Posts by redviolin87

Fellow Restonian here! Well, I'm away at UVA right now... but I grew up in Reston and love it to death :-)

Welcome to CC!

Be sure to check this with your doctor, but from my own experience I believe that if you have a true deficiency, then 1400 IUs should be fine.  I'm 21 but have osteoporosis (long story. . .  and no, it's not from an eating disorder!) so I've been prescribed a 50,000 IU Vitamin D supplement to take once a week for two months.  No, that's not a typo - it's actually 50,000 IUs!  And this is on top of the 800 in my daily multi-vitamin.  So, 1400 doesn't sound like too much for someone with low levels. (Most women over 50 are recommended 1200 IUs, vitamin-deficient or not.)  After a few months, however, you should get a blood test done to see if you're back to normal.  If so, you should return to the recommended 800-1000 total IUs per day (if you're under 50 years, 1200 if you're over), so you won't eventually overdose.

Hope this helps! :)

I'm recovering from a lifetime of Superior Mesenteric Artery Syndrome (never heard if it? See the Wikipedia article I wrote) which causes severe emaciation. I used to be 74 lbs (12.5 BMI), but now, nine months after a major surgery, I have battled my way up to 87 lbs (Improvement! But, I still have a long way to go...) I am 21 years old and 5'4.5".  Thanks to small-frame genetics and my gastrointestinal condition, I've always been the "littlest" kid in the class while growing up, and until today, I am frequently mistaken for being in my early teens.

That said, I had a conversation with the founder of my hometown himself at the City Festival in July that went something like this:

Him: How long have you been living here?

Me: My whole life.

Him: Wow. So, are you starting intermediate school this fall?

Me: Oh, um, I'm in college.

Him: ... What!?

Me: I'm 21.

Him: *Stares in shock* Goodness, you must've found the fountain of youth! Tell me where it is!

Haha!  A clever save, I must commend him. I can't even count the number of times I've been mistaken for a 12/13-year-old. And I'm almost twice that.  I'm not annoyed or angered at all, just amused. 

Everything You Need to Know About IBS (and Then Some)

by Red Violin

 * * *

Part I – DICTIONARY OF DIFFERENT TYPES

IBS-A :  "Alternates" - Swings back and forth between severe constipation and severe diarrhea.

IBS-C:  "Constipation" -  Rock-hard bowel movements less than twice a week. Severe bloating.  Pain after every meal.

IBS-D: "Diarrhea” - Liquid bowel movements more than twice a day. Getting "the runs" after nearly every meal, or after eating a "trigger food."

IBS-P: "Pain" - No predictable/detectable bowel-movement pattern (constipation or diarrhea), but considerable pain with each episode and/or meal.

Part II – BASIC INFO AND TESTING

If you've noticed that you feel particularly bad after eating a certain food, try cutting it out entirely for a week or so and see what happens.  Then, re-introduce it to test if that food really is the culprit.  If symptoms return, then you know you've hit the nail on the head.  If you're just plain unsure sure what's hurting you altogether, try eliminating the "traditional" IBS-triggers (dairy, caffeine, solid chocolate, carbonated drinks, rich cakes/pastries, sugar, anything too greasy/oily/high-fat, red meat, etc.)

Early satiety and abdominal pain after every meal is typical for IBS.  So, it is definitely a good idea to eat small, frequent meals instead of trying to force down three big ones.  If you are unable to tolerate volume, choose calorie-dense foods like nuts, dried fruit, beans, lentils, oats, granola, low-sugar protein bars, almond butter or peanut butter.  Liquid calories are also a great idea. Glucerna and Boost make delicious (and IBS-safe) vanilla and chocolate shakes. They are fortified with protien, calcium, and every vitamin you can think of, but have no added sugar or lactose, and very little fat and cocoa.  Perfectly IBS-safe, nutritious, and yummy!  (As an alternative, you could put soy-protien powder in lactose-free milk or fruit smoothies.) Try drinking these in-between meals, (or even as a dessert, since, with IBS, you can no longer eat "normal" desserts like ice cream, cookies, or cake.)

