So, let me start by saying I’m sorry for the lack of posts the past few months. This is definitely not how I planned to start my brand new paleo blog. This post is not only to help explain my absence, but to also let you all know I plan to be much better at routine posts and content in the future.
I have been dealing with a lot of health issues the past few years that have significantly worsened over the past several months. To understand where I am today we have to go back almost 6 years. At that time I had recently completed a ½ marathon and was continuing to participate in shorter races.
I was also a fairly new Physician Assistant and was in the process of buying my first home. Things were going well when I suddenly experienced severe pain in my abdomen. Being the good physician assistant I was I refused to get checked out (because I knew nothing was wrong) until my mom dragged me to the emergency room a few days later. The doctors discovered I had a large mass up under my left rib cage. They originally told me it was the size of a grapefruit, but when removed it was actually more like the size of a football. After this discovery I was admitted immediately and surgery was five days later. The mass turned out to be a benign cyst that was wrapped around several important organs including my pancreas and spleen. My spleen had to be completely removed as part of the surgery along with the tail end of my pancreas. The spleen is an important organ for your immune function and the pancreas has several functions including blood sugar regulation and the production of pancreatic enzymes to help with digestion. My stomach underwent a lot of damage too because as the surgeon put it, the mass had to be chiseled off my stomach.
My recovery was slow as expected after spending 1 day in the ICU and another 5 days in the hospital. My health was improving slowly until almost two years later (April 2012) when I was still significantly underweight (I lost 20+ pounds after surgery and had only gained a few pounds back). I also started experiencing nausea, feeling full after only eating small amounts, and abdominal cramping. I did what any person would do, I went back to my gastroenterologist. Every test imaginable was run including blood work, imaging studies and a colonoscopy. I even swallowed a camera that allowed the doctor so see what my small intestines looked like. No answers were found. I saw 3 gastroenterologists, nutritionists, and an allergist, all were stumped. The only abnormality I could grasp onto was a slightly abnormal Celiac panel on my blood work, but the gastroenterologist wouldn’t say I had Celiac’s disease because the biopsy during my colonoscopy was negative. Despite this I decided to try a gluten free diet. It was the only thing left I thought I could try. Within 3 days of going gluten free the cramping and nausea were going away. I thought I was on my way to better health once again. But my improvement again stalled several months later. Luckily, I had a co-worker that was already well-educated in a paleo diet and lifestyle. She loaned me a couple of books including Robb Wolf’s the Paleo Solution and Diane Sanfilippo’s Practical Paleo. Everything about the Paleo diet just made sense and I decided to give it a go. Even though I was already gluten free there were still a lot of changes that needed to be made to my diet including the removal of grains, legumes, and dairy. Again, these diet changes helped me improve but I was still experiencing the same symptoms and I wasn’t gaining enough weight that I could start running again. Along with all of this I was working with a gynecologist to try and figure out why I was no longer having a menstrual cycle. After another negative workup the only answer I was given was having such a low BMI (under 16). But they also discovered I have the bone density of an elderly woman because of my weight, poor nutrition, and lack of a menstrual cycle. Just another health concern to add to my growing list.
After conventional doctors had no answers for me I decided to try an integrative physician in 2014. (This is often thought of as a provider that practices somewhere between conventional and functional medicine). I thought for sure I would get some answers because I was doing a lot more testing including blood work and stool studies. A few nutritional abnormalities were noted, so some vitamins were recommended along with a follow up with their nutritionist. Needless to say, I was again frustrated. Since 2012 I had been educating myself on a paleo diet and many other aspects of nutrition. The nutritionist did not offer me any recommendations that I wasn’t already trying. After a few follow ups with the nutritionist and integrative physician I gave up and decided I may never have answers and my current health may have to be my new normal. I was not as healthy as I was before my surgery but I could still function – I was working, taking my dog on hikes, and hanging out with family and friends. Until the summer of 2015 I stayed in that state of mediocre health when I suddenly took a turn for the worse. I started experiencing pain in my upper abdomen that felt like I was consistently being punched over and over. The nausea was returning so I started limiting my diet more and more to the very few foods I could tolerate without getting sick – ground meat, seafood, and steamed or pureed vegetables. What did the conventionally trained physician assistant decide to do? I went back to my gastroenterologist. I guess I didn’t learn the first time. And what did my gastroenterologist do? More blood work and imaging that again led to no answers. All he could recommend was trying another medication for the nausea and cramping (I think I have just about tried every medication out there for my symptoms over the past 3 years).
It was at this time I decided conventional medicine had nothing to offer me. I started seeing a physical therapist that specializes in a form of therapy called neural visceral therapy that treats the fascia / connective tissue that surrounds the nerves and organs (You can find more information out about her on her website IMPT and about neural visceral therapy at The Barral Institute’s website). I continue to have treatments every 3-4 weeks with the goal of breaking up all the scar tissue in my abdomen from the surgery I’ve had.
Being frustrated with my current health I decided to take a test for small intestinal bacterial overgrowth which the integrative medicine physician recommended back in 2014 but I never completed. The test came back positive for SIBO. My current gastroenterologist didn’t want to treat me for SIBO because I wasn’t having the typical symptoms of diarrhea. That’s when I finally decided it was time to work with a functional medicine physician. I had heard Dr. Ruscio on several podcasts and decided to complete the application form to be his patient. I was ecstatic when I received an e-mail less than a week later that Dr. Ruscio would be willing to see me. I had my first appointment with him the beginning of January. As expected, he recommended a lot of lab testing including a repeat test for SIBO and several other blood, salivary and stool studies (the collection of these has not been the highlight of this process). I’ve since had a follow up appointment with him to discuss the results. Unfortunately there are a few studies that have to be repeated before an official treatment plan can be put in place. Stay tuned for more on this in a few weeks.
All of this to say, I have really been struggling physically the past few months. It takes all my energy to get through a work day. Other tasks (such as writing blog posts) have been getting pushed further and further down my to do list. Through this long process I have become even more aware how important it is to incorporate a more functional medicine approach into my conventional every day practice. The two areas of medicine need to learn to work together to help patients obtain their optimum health. This is why I have the goal of paleofying healthcare. And despite my own health setbacks I have a new found sense of purpose for this blog and my day to day interactions with my patients. Thanks for sticking around and I hope you will come back again and again as I start writing more about the life and adventures of a Paleo PA.