Yoga and Celiac Disease

This post is published on The Huffington Post Blog.

I was diagnosed with celiac disease (“celiac”) in 2012. As a result, my life changed dramatically. What I thought would be a diet change turned out to be a lifestyle change affecting every part of my life – family, social, travel, and work. My symptoms ranged from the traditional gastrointestinal symptoms to extreme fatigue, lactose intolerance, and vitamin D insufficiency. Four years later, planning and preparing meals and monitoring and managing symptoms are now a normal part of my daily life. The new normal.
Celiac is a genetic[i], systemic autoimmune disorder caused by exposure to gluten.[ii] Gluten is a protein found in wheat, rye, and barley. The immune response activated in celiac when gluten is ingested causes the body to attack gluten as if it is an antigen. This immune response causes damage to the villi within the small intestine. According to the University of Chicago Celiac Disease Center, there are approximately 200 hundred recognized symptoms of celiac,[iii] including cancer, infertility, and depression. Celiac affects 1 in 133 people in the U.S. Currently, the only available and medically accepted treatment for celiac disease is the strict adherence to a gluten-free diet.[iv]

Patients with celiac must avoid ingestion and in some cases physical contact with anything that contains or has come in contact with gluten (wheat, barley, or rye). This includes food, cosmetics, beauty products, cleaning supplies, and medications that contain gluten. Exposure to gluten from any of these sources can also result in a celiac-related immune response and accompanying symptoms.

Upon diagnosis, I immediately eliminated gluten from my diet after my diagnosis and over the following 10 months eliminated gluten from my beauty products and cleaning supplies. Only then did I receive a negative blood test and “no exposure” declaration from my gastroenterologist. In order to heal my gut completely I adopted a whole foods diet free from grain, alcohol, dairy, soy, and processed foods for six months. Studies show that the intestinal damage caused by celiac can be healed over time by adherence to a gluten-free diet, although it is less successful in adults than children.[v]

One of the primary challenges of living with celiac is avoiding unintentional exposure to gluten, typically due to cross-contamination of gluten-free food with gluten-containing food (e.g. via cutting boards, grills, utensils, or medications) in restaurants. An inadvertent exposure causes symptoms similar to those at diagnosis. The treatment of symptoms from an exposure to gluten may include rest for fatigue and brain fog, anti-diarrheal medications for gastrointestinal symptoms, and eating whole, easily digestible foods and drinking lots of water. However, this varies based on the needs of the individual.

Two years after my diagnosis I started a relationship with yoga, which as grown quickly and significantly. I practice Hatha and vinyasa flow yoga in the lineage of Krishnamacharya and Shiva Rea. I am now a registered yoga instructor (RYT200), trained at Pranayoga Institute of Yoga and Holistic Health. I was drawn to yoga for stress relief but have found it a great tool for gastrointestinal health and support for celiac symptoms.

However, there are no studies investigating a connection between yoga and celiac disease. Current medical research on yoga and gastrointestinal disorders is focused mainly on irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Similar to celiac, IBS and IBD symptoms include anxiety, depression, headaches,[vi] severe diarrhea, abdominal pain, cramping, weight loss, and fatigue.[vii]

In a study of patients with IBS practicing yoga once a week for 6 weeks improvement was found in the patients’ symptoms, including fatigue, physical functioning, and abdominal pain.[viii] Quality of life scores and functional abdominal pain improved in a study of 20 patients with IBS after practicing yoga for 12 weeks.[ix] Patients with IBS who practice one hour of yoga at home via a video-guided practice experienced improved gastrointestinal symptoms and decreased pain.[x] Additionally, the patients indicated that they would continue practicing yoga because it was beneficial to them. These studies demonstrate a pattern of improved symptoms and enhanced quality of life among those with gastrointestinal symptoms who practice yoga.

I have found that my yoga practice generally improves my health (mind and body) and specifically helps manage my digestive process. After two years of regular yoga practice with pranayama and inconsistent meditation I have found poses and techniques that help with specific symptoms. When I am experiencing constipation and other gastrointestinal symptoms I rely on balasana (child’s pose), apanasana (knees into chest or full gas release pose), viparita karani (legs up the wall), malasana (squat), and supta baddha konasana (reclining butterfly) to assist in elimination and relief. Apanasana or knees into the chest pose done with a micro-dynamic movement in and out with the breath (inhale and move the knees out as far as the arms will extend and exhale bring them back into the chest) provides immediate relief to bloating due to gas and constipation. And when I am experiencing extreme fatigue pranayama (alternate nostril breath and other deep breathing) and a balanced Hatha practice increase my energy level and help me to sleep better.

