The Endometriosis Diet: Alternatives to Dairy

Why Cut Out dairy?

Dairy is not an easy thing to cut from your diet, but there are a number of reasons that make it worth it. Dairy products have a high-fat content that contains oestrogen - a hormone that endometriosis sufferers often have too much of already. Oestrogen controls a number of processes in the body, but most importantly it controls our reproductive system and an imbalance of the hormone is closely linked to endometriosis. It 'feeds' the endometrial cells.

Series 2 prostaglandins are found in dairy and are known to promote an inflammatory response in the body. I'll devote another blog to these pesky things as they're also found in red meats and aren't easy to summarise!

Dairy can also cause a host of digestive issues such as constipation or difficulty absorbing other nutrients in your food. And finally there are a number of intolerances that are caused or worsened by dairy - not just the obvious lactose intolerance - that can manifest as illnesses such as asthma, eczema and arthritis.

Whether you're feeling the effects of all of these problems or just one, cutting dairy could give you a significant reduction in symptoms.

Cutting Dairy From Your Diet

Initially it can be tricky to get your head around all of the products that contain dairy - even things you wouldn't expect like salt and vinegar crisps! But as you acclimatise to your new diet it becomes second nature and the habits you develop will make it much easier to avoid.

I'd start by replacing your milk with a simple unsweetened nut milk such as almond or hazelnut. The taste is quite creamy and easy to adjust to and nut milk can be used the same as normal cows milk - in hot drinks, on cereal and in baking etc. These are found in the same section as normal milk and are slightly more expensive, but also have a much longer use by date so if you're an infrequent milk drinker you may even end up saving money - we have! :)

Once you've cut milk out, it gets easier to remove or find alternative products like cheese and butter. Sadly I've yet to find an alternative to cheese (vegan cheese contains soy), but I live in hope!

A Note On Yoghurt

Although a dairy product, there are certain types of yoghurt that are actually beneficial for the endometriosis diet. Commercial yoghurts are highly processed, sweetened and full of sugar, whereas the healthy yoghurts tend to be natural 'live' versions that contain bacteria that promote a healthy gut. These yoghurts can be made from animal milks as well as nut milks, however animal milk is still harder to digest and nut yoghurts would be better for you.

Dairy Free Dining

While not as common as gluten free, dairy free menu options are starting to become more popular - especially in new restaurants and smaller chains. They're often found in the vegan section, although don't assume that normal items can't be made dairy free. Often it's as simple as asking for no cheese/cream dip etc. If in doubt ask for the allergen information to go alongside the menu - restaurants now have to have this information by law so it's about to become much easier to dine out than it used to be!

Alternatives To Dairy

As mentioned already it's possible to get nut milks to replace dairy products. You can also get nut butters and yoghurts too. Rice milk is another alternative that you can buy from health stores - I've even seen it in larger Asda stores! Less obvious substitutes are water or fruit juices, depending on the use. For example water is a healthier alternative for hot chocolate and fruit juice can be used as a sweetener in baking.

Butter is fairly simple to replace too - simply use an olive or sunflower oil based spread. These should appear either in the butter section or closeby, depending on the store layout.

As I said, the only alternative I've yet to find is cheese. I've heard that cheeses made from nut milk do exist, but I've yet to find them and I'm pretty sure they'll come with a price tag I won't want to pay!

Roundup

While it's less common to cut dairy from your diet than gluten, in many ways it's easier as there are less products for you to slip up on. I would caution you to check labels, as milk can creep into some products you wouldn't expect it to, but you'll get used to this over time. Removing dairy can have a host of benefits, from clearer skin to less painful cramps and a healthier digestion.

Have you tried a dairy free diet? What alternatives do you use? And if you've found a dairy free cheese substitute (that isn't made from soya) I'd love to know!

BBQ Pulled Pork & Crazy Hormones

BBQ Pulled Pork has been a little obsession of ours lately. Thanks to a friend who was able to get us a lot of pork shoulder for pretty cheap, we were able to indulge more than usual over the last month. I've made 3 giant batches now, totaling about 18 portions of absolutely delicious pork, made even better by the homemade BBQ sauce I made to go along with it. Yum!

January was an interesting month - my hormones have been jumping all over the place and it's made me more than a little irritable. In fact I've even experienced full on rage, which was a new one for me. I think it had to do with having my first cycle in 6 months and it's not a feeling I'm looking to repeat...ever!

January also saw the return of another emotion I battle with occasionally: depression. After doing a vision board workshop I realised that I have rather few hobbies that I indulge in anymore thanks to the endo and for a while I did feel quite upset by it. But it's also a pretty exciting opportunity to explore some new hobbies and get back in touch with old ones (such as reading and blogging!).