Unfortunately, receiving an "official" IBS-diagnosis from a doctor does not give you much more than if you were to diagnose yourself.  What I mean by that is, IBS is incurable. Chances are, a doctor will give you the same recommended treatment as you would give yourself:  For example, all my doctor told me upon diagnosing me with IBS-C was "Eat fibrous foods, aviod triggers, and take laxatives."  That's it.  Telling someone that have IBS is like telling a person with a sore back that they have Sore Back Syndrome.

However, even though medical science cannot cure you, it is still important to get an official diagnosis from a doctor in order to assure that your symptoms are not caused by another (more serious and/or treatable) digestive disorder or disease. (For me, it was Superior Mesenteric Artery Syndrome, which is FATAL without proper treatment! IMAGINE what would have happened if I didn't press forward and get tested properly!)  Another example: Many people who think they have IBS-D (which is not cancerous) could, in reality, have IBD.  The confusion exists because many of the traditional IBS symptoms mimic those of other conditions.

Unfortunately, there is no one "test" for IBS, because it is a functional disorder (not a disease) in which the intestines appear normal but do not function properly.  Basically, a "negative" result on every test = a diagnosis of IBS (it's a catch-all.)  Tests that you must have include: An endoscopy, colonoscopy (with biopsy), ultrasound, CAT scan, and blood-test.  ONLY if everything on all five tests come out "normal," then you know you have IBS.  YOU HAVE TO GET ALL OF THESE TESTS DONE BEFORE YOU CONSIDER YOURSELF TO HAVE IBS.

Depending on the type (-A, -C, -D . . . etc.) and your bowel's individual peculiarities, "the IBS diet" varies dramatically.  For example, people with IBS-C generally tend to avoid white-flour products because those are known to cause even more constipation.  Conversely, those with IBS-D deliberately eat refined flour for the purpose of hardening their stool.  Many with IBS have a wheat and "leafy green" intolerance; I, however, find that my particular case is not aggravated by those foods - quite the opposite (the fiber helps move my bowels).

So, all in all, composing your own, personalized IBS-diet is part guessing-game (eliminating and re-introducing foods to see what "triggers" you) and part research (of your specific type – ie. People with IBS-C tend to react poorly to refined flour and vice versa for type -D, etc.).

Part III – IBS CAUSES EARLY SATIETY AND MAY THUS TEMPT YOU TO EAT LESS AND LESS – WHY YOU SHOULDN'T GIVE IN TO THAT URGE, AND HOW IT NEARLY KILLED ME

IBS often makes you feel full fast.  This means simply intuitive eating may not work well anymore.  You will have to learn to eat when you are not hungry.  Because of your IBS, maybe eating only three slices of bread all day may make your stomach feel nice and satiated until tomorrow, but the truth is, your body is still hungry.  After going through literally the worst physical experience of my life due to pain-induced undereating, I cannot help but to want to warn you about the dangers of it. What I’ve been through, I wouldn't wish on my worst enemy.

Outside of my temporary hyper-metabolic mode endured by 70% of all patients recovering from severe malnourishment, my real burn rate is probably far less than yours since I have very little muscle and a porous bone structure (I am 79 lbs, small-framed, and have osteoporosis). According to my doctor, my body burns only 1300 a day, sedentary. 1200 of those calories go toward simply keeping my organs functioning and my blood flowing:

-The heart needs 144 cals just to keep pumping
-The kidney needs 144 cals just to keep filtering urea
-The liver needs 276 cals just to keep filtering toxins
-The brain needs 276 cals just to stay out of a coma
-The skeletal muscle needs 360 cals to keep its mass and not trigger osteoporosis