FullSizeRender 2Yoga certainly isn’t magic but the management of my digestive health and symptoms have improved since I began practicing yoga. Whether the improvement is a result of decreased stress and increased relaxation that comes from yoga or a direct physiological response to certain movements, I can’t be certain.

It is difficult to separate the whole body, wellness, and life experience into parts that isolate what activities affect certain conditions. However, for me it is clear that the holistic practice of yoga supports the healthy functioning of my body as a whole – mentally, emotionally, and physically.

Many of the same symptoms and body processes present across gastrointestinal diseases, including IBS, IBD, and celiac disease. Given the scientific evidence and my experience, it is an easy leap to suggest that a regular yoga practice can lead to positive outcomes for people with celiac and other gastrointestinal diseases or distress.

Ultimately, every body is different and each person must know how their body responds to their specific condition. That awareness will aid in finding the right physical yoga practice to feel whole and well again. Because, yoga is for everyone.

 

[i] Celiac Disease. U. S. National Library of Medicine website. https://ghr.nlm.nih.gov/condition/celiac-disease. Updated May 10, 2016. Accessed May 11, 2016.

[ii] Celiac Disease. National Institute of Diabetes and Digestive and Kidney Diseases website. http://www.niddk.nih.gov/health-information/health-topics/digestive-diseases/celiac-disease/Pages/facts.aspx#what. Updated June 2015. Accessed May 11, 2016.

[iii] Symptoms of Celiac Disease. The University of Chicago Medicine Celiac Disease Center website. http://www.cureceliacdisease.org/symptoms/. Accessed May 11, 2016.

[iv] Treatment of Celiac Disease. The University of Chicago Medicine Celiac Disease Center website. http://www.cureceliacdisease.org/treatment/. Accessed May 11, 2016.

[v] Celiac Disease – Sprue. U. S. Library of Medicine Medline Plus website. https://www.nlm.nih.gov/medlineplus/ency/article/000233.htm. Updated February 21, 2014. Accessed May 11, 2016.

[vi] Kavuri V, Raghuram N, Malamud A, Selvan SR. Irritable Bowel Syndrome: Yoga as Remedial Therapy. Evid based Complement Alternat Med : eCam. 2015;2015:398156. doi: 10.1155/2015/398156.

[vii] Mayo Clinic. Diease and Conditions: Inflammatory Bowel Disease. Available at: http://www.mayoclinic.org/diseases-conditions/inflammatory-bowel-disease/basics/symptoms/con-20034908. Updated: February 18, 2015. Accessed: March 14, 2016.

[viii] Evans S, Lung KC, Seidman LC, et al. Iyengar Yoga for Adolescents and Young Adults With Irritable Bowel Syndrome. J Pediatr Gastroenterol Nutr. 2014; 59(2):244-253. doi:10.1097/MPG.0000000000000366.

[ix] Brands M, Purperhart H, Deckers-Kocken J. A Pilot Study of Yoga Treatment in Children with Functional Abdominal Pain and Irritable Bowel Syndrome. Compliment Ther Med. 2011.19(3) 109-114.

[x] Kuttner L, Chambers CT, Hardial J, Israel DM, Jacobson K, Evans K. A randomized trial of yoga for adolescents with irritable bowel syndrome. Pain Res Manag : The Journal of the Canadian Pain Society. 2006; 11(4):217-224.

What Happens When You Get a Bug in Your Ear

One of my very favorite southern sayings is “like a duck on a June bug.” You know, he was all over her like a duck on a June bug or like white on rice. I have friends who had a great time as kids tying strings to the legs of June bugs and watching them fly in circles.

These things make June bugs seems charming, even cute.

They are not.

This summer I came face-to-face, well, ear to body, with a June bug. We went to the woodshed and I survived, but it wasn’t pretty.

JPEG image-7BC76CC603FD-1I was enjoying an evening at the Romp Bluegrass Festival in Owensboro, Kentucky. It was a lovely evening, despite the tiny little chairs we brought to sit on for hours. In an effort to relieve our rear-ends we laid on a blanket in the grass. It was just like a country song – laying under the stars with your boyfriend listening to music and enjoying a warm summer night. It was until, without warning, a bug flew into my right ear.