On the flip side of all that January also brought me a need to declutter - a lot! I'm still in the middle of the process, but I've sold off some of our bookshelves, taken a few bags to charity and even sorted out my underwear drawer and put some to one side for a homeless shelter. I have a strong desire to purge all of the unnecessary stuff that's accumulated in the flat over the last 2.5 years and make room. Call it hormones or energy, but I suddenly feel a little claustrophobic with all the stuff we own. It's actually nice getting rid of some of it!

This has been a bit of a random post, but I guess that's what crazy hormones do - make everything a little random! I've really enjoyed putting together the first few posts about the Endo Diet and its alternative, so look out for those over the new few weeks. :)

How was January for you? Did you make some great progress on new goals or get distracted and forget them (like my healthy eating idea...)?

Reflection - My Story

I'm awake. Awake and in pain. A familiar yet unfamiliar pain that I haven't felt in almost 5 months now.

Rather than get annoyed, I find myself reflecting on the last year and all it's brought me.

12 months ago I was experiencing just the beginning of what would soon become daily agony. I didn't know that I was soon to experience crippling pain that would have me sleeping on the living room floor wrapped in heat pads and blankets, on the strongest painkillers the doctors would give me, all in the hope of an hour or two of sleep before work. Pain that bloated my body and made every day a surprise of whether I'd make it to the end of the work day. Weekly osteopath appointments would just about keep me standing with the back pain and weekly doctor appointments would become more and more frustrating as my suffering fell on deaf ears.

9 months ago was the start of the pain. After 3 months of particularly bad 'womens problems' the pain was no longer just a symptom of an (extended) 'time of the month'. The pain became my month - all of it. And then it became two months. Then three and finally four. Four months of pain that was completely unexplained and the doctor settled upon IBS as the diagnosis from Day One. When each drug didn't work I was given another. Diet advice. Pain relief. No offer of an alternative diagnosis, further testing or anything that would've looked into the real cause.

7 months ago came the first blood test. The first admission that it might not just be IBS. By this point I hadn't slept in weeks and I was so bloated I looked 6 months pregnant. Work was becoming a struggle and I was starting to suffer depression from the constant pain. That blood test showed I had signs of infection in my blood, but no antibiotics were offered. Just an appointment in two weeks time for another blood test "to see if it's gone."

6.5 months ago came blood test number two. All my hopes pinned on this one - something had to show. Something that would explain everything. But life stepped in before I got those results.

Sunday 28th July I was in agony - even more so than usual and I couldn't even sit still. My blanket of heat pads didn't cut it and I rang the NHS advice line to find out what my options were at 9pm on a Sunday night. Within an hour I was at Frenchay Hospital Out of Hours GP seeing a lovely doctor who was probably the first to touch on the real problem. But he wasn't to be the one who would save me. Being late on a Sunday night he advised I visit my GP the next day. So back to my GP I went, for my blood tests to show more infection. And once more I was given an appointment in two weeks "to see if it's gone."

But Tuesday 30th July changed it all. Sat in my mum's kitchen I was in tears, not because of the pain but because I gave up. My family was outraged at the way I was being ignored, but I was just used to it. My fight left me that morning and I resigned myself to constant pain. I told my mum that someone else would have to fight for me, because I just couldn't anymore.

It's funny how the universe knows when you mean it. And I couldn't have meant it more. I was defeated. Within 30 minutes I was white and throwing up. Laying limply on the sofa an emergency doctors appointment was made  for the afternoon. It's funny looking back that I didn't consider it serious enough for an ambulance even at that point. It was 'just IBS' after all.
That afternoon I saw a different GP. If angels exist she is one of them, because she saved me that day. I had a fever on top of the vomiting and I was sent straight home to pack for Frenchay. Something was very wrong.

At midnight after seeing a number of doctors and being sent to a different hospital I was finally admitted to the Gynae ward in Southmead Hospital with a suspected infection of my fallopian tubes. Tears streamed down my face for most of the night, especially at 2am when my mum had to admit defeat and head home to sleep. It was all just too much.

Wednesday 31st July I got my first glimpse of a real diagnosis. A scan showed two cysts - 8cm and 4cm - one on each ovary. My insides were a puzzle; it took them a lot of searching to find my ovaries in the first place as they were up by my bellybutton, touching in the middle. Blood tests also showed I had not one, but two infections. The one that had caused my fever but also a chronic infection that had been around for at least a month by that time. A very nice consultant gave me the news; it was either an abcess or endometriosis. I was put on antibiotics and watched constantly - if it was an abcess and it burst I'd need emergency surgery, but they wanted to wait until the infection was under control before surgery if possible.

I spent the next few days staying positive, meeting each new patient as they came and went and getting to know the nurses. I've never been more grateful for my family (especially my mum and Tom) as not a visiting hour went by that I wasn't surrounded by people, presents and food.

