Friday, January 30, 2015

On GI problems

Seeing as we're fully acquainted now, with my first post detailing the good (lovely soft skin) the bad (dislocating jaw) and the ugly (ahem – gastrointestinal issues), I thought I'd dive right in and talk about the shit us EDSers have to deal (pun fully intended, and they're not stopping any time soon!) with in the toilet department. Once we've got this out of the way we can all breathe a sigh of relief! Prepare yourselves, and stay tuned for the giveaway at the end of the post!

Put simply, we have a bum deal (see?) when it comes to issues of the gut. All the symptoms of Irritable Bowel Syndrome (IBS) are present and correct, but it doesn't stop there. We're talking issues along the length of the GI tract, from input to output, as it were. Let's start from the top:

G.E.R.D aka, Gastroesophageal Reflux Disease

For as long as I can remember, I've had what I could only ever describe as a 'burny throat' feeling. It's intermittent, and I've never pinned down the trigger. It seems to be random, so far as I can tell, and a bout of it can last anywhere between a few hours and a few days. In essence, it feels like I have a toxic fireball stuck in my throat, and no amount of swallowing, drinking, or eating will help the discomfort pass.


Finally, at the appointment I had with Professor Grahame at the St John St Elizabeth Hospital in London (the appointment that saw my diagnosis of EDS finally made official, which I'll tell you about in an upcoming post!), I was able to describe the burny throat feeling to him. He instantly said “Yes – that's Gastroesophageal Reflux Disease – perfectly common with EDS”.

Essentially in EDSers it's caused by laxity in the oesophageal sphincter, meaning the strong acidity in the stomach isn't kept in its place. So now you know!

Early Satiety

This is, I assume, because of the GI dysmotility issue (see below) that we have, and it appears to be par for the course. Like most EDS issues, I had no idea it was a symptom until I started researching the seemingly never ending list of crap (there I go again) that we put up with in our daily lives. It's always the small things that surprise me the most, and usually things I thought were completely normal. Let me tell you, finding out that half your body functions are far from completely normal is a trip.


Anyway – early satiety, or feeling full after eating very little, is a symptom, it turns out. My mum, my sister and I have all been this way our entire lives, much to the disdain of my father who seemingly has the opposite issue. Family meals usually involved the three of us eating half of what was on our plates, while my father happily polished our plates off for us after wolfing his own down.

Gastrointestinal (GI) Dysmotility and IBS

GI Dysmotility, for EDSers at least, is a clear cut case of faulty collagen, as collagen is instrumental in the biomechanical properties of the GI tract. Our intestines simply don't move the production line along as they should. This can also lead to bloating, which is unfortunate. Nobody likes feeling bloated, but it really is the least of our problems! Then there's the irregularities of our bowel movements (we're well and truly in too-much-information territory here... sorry guys) which is closely linked to the IBS symptoms we present with, including inconsistencies in 'output', swinging like a pendulum between constipation and diarrhoea, and intolerance of food groups - in my case dairy. Which sucks, because I love cheese.

The GI problems are also linked to dysautonomia, which I'll talk about in another dedicated post. There is a lot to say on the subject of EDS and FGID (Functional Gastrointestinal Disorders), and I'll happily let the pros tell you all about it here.

I've never taken prescription medication for my IBS symptoms. This is in part due to my personal brand of stubbornness... some kind of attempt to be super human and rely only on home remedies and lifestyle changes to combat most ailments. I didn't even get myself antibiotics for the strep throat I suffered before Christmas, a decision that came back to haunt me when the bacteria ended up hitting my chest pretty hard on New Year's Day. Miserably, I sloped off to the doctor, who sounded my chest, slapped me on the wrist for not going in earlier, and packed me off to the pharmacy with a prescription for Clarithromycin.

Those antibiotics led me to a discovery, though. After my round of Clarithromycin was over, I started a round of probiotics. My tummy-woes were bad enough without the antibiotics killing off all the good bacteria in my stomach!

But more than simply replacing the good-gut-flora lost after taking the antibiotics, the probiotics seemed to help with everything, particularly the bloating and . The IBS symptoms appeared to subside, with the probiotics even helping with the ill-effect of eating dairy cheese (my dietary nemesis).

In the past week, I've been trying a new brand of probiotics called Microbiome Plus+ GI. I've tried all manner of probiotics, including BioKult, Biotic Balance, and straight-up Acidophilus.


I'm a week in, and so far I'm fairly impressed. When they arrived, I was a little alarmed at the size of the one-month-supply package. There are four boxes, each containing a week's supply, and each of those boxes is larger than the entire one-month supply box of my previous probiotics. Part of the reason for this is that the dose is twice-daily, and it's not just a probiotic you're taking - they also give you a prebiotic caplet to take at the same time. Each box contains two blister packs, one for AM and one for PM.

The amount of good bacteria in Microbiome Plus is lower than some other brands I've tried, at 3.5 billion cfu of Lactobacillus Reuteri. For comparison, the last brand I used (Biotic Balance) has 5.8 billion cfu of Lactobacillus Acidophilus, 5.8 billion cfu of Lactobacillus Rhamnosus, 5.8 billion cfu of Bifidobacterium Longum, and 2.6 billion cfu of Saccharomyces Boulardii. Whether that brand is simply overkill, or if Microbiome Plus is not quite up to the mark, I'm not sure - it's a different strain in Microbiome, and I'm not up on my bacteria knowledge enough to know what the different strains represent!

