Day 27: Conclusions about the SCD

Today was Day 27 of the Specific Carbohydrate Diet, and my one-month trial was almost over. It was time to make some decisions.

I’d given this diet a month because Breaking the Vicious Cycle states that you need a month to know if it will work for you. Presumably, if it works, your symptoms will improve: less diarrhea, less blood in your stools, more energy. If after a month your symptoms haven’t improved, it’s time to drop the diet and try something else.

My symptoms had improved. One month ago, I’d been so exhausted that I often lay on the couch for days. Many days, I spent hours in so much abdominal pain that it made me nauseous. Nowadays, I only rarely had pain. It was almost two weeks since my last day of fatigue. I had energy again! I could finally participate in summer! My writing conference was fantastic!

Two days ago, Ron and I had canoed across the lake. The air was warm and humid, the lake smooth as we slid the boat off the beach and dipped our paddles into the water. We disembarked at Olin Park and hiked through the cool woods, then canoed back, and I still had the energy to go for a jog through our neighborhood afterwards. Weeks ago, this kind of sustained exertion had been unfathomable. This was the real me, the me that had been absent all spring. The SCD had given me my life back.

I was not yet in remission, it should be noted. While the pain and fatigue were largely gone, I still had around two BMs a day, always urgent, always explosive, often with blood. This signaled that my colon was still at least somewhat inflamed. Troublingly, over the past two weeks my improvement seemed to have plateaued–I had the same symptoms now that I’d had two weeks ago. When I first noticed this, I wondered if I’d progressed in the diet too fast. You’re supposed to add a new food every few days, but I had added one every day. Had I added spinach and squash too quickly? I backpedaled, taking them out again, but my symptoms remained the same. That was the only troubling part, though. Overall, this diet had been a wonderful success, improving things at least as much as had any medication.

So it might surprise you to hear that I had begun researching other diets, and that I had decided to try prednisone.

Let me explain.

For all my improvement, the plateau worried me. It was familiar and frustrating–things were livable, but I was not in remission. I was still a little bit inflamed. I seemed to have hit the same wall I’d hit with my previous med regimes, and I couldn’t be sure, but it felt like things might be as good as they’d ever get, for me, on the SCD. I sensed I had reached some inner limit on the diet’s effectiveness.

I’d been thinking a lot about two recent conversations with friends. While throwing the Frisbee, Josh had asked me why I didn’t just try prednisone. I had argued that if I zapped my disease with meds, I wouldn’t understand what caused it. I wouldn’t know what I needed to change, in my diet or my lifestyle, to keep the disease from flaring up in the future.

But his question had begun to haunt me. With every week that passed, I grew more anxious about pregnancy. According to Breaking the Vicious Cycle, the Specific Carbohydrate Diet takes up to two years to fully work for colitis. Perhaps I should stick with it and give it more time, but in two years, if the diet did work, then I’d be almost thirty-eight. I never thought I’d still be trying to have a baby at thirty-eight. With all due respect to the older mothers out there, thirty-eight was older than I wanted to be.

As the weeks ticked by, my resolve began to waver. Yes, I wanted to master my own health. But what if the prednisone worked for me, as it did for Josh? What if, as if by magic, my symptoms just disappeared, the med tricking my body into some new alignment? The allure of this vision began drawing me in. The fantasy of popping a pill and making all my problems disappear. No more isolating diets. No more blood and despair. Surrendering to the mystery of not knowing what caused it all, and just trusting my Western doctors to know what was best. Getting my life back, my health back–sort of–enough to gain weight and be stable and get pregnant sooner.

What would be worse for a baby: being a little inflamed, or being a few years older? This was the kind of choice my disease was now forcing me to make.

I emailed my doctor and requested the drug. I explained about my plateau, and my new plan: I’d stay on the diet for now, while adding prednisone. (Ever the scientist, I would stay on the diet to avoid changing multiple things at once.)

I would take prednisone for just a couple weeks. There couldn’t be much harm in that. I’d met lots of people who’d been on it for two weeks, and a few, like Josh, had no side effects at all. Many others had terrible symptoms, like weight gain, “moon face” (puffy cheeks), depression, mania, and insomnia. But maybe I’d be lucky, and if I hated it, I could just go off it again. Right?

I wanted to be healthy and have a baby. If doing something toxic for two weeks might help me be healthy and have a baby sooner, I supposed it was worth it.

And I’d also been thinking of my meeting with Alison. Her words had also given me pause. She’d articulated what I already sensed about the SCD: that while this diet seemed to be helping my gut, it might not be good for the rest of me. Meat is inflammatory and is associated with disease, particularly cancer. My dad had died of stomach cancer. I was eating over a pound of meat a day. For all my improvement, I still often felt the weird, unsettling sensations that seemed to come with this meat-rich, carb-poor diet. There were sudden energy crashes where I went from strong and vigorous to shaky and weak. There was sudden, ravenous hunger, as if my body had no reserves at all and when hunger hit, it hit with dangerous urgency. There was the unnerving metallic taste in my mouth. Meanwhile, Alison was on a healthier, plant-based diet that worked well for her own proctitis. I wanted that–a diet that helped my gut, and wouldn’t freak me out if I needed to stay on it for years.

I had made some progress in my research on plant-based diets, and was formulating a post-prednisone plan for my big switch. But for now, I’d stay on the SCD for the weeks I was on the drug. I crossed my fingers that the dreaded prednisone would work for me.

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