On food and back pain
Dec. 20th, 2010 02:59 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
selenayI've been meaning to write this for a few days now, but haven't really had the time (or energy) to think it out properly. So, here we go.
My back pain is the frustrating kind where gentle activity helps, but sitting, lying or standing for any length of time is deeply uncomfortable. And too much activity is also a no-no. I'd imagine there are lots of people out there in similar situations.
That makes many aspects of normal life challenging, but feeding myself is one area of particular challenge. The cause of my back pain is inflammation in the SI joint. The inflammatory process is pretty hard and draining on the body: I'm told that it's part of the reason that I'm exhausted right now. To give my body the best chance of getting through this without doing any other damage, it is important that I eat regular, balanced, healthy meals.
I find that the pain is harder to cope with when I'm hungry, which is why I emphasise regular.
On the one hand, my activity levels may be lower than normal (although all the walking around I do to ease the pain and the physio exercises several times a day may be making up for this) so I don't want to eat a ton of high-calorie stuff. On the other hand, my body is using up a lot of nutrients on inflammation so I need to replace them.
At the same time, standing for long periods of time is hard so I'm trying to make meals that require minimal tending and standing. A big stir-fry may be very healthy, but it's a high-prep meal. Most of my evening meals are tending to consist of a protein source plus a big pile of veggies (which are easily steamed in the microwave). My lunch is wholemeal bread, some kind of filling and a helping of fruit.
The hardest part is finding a protein source that is tasty, easy to prepare and can be chucked into an oven (so minimal tending required) without resorting to boxed or package things more than once a week. As easy as it is to grab something from the freezer, a lot of prepared things are high salt and high fat so I try to minimize them even when I'm feeling good.
Thankfully I've got a reasonable repertoire these days and my local grocery store butcher and fish monger do some lovely things that are moderately healthy and require very little prep beyond popping into an oven. So most days, I don't struggle although I know a lot of people who find this side of things difficult.
For me, the hardest days are the ones where I don't want to eat.
I get days when I'm so exhausted from the pain, the lack of sleep and all the other fun stuff that the action of chewing and swallowing is too much. My swallow reflex wanders off somewhere else, things get stuck in my throat, and the thought of eating something is more than I can cope with. It's not just that preparing food is beyond me, it's that eating it is beyond me so there's no point ordering something in because I'll get through two bites and want to give up.
Those are the days when I have to bully myself into eating, find things that are easy to chew and swallow and generally be mentally tough over it. Food needs to be interesting and tasty to overcome my exhaustion, but not taxing to prepare. Grilled chicken breast may be easy, but it's hard work to chew and frankly boring so it's not the solution on those days.
I have to bully myself because not eating means not having my NSAIDs and that would be bad. If it weren't for the NSAIDs, I wouldn't bother on those days. As it is, those are the days when soup and toast is often all that I can manage to get down.
Then there are the days when I've gone beyond there and I'm nauseous from the pain and exhaustion. I'm not just too tired to eat, the thought of food makes my stomach turn. I'm too far gone for soup and the thought of greasy takeout is so unpleasant that I can't even stand to see the pizza place on my drive home from work.
These are the days when I eat some crackers or toast, so that I can take my NSAIDs, and give up entirely on eating anything more nutritious. I've had three days like that since this started and there may be more.
There are days when I swing to the other extreme, wanting to comfort eat myself silly, and those are almost as hard to deal with because all other foods become completely boring in comparison. Mostly I can tell myself to eat the good, nutritious meal that I am preparing and then I can eat some comfort (junk) food afterwards if I have room. As all those veggies are pretty filling, it curbs the worst excesses.
Those days when I can't eat are a part of the reason that I am so careful with my diet right now, but I have to carefully work out what to prepare so that I'm in a fit state to eat by the time it's all ready.
I can easily see why people put on weight when something like this happens. The temptation to grab something out of the freezer to nuke or order takeout can be almost irresistible when you're too exhausted or filled with pain to cook but haven't reached the can't eat stage. And it's easy to do it over and over, every evening, because it's easy to justify. It has become so common to see people who's weight issues started with an injury that it's almost a cliche.