This time 6 months ago it was Thursday 1st August - the day before the first of two operations that changed my life in so many ways. In every way.

Me with presents after Op #1

On Friday 2nd August an exploratory laparoscopy showed I had Stage 4 (severe) endometriosis. I would need another surgery once the cysts had been shrunk as it was too dangerous to cut them out at that point. I was given Zoladex to put me into a medical menopause for 3 months which would shrink the cysts and conversations delicately skirted around the real fear we all had. Would it affect my fertility?

3 months ago I came to the end of a new hell; the menopause was not kind to me. I was angry a lot of the time, depressed the rest and fighting to see an end to any of it. I'd also started on the Endometriosis Diet and combined with the Zoladex September and October were almost pain free for me. In one way I was so grateful for that relief, but in another the hormones took that gratitude from me as I was too emotional to enjoy it. And it still wasn't a solution. Zoladex was just a stop-gap on the way to the next surgery.

On Friday 22nd November I was admitted once more for another laparoscopy - this time to cut away the cysts and any endo they could get to. They were also checking my fertility and making sure all was working okay. At pre-op I'd been told I would be going home that night, but my consultant said it wouldn't be until the next day at least. So mum went off to work to keep occupied and I was taken off to surgery.

That afternoon I came around just long enough to hear the results before sleeping the rest of the day and night. The cysts were gone but they had bad news about my bowel, which was attached to my fallopian tubes. It was too risky to cut them apart, so they'd been left. And in my haze I almost missed it as the consultant said my fallopian tubes were blocked. I sat in shock and at that point I could only muster a few tears. I didn't believe it. Of all the things I thought they might say, my fertility was the one thing I'd been sure of. As the consultant explained further I just stared at her blankly. Once she was gone I could barely keep my eyes open. I knew I should be talking to mum and Tom, but the pull of sleep was too strong and so I sent them home. Sleep provided me with an escape from all the things I just couldn't cope with right then. The next day I was discharged from the hospital and left to the care of my family.

And now here we are, 2 months on. There are still so many things I'm struggling to come to terms with and I think it'll be a while before I do. But this morning has me reflecting on all the things I've overcome. I'm now pain free, completely. I've lost a stone and everyone tells me I've got my sparkle back. Not only am I back at work, my own business is now 3 months old (yup - started before the op!) and thriving. I've started with a personal trainer to regain the core strength I've lost and I'm improving my diet constantly. I've made new friends along the journey too.

With my cousin and sister at Christmas.

But I think the best reward I've had from all of this is the relationship with my family. The support they've given me brings me to tears. There aren't words to describe what it means to me - my mum and Tom never left my side. Mum with her pep talks, her sympathetic ear and her endless patience in waiting rooms. Tom with his bear hug every time it all got too much, his constant support and his endless patience with my mood swings! Kassi with her sunny outlook on everything and her ability to make me laugh so hard I had to curl into a ball to protect my stitches. My grandparents with their endless generosity, helping me with anything I needed and just being there. And not forgetting my Dad who brought me crisps and Rachel who brought me magazines and distraction. I couldn't have done it without them. I still couldn't. They're my support, my inspiration and what keeps me going.

So there's my story. I don't want your sympathy, that wasn't the point. But now you know a little more about me and why I sometimes need a moment to compose myself or have to excuse myself from plans when I get tired. If you know me I hope it's given you insight into why I've been so absent from a social life lately and if you don't know me, I hope it's given you hope. Or at least been interesting to read for a while.

If you have any questions or stories of your own I'd love to hear them. You can leave a comment below or if it's personal you can email me: amirosemarshall@gmail.com

Thank you for reading.

Hospitals, Hormones and The Traumatic Incident of the Dog in the Evening.

Monday marked exactly 1 month from the day I was discharged from hospital, which surprised me! It seems like no time at all! To celebrate, yesterday I went to the doctors for my second Zoladex implant and to the hospital for my post-op check up. Seems like an odd way to celebrate, but that's the medical profession for you. ;)

I'm happy to say that all went well. The implant wasn't half as scary as I was worried it would be! As for the hospital check up, everything was better than they'd expected, which can only be good! Both cysts have shrunk - the larger one is now half the size which is pretty impressive! So they're happy to go ahead with my next surgery in October, which is great news.

The only downside so far are the mood swings and hot flushes. I've not quite turned into a fire-breathing city-destroying monster, but irritability is never too far and more recently I've been feeling quite fragile and easily upset. Not to mention turning into a furnace at the drop of a hat!

This all came to a spectacular explosion after a particularly traumatic incident yesterday evening with the neighbours dog that left me a shaking mess in our hallway! (No dogs or Amis were hurt, just mentally scarred for life...)

So if I'm snappy, over-react or just seem plain grumpy, please forgive me. There is hormonal warfare currently taking place in my body and right now I'm not winning!