What I do know is that Microbiome is up to the challenge of eliminating the post-meal (especially post-dairy) bloat, which has caused severe pain in the past. It doesn't seem quite so robust in terms of regulating output, but that's only when comparing it to the previous super-charged probiotic. On Microbiome, I'm still leaps ahead of where my body would be if I were on no probiotics at all.


Another pro is that unlike some probiotics, you don't need to keep it refrigerated, which is good for travelling. I decided to label each day's tablets, just to keep track of the twice daily dose, which has to be taken with a meal. The size of the tablets doesn't bother me, but I know we're all different when it comes to that - my Mum would probably try and chop the prebiotic tablet in half!

I have three one-month supplies of Microbiome's probiotic to give away this week. If you want to give these probiotics a go, email jessie.estella@gmail.com and tell me the three awful puns I dropped in to this post. This one's for US-based readers only, I'm afraid, as the coupon-codes I've been given are valid only for contiguous US amazon.com accounts.


Friday, January 23, 2015

What is EDS?


If a tree falls in a forest, does it make a sound?

I've decided to write all this down... to keep all my thoughts in one place, here, so that other people – people like me - might someday find it. Maybe this will be a useful journal for others, maybe I can impart some knowledge, or maybe this journal will fall on deaf ears in the abyss of the internet, like the tree in the empty forest. So here goes:

Hi! My name is Jessie, and I have Ehlers-Danlos Syndrome: Hypermobility type. EDS3 or EDS-HM or HEDS for short. Yeah, it's a mouthful.

I must have read a million blog posts that start that way now, because like most people with EDS, I'm on a constant quest to consume all the knowledge I can about it. It's so misunderstood by the medical profession that Professor Rodney Grahame remarked to me that EDS patients are often better experts than the medical practitioners they encounter. There's a big online community of EDSers out there, and for good reason: we make up a surprisingly large proportion of society, with 1 in 5000 affected by this particular heritable connective tissue disorder (HCTD or HDCT).

We are also such an active online community because we are so engaged with our own self-help and health care. With the medical community allowing it to go unrecognised and under-medicalised, telling EDSers that we're hypochondriacs, imagining our condition, or making it up, we end up turning to one another to seek advice. We take charge of our invisible illness, because we've so often been failed by the 'professionals'.




I say 'we' with such broad brushstrokes because in every single personal story I've ever read, I've yet to find one that tells of a smooth, bumpless road towards a swift diagnosis. On the contrary, it's a long, arduous, exhausting mess... not even a road at all. It's a dense forest in the wilderness with no way-finders. You stumble, blind, trying to find your way out of that forest, never able to see the wood for the trees.Sound familiar? If you've got an invisible illness, you'll know the exasperation well.
So what is EDS? If you're here reading this, you'll probably know the answer to that already, and there are many lists of EDS symptoms out there on the internet (don't read the Wikipedia one – it's incomplete and a bit of a let down).


The most important thing I can tell you in terms of defining EDS is that it occurs due to a genetic mutation in the connective tissues. I've heard it said that our 'blueprint' for collagen is faulty, which is why there is no cure for EDS, and no supplement that can help EDSers... no matter what building blocks we provide our bodies with, we will never be able to make collagen the same way that the majority of the population can. Normal, healthy collagen is robust, strong. In EDSers, the collagen is fragile, and vulnerable. Think of us as an old, overstretched rubber band at the back of your desk drawer, while the rest of the population are fresh out of the box.




Instead of giving you a complete diagnostic list (HMSA, EDNF, and EDS Awareness have great resources for that information) I'll list the symptoms of EDS-HM that I experience. Each EDSer is different, and presents in different levels of severity for a number of different reasons, so take this list for what it is: a laundry list of my personal experience of EDS.

Musculoskeletal

  • Hypermobility of joints in most joints of my body
  • Subluxations in ankles, wrists, shoulders, knees, cervical spine, SI/hips and jaw (regularly)
  • Dislocations in jaw, knee, ankle, shoulder (less regularly)
  • Disc degeneration in my spine from the age of 15
  • Crepitus (chronic spontaneous cracking of the joints)
  • Arthralgia (joint pain)
  • Myalgia (muscle pain) and myofascial pain
  • Susceptibility to bursitis
Skin
  • Poor wound healing
  • Spontaneous bleeding
  • Easy bruising
  • Hyper extensibility
  • Velvety, doughy texture
  • Translucent, can see veins all over my body
  • Lots of stretch marks (including in places people don't usually get stretch marks!)
  • Atrophic scarring

Gastrointestinal

  • GERD
  • IBS
  • GI dysmotility
  • Early satiety

Dysautonomia

  • Postural Orthostatic Tachycardia Syndrome (PoTS)
  • Inability to regulate body temperature
  • One sided sweating
  • Raynaud's Phenomenon
  • Blepharitis (dry eyes)
  • Brain fog

This list might not be exhaustive, mostly because of that pesky last symptom: Brain fog!Some of my skin symptoms suggest overlap with Classical EDS (formerly types I and II), and there is a genetic test for this that I can't afford to have done. The outcome of that test is purely academic, as the 'treatment' remains the same.

Jessie x