It is probably less obvious that a lot of people lose weight in this situation. The side-effects from the drugs often include nausea and difficulty swallowing. If you're too tired to eat (never mind cook) or too nauseous, it's easier just to take the drugs and go to sleep.
It is hard to find that balance between between how bad you feel and what you need to eat to be healthy. Anyone who has never experienced chronic pain of any kind will struggle to understand. Missing the odd meal or indulging occasionally when you're healthy is not a problem. Missing lots of meals (or just eating toast all the time) is as bad as consistently eating too much or relying on takeout, though, and that is what happens to a lot of people with chronic pain. We end up at one extreme or the other, neither healthy, and that just makes the root problems worse.
My back pain is the frustrating kind where gentle activity helps, but sitting, lying or standing for any length of time is deeply uncomfortable. And too much activity is also a no-no. I'd imagine there are lots of people out there in similar situations.
That makes many aspects of normal life challenging, but feeding myself is one area of particular challenge. The cause of my back pain is inflammation in the SI joint. The inflammatory process is pretty hard and draining on the body: I'm told that it's part of the reason that I'm exhausted right now. To give my body the best chance of getting through this without doing any other damage, it is important that I eat regular, balanced, healthy meals.
I find that the pain is harder to cope with when I'm hungry, which is why I emphasise regular.
On the one hand, my activity levels may be lower than normal (although all the walking around I do to ease the pain and the physio exercises several times a day may be making up for this) so I don't want to eat a ton of high-calorie stuff. On the other hand, my body is using up a lot of nutrients on inflammation so I need to replace them.
At the same time, standing for long periods of time is hard so I'm trying to make meals that require minimal tending and standing. A big stir-fry may be very healthy, but it's a high-prep meal. Most of my evening meals are tending to consist of a protein source plus a big pile of veggies (which are easily steamed in the microwave). My lunch is wholemeal bread, some kind of filling and a helping of fruit.
The hardest part is finding a protein source that is tasty, easy to prepare and can be chucked into an oven (so minimal tending required) without resorting to boxed or package things more than once a week. As easy as it is to grab something from the freezer, a lot of prepared things are high salt and high fat so I try to minimize them even when I'm feeling good.
Thankfully I've got a reasonable repertoire these days and my local grocery store butcher and fish monger do some lovely things that are moderately healthy and require very little prep beyond popping into an oven. So most days, I don't struggle although I know a lot of people who find this side of things difficult.
For me, the hardest days are the ones where I don't want to eat.
I get days when I'm so exhausted from the pain, the lack of sleep and all the other fun stuff that the action of chewing and swallowing is too much. My swallow reflex wanders off somewhere else, things get stuck in my throat, and the thought of eating something is more than I can cope with. It's not just that preparing food is beyond me, it's that eating it is beyond me so there's no point ordering something in because I'll get through two bites and want to give up.
Those are the days when I have to bully myself into eating, find things that are easy to chew and swallow and generally be mentally tough over it. Food needs to be interesting and tasty to overcome my exhaustion, but not taxing to prepare. Grilled chicken breast may be easy, but it's hard work to chew and frankly boring so it's not the solution on those days.
I have to bully myself because not eating means not having my NSAIDs and that would be bad. If it weren't for the NSAIDs, I wouldn't bother on those days. As it is, those are the days when soup and toast is often all that I can manage to get down.
Then there are the days when I've gone beyond there and I'm nauseous from the pain and exhaustion. I'm not just too tired to eat, the thought of food makes my stomach turn. I'm too far gone for soup and the thought of greasy takeout is so unpleasant that I can't even stand to see the pizza place on my drive home from work.
These are the days when I eat some crackers or toast, so that I can take my NSAIDs, and give up entirely on eating anything more nutritious. I've had three days like that since this started and there may be more.