This wasn’t just a bug crawling on my head. This bug dive-bombed my ear and was in my ear canal before I could raise my hand to swat it away.

What happened next was mostly a blur of me crying, screaming, and dancing around trying to get the moving, wing flapping, biting, and scratching bug out of my ear. I can only imagine what the other concertgoers thought as they watched me. In a moment of desperation I opened our Nalgene bottles and poured water in my ear. By the time we reached the security tent the June bug stopped moving. I was relieved that the pain had stopped and horrified that I was bleeding from my ear and had a dead bug in my head.

The kind security guard called for a cart to take me to the EMT (the first aid tent closed at 8:00 p.m.) and talked to me until it arrived. Very encouraging. But that feeling quickly faded when the cart arrived. The driver, a man I can only describe as Bubba, told me to get in. He was accompanied by what appeared to be his girlfriend and her little sister, who was holding a dog. I explained the problem and the little girl, sitting next to me, said “you can get a bug in your ear?” I braced myself.

We started down the narrow road, carving a path through the concertgoers who were surely camping (all night – long after first aid closed). I noticed the cart slowing and heard Bubba call out to a man at our right as he stopped the cart to say, “hey man how’s it going?” I was near the end of my rope, as nicely as I could I said “dude, seriously?” He promptly starting moving and announcing that there was a “woman in the cart who is bleeding.” This did not do much to move the crowd.

We arrived at the ambulance. The EMT was not there. But in the distance we saw a small form running toward us. He arrived and while nice he seemed about 19. He looked in my ear and promptly declared that he could not see anything, “could not do anything” for me and that I would have to go to the hospital.

We explained that we are from out of town and aren’t familiar with Owensboro or the hospital. He attempted the give us directions, which culminated in, “Do you have GPS? Use that.”

We walked silently back to the car. In the dark. In the middle of a field in Owensboro, Kentucky.

I started to cry – the I-am-at-the-end-of-myself slow weeping – as I opened my Google Maps app and found the directions to the hospital. It was nearby.

I walked into the emergency room and spoke to the nice lady at the registration desk. I gave her my information and story with big tears rolling down my cheeks. She sweetly asked if I was alone, I said no and that I am from out of town. She tilted her head and looked at me as only an elderly southern woman can and said slowly and sweetly, “bless your heart.”

Then we sat in the waiting room for an hour, my head in the only position that wasn’t painful and bleeding on my boyfriend’s shirt.

After an hour they called my name. I went back and met with a cheery physician’s assistant who wanted to know “what’s going on tonight?” Through my now dry swollen eyes I explained that there is a bug in my ear.

He took a look in my ear and proclaimed that he “could see something brown and it could be a bug, but it could be earwax.” He does not know how close he came to getting smacked in the face. I calmly but condescendingly explained that I could feel the bug moving in my ear (back when it was alive) and I am certain that is not earwax. Suddenly, he was a bit more motivated to take a closer look.

We went into a procedure room where I promptly refused to lay on the bed because there was a distinctive looking black hair on it. We moved rooms. He was annoyed. I was indignant.

I laid down on my side in the clean room. The PA took forceps with a long nose and immediately dove into my ear. I immediately screamed and insisted on sitting up. As I did I watched as he examined a tiny piece of something he pulled out of my ear, which he described as “not part of your ear.” Duh.

Meanwhile, I was reeling from the pain. He did not warn me that taking whatever was in there out would be far more painful than when it went in (and that was very painful). I asked, nearly begged, if there was another way? He offered irrigation but said it might cause the bug to break apart and that did not seem desirable.

So, I braced myself, squeezed my sweet boyfriend’s hand, and employed my yoga breathing as he made 3 more pulls from my ear. The last drew out the bulk of the bug’s body to which he exclaimed “oh my God.” Turns out, it was a bug. I exclaimed, “thank you, Jesus.”

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I thought we were finished, but he explained that he thought that there was a leg left behind in my ear (we counted only five on the bugs body). He could not go searching for it because of the blood and swelling and danger for my eardrum, but “it isn’t a big deal, it will come out in wax.” Easy for him to say, he didn’t have a bug leg in his ear.

JPEG image-3E68EC8E76E1-1I was release from the hospital a short time later. The next day we returned to the festival (I wore ear plugs), listened to some great music, and celebrated me not having a bug in my ear.