Cutting food intake because of IBS-induced premature satiety full puts your body in a state of alarm (often called "starvation mode"), in which it pushes to conserve every bite you eat rather than burn it. (Which is why you may feel like you have to eat little in order to maintain your weight, when in truth if you slowly begin eating more and more, your body will simply adjust to the higher intake). Without enough food, you may start feeling cold and tired as your body is forced to break down muscle and tissue to fuel its vitals. Undereating slows metabolism so that you need fewer calories to maintain a higher weight; as muscle tissue diminishes, your burn rate reduces. Depending on how long your metabolism stays slowed and how low your calorie intake goes, your body will begin to react in bad ways. (Trust me, I've felt them all. More about that later). Only if you start eating enough again will your body slowly raise your metabolic rate. Since the brain is metabolically very active (uses about 20 to 30% of a person's energy intake at rest) undereating will result in changes in mental functioning. Simply skipping a meal can hamper problem-solving ability, energy, motivation, mood and responsiveness, since the body responds to energy deprivation by first shutting or slowing down nonessential functions, then altering activity levels, hormonal levels, oxygen and nutrient transport, the body's ability to fight infection, and many other things that impact brain function. After a month of undereating (due to my SMA Syndrome and IBS), I still felt okay, sure. But after that, I went through a year constant apathy, sadness, and hopelessness. Four of those months made up my entire fall '07 semester at the University of Virginia. I can honestly say it was one of the worst times of my life.

Being underweight has caused its own set of problems, like osteoporosis (porous, brittle bones), coldness, bloating, constipation, exhaustion, muscle aches, mood swings (awful feelings of depression), leukopenia (low white blood cell count), amenorrhea (lack of menstruation), chest pain (from pressure on the aorta by the SM artery and the duodenum), hypotension (low blood pressure), and chronic hypothermia (constant body temperature of 95 degrees, since my body apparently thought it was in a famine and so it couldn't afford to burn more calories to reach a healthy temperature like 98).

My surgeon told me to my face that I was slowly dying of starvation.  He said that, according to the World Health Organization (the WHO), a body mass index (BMI) at about 16 is considered starvation. Under 15, you are at risk for cardiac arrest and other organ failures. A BMI under 18.5 is underweight, and above 24 is overweight. My BMI post-SMA Syndrome (at 74 lbs) was a 12.7. It's now almost a point higher since I'm nearing 80. People like me who are very lean can't afford to be starved by IBS or any other gastrointestinal condition, even for a short while.

 PART IV – HOW DO I KNOW IF MY IBS IS STARVING ME?

The symptoms that I mentioned above (osteoporosis, leukopenia, amenorrhea, chronic hypothermia, etc.) only start to appear if your starvation is advanced. Hopefully, you will never reach that phase.

 Here are a list of symptoms of the earlier stages of undereating:

 Constipation: If nothing goes in, nothing can come out. When I was eating only 1000 or so calories a day, the most I ever pooped was once a week.

Pains in the chest, ribs, sides, lower back: When deprived of food, the body begins to burn fat and muscle at the same rate. If you are already lean, so your body may feel compelled to start atrophying organs (which are muscles) right away, as did mine.

Headaches / difficulty staying awake: The only type of calorie the brain can use is a carbohydrate. It can't use protein or fat (which are the types of molecules your body stores as energy). If there are no carbohydrates to spare (ie. low blood sugar caused by recent undereating) it will ache and want to shut down, since it cannot easily use the fat or muscle stored on your body (only the carbs you've recently eaten).

Cramping / bloating: If there is no food in your gut (and thus no stool in your intestines), all that space can be filled with air instead. Cramps and constipation go hand-in-hand.

General sense of weakness and fatigue:  If you put no fuel in the car, the car won't start. When I was undereating, I could hardly walk down the street without literally feeling like I was going to faint. I would actually sit down on curb to take breaks on the way to class.

