Stomach trouble

Not feeling great this evening. I don’t know yet whether this is just an IBS (irritable bowel syndrome) episode or if it’s something worse. Jim isn’t sick, so I doubt it’s food poisoning or food gone bad. We had some pre-prepared stuff from Whole Foods, which usually is safe – but any pre-prepared food comes with risks. Perhaps there was too much oil in the food prep? I can’t tell now. I’ve taken some meds to quiet any cramping, and have only had one run to the bathroom. Time will tell. If I have another run soon, and it’s watery – then I’m sick. If there’s another run in an hour or two, more likely IBS. And if I start to feel nausea and not just gassy, that’s more likely a flu.

It wasn’t my intention to write about gastrointestinal problems today, but I’ll seize the moment.

It is very hard when you don’t have full sensation inside your body, to sort out symptoms and know what the problem is. Full bowels, full bladder, stomach cramps, menstrual cramps, gassiness, and bladder infections can all feel about the same. It takes years of paying attention to your body, increasing your body awareness and even then it’s hard to tell the difference at first.

Generally when something isn’t right in my lower body, creating a condition that would be uncomfortable or even painful for someone with full sensation, I get a condition called autonomic dysreflexia. When the pain signal doesn’t go up the spinal cord properly, a back up system kicks in – and makes your blood pressure rise, and usually gives you a headache and a slightly sweaty clammy feeling right at your injury level. When the dysflexia is really bad, like while I was in labor, the headache is severe and you feel like your eyes are going to bug out. Thankfully, usually, it is mild.

So, to solve the mystery of what isn’t right, I evaluate my sense of what my blood pressure is, whether my stomach feels cramped, whether I’m gassy, or have a fever (rare). Today my bp rise is very low, I feel gassy, and the crampy feeling had been coming in waves every 20 minutes or so – conclusion is bowel trouble. Bladder infections are slightly higher bp, more sweaty, and the crampyness is more constant. Fever only comes if the infection is really bad. Menstrual cramps, which I no longer have (knock on wood!) are more like bladder infections, without the fever, though I used to feel like I was getting sick with a flu, not hungry or interested in food.

The last time I had really bad dysreflexia was when I was very constipated from a day of flying, about 3 years ago. I imagine my hemorrhoids were really hurting, and it took 3 days to subside, though was only severe during bowel movements, not all day. My blood pressure was so high I debated going to a hospital because there is a risk of a stroke when it is that high, but I was in Huntsville alone staying at a hotel, while my mother was in the hospital recovering from surgery. Many emergency room doctors don’t know what autonomic dysreflexia is (I kid you not!) and I chose instead to keep my eye on it. There is a medication we can take that will lower the bp immediately, but stupidly I had left mine in San Diego. Never again will I travel without it. Luckily, like most paras, I have low blood pressure normally – 90/60 or 100/70 most of the time. It used to be lower when I was younger, prompting doctors to ask me if I was ok, and did I need to lie down. So, even if my bp shoots up, it is rarely high enough to cause me to worry about a stroke.

The easiest way for us to manage our bowels is to create a schedule with a regular frequency (once a day or every other day are most frequent) and then with one method or another, to stimulate the bowels to empty. If you eat foods at a consistent level, you can do this. It’s not that hard, but takes time to learn what your body can handle. How much corn or cherries or prunes can you eat?

I imagine that every SCI at some point has had bowel accidents from poor food control and when sick. They are NOT fun. You just don’t have the sphincter control to hold stuff IN. And of course these moments like to come when there’s no accessible bathroom at hand. I could tell some really gross out stories, but won’t – as much to spare myself the memories as to keep my audience! My worst days were about 10 years ago. I think I was starting to have IBS then, but didn’t realize it. I knew I was getting more sensitive to foods I was eating, but thought I had just stretched the rules I had set for myself. With time I’ve learned that the foods that trigger me most are animal fats and high roughage foods. I’m particularly careful with fast food, and only eat it when I’m heading home, and to a perfect bathroom. Spicy oily foods are a problem, like Thai and Indian, but I like them, so I just watch what I eat. And once in a while very hot soup triggers a reaction too. I suspect I have diverticulosis too, so I’m staying away from nuts and corn, at least a lot of them at any one time. A little is ok.

Anyone could have IBS and many people do. I bet a lot have it at a mild level, and don’t really know it, they just know that after eating they always head to the bathroom. I’ve noticed someone who often gets up in the middle of a meal to use the bathroom, and think this is unusual. But for someone who can get to a bathroom almost anywhere, quickly, it’s not a real issue. Or if someone can hold-it-in, albeit uncomfortably, for the time it takes to get to a bathroom, they’ll be ok.

About 5 years ago, I had jury duty, and my biggest worry that week was that I’d have a bathroom problem. I had just started to get a handle on my IBS, and take medication. I could easily have gotten a medical excuse, but I really wanted to do jury duty, because I never had before. For that whole week, I didn’t eat lunch. I couldn’t afford to have an IBS episode after eating lunch. The accessible bathrooms were a 15-minute walk from our courtroom (regular bathrooms were about 2 minutes away), and when I feel an urgent call to go I only have about a 10 minute warning. Plus you can’t just up and excuse yourself out of a courtroom any time you want to. So, to be on the safe side, I didn’t eat anything except fruit till I got home. And I was fine. A week of weird eating won’t hurt you. I was glad to do jury duty once, but not likely to do it again.

Now, about an hour after getting out of the bathroom, I can feel the cramping dying down. The medicine is probably relaxing those tissues, so it’s most likely IBS triggered by something in my dinner. I’ll be ok by the time I go to bed, and it’ll be forgotten by morning.