I am still okay with bugs and my ear no longer hurts, but I’ll never hear the old saying “put a bug in someone’s ear” quite the same way ever again.

Appalachia Natives: The Mountains Do Not Limit Us, We Do

I recently met with a former coal and gas executive from the Midwest. He used to travel to Central Appalachia – Eastern Kentucky – to supervise mining operations. This is same section of Central Appalachia where I was raised; in fact the mines he visited were within an hour or so from my childhood home.

He shared a couple of great Central Appalachia tales with me – gun-wielding grannies and copper thieves. But the most interesting description he gave was about how he felt in the mountains. He had never been in mountains so steep or been in a place where the sun comes up before you can see it and it disappears behind a mountain before it gets dark.

He said, “I felt claustrophobic.”

This made me think about how those mountains make me feel. To me those mountains are like a warm blanket surrounding, nurturing, and protecting all who walk under them. Keeping the good in and the bad out.

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Then I thought about how the landscape of the Midwest, where I live now, made me feel when I first arrived. The word that immediately came to mind was exposed. I felt exposed by the size of the sky, the distance of vision, and the constant wind. I have never been exposed to this much sky for this length of time (thus my fixation with sunrises and sunsets). In the mountains of Central Appalachia the sky is always framed with the jagged edges of tree limbs and mountaintops like a giant living, real-time painting.

This discussion reminded me of a quote from a book I read in college – Salvation on Sand Mountain by Dennis Covington. Mr. Covington writes about his drive from Alabama to and through these very mountains and my hometown of Grundy, Virginia.

All along the highways through Tennessee and southwest Virginia, the signs were everywhere: Crazy Joe’s Fireworks, Jack Daniel’s whiskey, drag racing, turkey shoots, and barbecue. The South they suggested was straight out of the movies – idiosyncratic, lazy, restless, and self-absorbed. And that was what Jim and Melissa and I talked about on the drive, the discrepancy between the South of the popular imagination and the one we lived and worked in every day. But once the road narrowed and entered the mountains, the signs disappeared, replaced by mine tipples, mantrips, and long lines of train cars filled with coal that steamed in the rain. The last motels and hospital were at Grundy, Virginia, a mining town on the lip of a winding river between mountains so steep and irrational, they must have blocked most of the sun most of the day. It is difficult to imagine how children can grow up in such a place without carrying narrowed horizons into the rest of their lives.

But Grundy was an oasis compared with the country between it and Jolo.

He, like my friend, saw the mountains as hard – hard to adjust to, hard to live in, and hard to understand. They immediately saw the limitations of the mountains.

As a child of those mountains it never occurred to me that the mountains were limiting, restrictive, or negative. It never occurred to me that the mountains were preventing me from seeing something more. When I lived in the mountains I never missed the orange and pink glow of the sun as it came up and went down along the horizon. Rather, I enjoyed the light as it slowly lowered down the hillside in the morning and as it retreated up the hillside in the evening. Neither one is limiting, only different.

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The mountains were a vast playground of trees, moss, creeks, and rocks – where the only rule was to be back before dark. All of those hills, rocks, crevices, streams, and hollers were a big classroom for learning life skills. These are a few of my favorite lessons :

  • In order to walk down the side of a hill without falling adjust your stance, turn your feet horizontally and descend slowly.
  • If you want to create an extra source of water for yard work then you dam up a section of the creek, gravity feed the water down the holler, then pump it up the hillside.
  • Always make sure your walking stick is sturdy.
  • Never kill a black snake, because it eats the rodents.
  • Be careful what you do at the head of the holler because it will show up at the mouth – it all runs downhill.
  • Respect everyone and things that are bigger, stronger, and/or more powerful than you – the mountain, weather, a loaded coal truck, bears, and water.
  • Never kill a mama bear or a deer that isn’t big enough and throw the fish back. If you kill it, then you eat it. No waste.
  • Don’t be a wimp. Play when you are hurt, work when you are tired.
  • Never forget where you came from or deny your family.

All those lessons live on and color the life we make in and out of the mountains. Just like the mountains, those lessons are timeless. And what we learned from and in the mountains can carry us far beyond and right back to where we started, if we choose to wander.

The mountains don’t narrow our horizons, only we do that.

A Christmas Wish: To Love Our Differences

I promised myself that I would not spend my holiday on my phone. But, I allowed myself one round of Facebook on Christmas Eve morning. I scrolled through the standard holiday wishes, complaints and celebrations about the unseasonably warm weather, political rhetoric of all sorts, and pictures of parties and food. But there was one post that caught my attention. I stopped and thought about the post. It made me feel both happy and sad.

