Saturday, February 28, 2009

Interstitial Cystitis: Are You An Extrovert or an Introvert? Are You Sure?

Interstitial cystitis: what's behind the mask?IC patients often ask me about personality changes they seem to experience when diagnosed with a chronic illness. Most people think that being an introvert means being shy and reserved while being an extrovert means a person is charismatic, a great communicator, in short, terrific with people. There are many people who would classify me as an extrovert based on those definitions, when in reality, I am an introvert. Yep, even I had a hard time understanding that one at first.

You see, being an introvert or extrovert is all about how you regenerate your energy stores and whether you gain or lose energy around other people. Introverts are energized by spending time alone and are drained very quickly by large gatherings and when they are exposed to massive amounts of stimuli (think action movies or amusement parks).

On the other hand, an extrovert thrives on these high energy events and may even become depressed and anxious when alone with only themselves as company for any length of time. These personality characteristics are actually thought to be hardwired, reflecting a person's individual reactions to the neurotransmitters dopamine and acetylcholine.

What does this mean to you? As someone with a chronic illness like interstitial cystitis, it is important for you to know what nourishes you and what depletes you.

If you are an introvert: Parties, high energy situations, and overstimulation will create great challenges for you and may even send you into an IC flare. It is important for you to discuss this with your family and friends so that they understand when you step away from the action it is not a reflection of them, but rather a deep seated need of yours for some quiet time. For example, you may actually feel increased anxiety when thinking about family gatherings. In these cases it is important to plan ahead. If these events are to last all day--for example a family wedding--arrange for small periodic breaks. Even if you never take advantage of the opportunity to escape, just knowing you have an exit strategy can be a relief. Stress management strategies can also help. Guided imagery, yoga, meditation, prayer, even three deep breaths can do wonders for an introvert's energy level.

If you are an extrovert: Having a chronic illness like interstitial cystitis can be isolating at times, which can really drain an extrovert's energy level. As an extrovert you crave a party atmosphere, high energy situations, and frequent interactions with people, but your physical condition may become a barrier at times. Talk to your family and friends and let them know your need to be with people even if you are not feeling well. Inviting other gregarious people into your world can refresh and renew your spirits. Other ways to boost your energy if you are not able to participate in social events include watching action movies or sporting events, and playing high action video games. Consider attending in-person support groups rather than spending a lot of time online trying to recreate the "fuel" of a social network.

Finally, no one is 100% introvert or extrovert. Although you will primarily identify with one or the other, in different circumstances you may be drawn more in the other direction. Just remember that spending too much time "stretching" how you are naturally wired can itself be a huge energy drain, so the best use of your talents and energy is to simply be who you are!

Author, Speaker, Patient Advocate

Helping Yourself Is the First Step to Getting Well

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder



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Friday, February 6, 2009

Interstitial Cystitis Body pH vs Urine pH

Acid Alkaline Confusion
People often ask me why they need to avoid "acidic" foods if they have interstitial cystitis. The answer isn't as clear cut as you may think, however. I believe what has happened over the years is that it is convenient to "explain" an IC diet to someone quickly by telling them to avoid acidic foods in order to protect a painful bladder.

That, however, is also part of the historical resistance of doctors and dietitians to accepting a diet for IC. People who have studied biochemistry and physiology know just what you said, "acid in doesn't equal acid out." (An acidic orange juice forms an alkaline metabolite when digested, and the acidic cranberry juice forms an acid metabolite. There are many more interactions here, but you get the point.)

It isn't all about acid/alkaline, however when it comes to an IC bladder. There are other reasons why a food bothers us.

One is an allergic or inflammatory type response that kicks up the degranulation of mast cells. This can even be caused by stress. (Maybe you or someone you know has gotten hives when they were under a lot of stress...that is the mast cells of the skin going haywire, just like can happen in the bladder.)

The second way a food can affect the bladder is as a chemical reaction on the nerves - think about caffeine and MSG - both stimulate bladder spasms or frequency.

The third way is related to the acid/alkaline theory but isn't as clear as we would like it to be. Nearly everyone's urine pH bounces around all day long. The BODY pH needs to be kept at a fairly constant level or, simply put, we would die. So there are feedback mechanisms in our bodies to prevent wide swings of BODY pH. One of those feedback mechanisms is the urinary tract system. The BODY is kept at equilibrium by expending acidic or alkaline properties often through the urine. (see http://www.rnceus.com/ua/uaph.html for more information.) So as you go through the day, depending on what you consume, if you are exercising, or are under stress, your body is very hard at work trying to keep that pH steady. As a result, the URINE pH bounces around, as I said a bit ago, in an effort to maintain a steady BODY pH.

Now, the next step in this thought process is to remember that most people have healthy bladders and are not even aware that this is happening. In our cases, however, we have wounds in our bladder - everywhere from tiny hemorrhages to full blown Hunner's ulcers. Do you see where I am going with this?

If you had a cut on your hand, would you put it in a bucket of lemon juice (an acid product)? NO way, right? BUT, you also wouldn't put that wounded hand into a bucket of bleach (an alkaline product). It would hurt also! Neither of those liquids would hurt a healthy hand in the short term, right?

The same goes for your bladder....if the pH of the urine is bouncing around all day and you have wounds in your bladder, you are going to know it!

So, the acid/alkaline situation doesn't explain everything, but it can explain some of our symptoms. The pH issue, however, is not as easily controlled as one might think, nor should we rely only on pH as a way to control our symptoms. Some of the MOST reactive foods are the allergic/inflammatory and neurostimulatory properties of foods.

For more information on the delicate pH of your body, see Cooper Clinic's article: Myth or Fact: Balancing Acidic and Alkaline Foods


Author, Speaker, Patient Advocate

Helping Yourself Is the First Step to Getting Well

For step by step guidance for creating your own personal interstitial cystitis meal plan, see: Confident Choices®: Customizing the Interstitial Cystitis Diet.

For some basic, family-style, IC bladder-friendly recipes, see: Confident Choices®: A Cookbook for Interstitial Cystitis and Overactive Bladder



 **Please SHARE using the links below!**