Lying awake in bed with a panic-stricken heartbeat (This symptom is a little more advanced than the others): While you sleep, that is the time your body uses digested food to repair muscles and "refresh" yourself. This may sound odd, but when you don't give your body enough to properly conduct its nighttime repairs, it refuses to let you sleep in the hopes that you will eat something more before going to bed. It's a basic survival instinct. Low blood sugar is often the culprit for insomnia and heart palpitations.

* * *

I hope this helps, everyone! :)

~Red Violin

I'm recovering from a lifetime of Superior Mesenteric Artery Syndrome (never heard if it? See the Wikipedia article I wrote) which causes severe emaciation. I used to be 74 lbs (12.5 BMI), but now, three months after surgery, I have battled my way up to 81 lbs (Improvement! But, I still have a long way to go...) I am 20 years old and 5'4.5".  Thanks to small-frame genetics and my gastrointestinal condition, I've always been the "littlest" kid in the class while growing up, and until today, I am frequently mistaken for being in my early teens.

That said, I have far too many of these "you're so skinny" incidents to list. (A lifetime of comments, literally...) I'll just rehash a few recent ones.

Last semester, after being weighed by a nurse at the Student Health Center, I was waiting for the doctor to come when she struck up some *casual* conversation . . . after a few minutes she asked me if I eat three meals a day, which I thought was odd of her to suddenly bring up, and I said yes, I do. And then, after a bit more "chat" she slipped in a strange question rather out-of-the-blue: "Do you purge after meals sometimes?" I was completely baffled because, at the time, I didn't even know what "purge" means, so I asked her. She said (rather uncomfortably) that purge means to vomit. So, I stared at her, horrified, and was like “What? No!”

A couple months ago, at bible study, the preacher called us to a special time of fasting throughout the week, skipping one meal a day for seven days. Then, after the meeting, when he was talking with the people at my table, he looked right over at me and said, in front of everyone, "You’re excused from the fast." I just kind of looked at him, too embarrassed/mortified to say anything in response. So he insisted, "Really, I don’t think it would be a good idea for you to do it. I mean it."

I was at a birthday party a few weeks ago and I decided to wear a skirt for the first time in a long time. One of my guy-friends actually walked up to me, looked at my legs, and started telling me that his sister's health is so bad right now and that she can no longer keep up with her job because she is tired all the time. So, I give him my condolences and such, then I ask him what is making his sister sick. He gets all serious and quiet, and says, "She's anorexic." Then, there is this long pause, and he adds (glancing at my legs again): "I've been meaning to ask you . . . are you suffering from an eating disorder too? 'Cause I notice you are really, really thin." I just kind of looked at him for a while, not sure where to start. I didn't really want to go on a tirade about my weird condition, so I just told him I had a syndrome that causes emaciation, but I had surgery for that and am now recovering. Not sure if he believes me.

I think I'll be sticking to long-pants and long-sleeved shirts from now on.

• French toast or a blueberry muffin (normally, the eggs and oil would slaughter my stomach, plus any refined/white-flour products would constipate me for a week)
• An iced, dark-chocolate-peppermint latte from Starbucks or a glass of chocolate milk (chocolate, milk and caffeine are all serious symptom-triggers).
• Hash browns (again, the oil would get me)

• Munster or brie cheese (how I miss dairy!)

• Chinese food: Particularly sesame chicken (yikes, oil), white rice (the king of constipation!), or, even better - fried white rice (a double whammy!)
• Sparkling cider (carbonated drinks are a big bloatation-trigger)

• Chocolate-peanut-butter ice cream with chocolate chips, hot chocolate syrup and a banana (there goes the chocolate and dairy again!)

• A steak Chipotle burrito with extra cheese. (Red meat, white flour products, dairy, AND spice in ONE food-item . . . This burrito would be a delicious way for me commit suicide)

• A slice of pumpkin pie with whipped cream (last time I had this--which was last week, when a professor of mine brought some to class--the sugar made me feel SO bloated and sick, I wanted to explode/cry.  I couldn't eat for the rest of the day, literally.)