A friend and colleague of mine posted a holiday wish that was different than the others. It was a sincere Christmas wish and blessing, for sure, but there was no decorated tree, nativity scene, Biblical quote about the birth of Jesus, or reminder about the “reason for the season.” All that was missing because my friend is a devout Muslim.

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This message is something very different from what I see in my social media feed, on the news, and in the world. It was lovely to see my friend support and respect his many Christian friends who don’t share his beliefs. He didn’t have to; he could have ignored Christmas like many Christians ignore or are unaware of the holidays he celebrates with his family. He clearly values his community and his friends, but even more I believe that he honors his own beliefs by honoring others. Even those who are not like him.

Ahmed’s thoughtful and loving message is a reminder that we don’t have to hate people who are different. Someone else’s beliefs are not by their mere existence an attack on my beliefs because they are different. We can love, serve, befriend, and care about those who are different from us without compromising our own values and beliefs.

My Christmas and New Year’s wish is that I and many others will make the choice to learn about and from our differences. Or at the very minimum learn to respect the different lives and beliefs of others – whether that difference is religious, political, socio-economic, a preference for Star Wars over Star Trek, or just a different accent.

That is love. And isn’t Christmas all about love? I believe it is.

 

The Polar Vortex of 2014

I came to Fort Wayne for the first time in November 2010 for an interview. On the drive to town I became convinced that it was too far from home, too weirdly flat and not easily accessed. The weather was chilly but sunny. There was talk about what the weather would be like but in this two-day visit I fell in love with the academic community and small college campus I was going to join. I left Fort Wayne trying to decide how I was going to explain this move to my family and friends.

I returned in February 2011 to find a place to live. I flew this time and found myself in the midst of the Groundhog Day blizzard. It was cold, roads were snow-covered and at some point prior to my arrival there had been a travel warning prohibiting non-emergency travel. During that visit it all seemed manageable. My realtor drive me around in her minivan. I drove myself around in a rented Ford Explorer. It was an adventure and surely would not happen all the time.

My assessment of the Indiana winter weather was true for the first two winters I was here. The winter of 2011-2012 was barely existent. It kind of snowed once. The winter of 2012-2013 was a bit more serious, it snowed twice and I learned how to shovel (there are strategies and techniques for shoveling snow). That was manageable and I learned something.

Now we have the winter of 2013-2014. This one is not like the others.

Since December it has snowed over a 12 inches. In the last week we have lived in the snow globe that was early January 2014. Thanks, polar vortex. This has been an unwelcome introduction to the other extreme of Indiana winters. On day one of the storm I shoveled 5 times to keep up with the snowfall.

A state of emergency was declared, the National Guard was called out and a non-emergency travel was prohibited. On day two the temperature and windchill was frightening. The temperature was around -20 with windchills as low as -40 and wind speeds of 20 mph. I did not venture out that day.

IMG_6041On day three the temperature got up to 5 but the roads remained nasty with snow drifts and layers of ice. On day 7 we got a break, it reached nearly 40 but it rained (yes, that is nearly a 60 degree change in 3 days).

Now roads, yards and fields are slush-filled ponds. Yesterday on a dog walk I stepped into an area with shin-deep slush on the sidewalk.

I’ve never seen anything like it. It is only January.

I’m told that this kind of weather builds character and stamina. I appreciate that and while I’d prefer to do that voluntarily and in the sun it is rewarding to know that I can handle it – I can live in an extreme weather event by myself (I was in the house for 3 days without any face to face human contact). One day when I live or am vacationing somewhere very warm I’ll say something like “I remember the Blizzard/Polar Vortex of 2014 and it was a mess, but Scout and I had fun.”

Also, snow in large quantities is pretty.

Gluten-Free Fine Dining in Fort Wayne

I am over at the Fort Wayne Insider talking about eating gluten-free at The Oyster Bar and BakerStreet Steaks, Seafood, & Spirits. These two fabulous Fort Wayne spots are ready, willing, and able to serve up a great gluten-free meal.

The Oyster Bar impressed me with raw oysters and fish done on cedar. BakerStreet offers a full gluten-free menu and the best steak in town, oh, and a to-die-for flourless chocolate cake.

Check it out and enjoy.