible — these are my lifelines, my sources of energy and creativity and a sense of generativity. I’ve just needed to add in a dose of closer attentiveness to this ailment I’d rather pretend didn’t exist.
I had an excellent phone consultation with Julie Sorenson of Glass Jar Nutrition. She seemed to get me right away and to fully understand what I’m hoping to accomplish. I’m working on her intake documents and a three-day food journal to get us started. Meanwhile, I got a call back from the nutritionist’s office at GW. The message explained that she “doesn’t counsel people with gastric issues.” Then they referred me to the GW Weight Loss Center.
Question: How do you work as a nutritionist and not deal with the human digestive system? That seems as absurd as a therapist who doesn’t treat anxiety or depression. And is it their assumption that the only reason a person wants to see a nutritionist is to lose weight? Hearing these messages, I was furious.
And as much as I’ve held myself accountable all these years for not tackling this condition more assertively, I realize now I’ve also been at the affect of our traditional Western medical system. I met my primary care doctor the first time I was hospitalized in 2000; I’ve stayed with her ever since and have the highest respect for her knowledge and experience. But she’s limited by the short-sightedness of the world in which she was trained and has practiced for nearly 40 years. She knows what to do with sickness; not so much with sustaining wellness. Learning of my recent flare-ups, she suggested two things: a CT scan and a referral to a colorectal surgeon. These options might be in my future, but I’m going to focus my attention for now on food as medicine, with the help of a nutritionist who does pay attention to our glorious guts.