There are days when I swing to the other extreme, wanting to comfort eat myself silly, and those are almost as hard to deal with because all other foods become completely boring in comparison. Mostly I can tell myself to eat the good, nutritious meal that I am preparing and then I can eat some comfort (junk) food afterwards if I have room. As all those veggies are pretty filling, it curbs the worst excesses.
Those days when I can't eat are a part of the reason that I am so careful with my diet right now, but I have to carefully work out what to prepare so that I'm in a fit state to eat by the time it's all ready.
I can easily see why people put on weight when something like this happens. The temptation to grab something out of the freezer to nuke or order takeout can be almost irresistible when you're too exhausted or filled with pain to cook but haven't reached the can't eat stage. And it's easy to do it over and over, every evening, because it's easy to justify. It has become so common to see people who's weight issues started with an injury that it's almost a cliche.
It is probably less obvious that a lot of people lose weight in this situation. The side-effects from the drugs often include nausea and difficulty swallowing. If you're too tired to eat (never mind cook) or too nauseous, it's easier just to take the drugs and go to sleep.
It is hard to find that balance between between how bad you feel and what you need to eat to be healthy. Anyone who has never experienced chronic pain of any kind will struggle to understand. Missing the odd meal or indulging occasionally when you're healthy is not a problem. Missing lots of meals (or just eating toast all the time) is as bad as consistently eating too much or relying on takeout, though, and that is what happens to a lot of people with chronic pain. We end up at one extreme or the other, neither healthy, and that just makes the root problems worse.
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no subject
Date: 2010-12-20 09:13 pm (UTC)Things that you can keep around that aren't greasy takeout and involve minimal prep:
* soy milk
* smoothies
* canned salmon, tuna, sardines
* almond butter
* hummus and other bean spreads
* ricotta or similar low-fat cheese
* apple butter or similar fruit spreads
* fruits canned in fruit juice
Also, if you're having a decent day and are OK to cook, you can freeze leftovers in microwaveable packages, and have a good-quality healthy ready meal available if it's an OK to eat, not OK to cook day.
no subject
Date: 2010-12-21 02:47 am (UTC)A few of my tricks:
Use the timer. Not just for how long something sits in the oven, or on the stove, but how long it takes for the water to boil for pasta or the stove to heat up.
Split a chicken breast into two portions. One for grilling (I use spicy seasonings to liven it up, and I have a few different choices) and one gets cut into chunks and stuck back into the refrigerator (often but not always in a marinade). If I don't marinade, it often goes into a pot with chicken broth, frozen veggies and rice the next day. Set the timer as if you were cooking plain rice and wander away until it's done.
I'm still experimenting with my new slow cooker, but it looks promising. Dump stuff in, leave it to cook whilst I'm at work, nom when I get home.
I've also been experimenting with buying a bag of apples and leaving it on the counter. If I can see them, then I have an option other than sweets when I'm not ready to eat dinner. I keep cheddar cheese in the fridge, and there've been times when that's been enough for me for dinner. I also try to grab a carrot or two, every time I feed the buns.
Also, your description of the type of back pain exactly describes what I'm hitting right now (on a much milder level). It's all new to me, so it's good to have some reference points.
no subject
Date: 2010-12-21 02:49 pm (UTC)Have you tried cooking more than one dinner when your back's good enough, and then freezing them for when it's bad?
no subject
Date: 2010-12-21 11:33 pm (UTC)The slow cooker is wonderful. I generally use it at weekends: I can put something together when I'm feeling good, let it do its thing all day and not only have I got supper at the end, I've generally got enough for several portions to go in the freezer. I love home-made TV dinners :-)
I need to keep a few things around that I can eat when I've hit the so-tired-and-sore-that-I'm-nauseous stage, that tends to be where I completely fall down. I err more on the side of not eating when I feel crappy, which is no better than eating bad stuff.
I hope your back pain stays milder :-( I wouldn't wish this on anyone!
no subject
Date: 2010-12-21 11:38 pm (UTC)My biggest problem is the days when I really feel too dreadful to eat. A entire day of bad pain plus the exhaustion and the not sleeping just makes me feel like crap and want to throw up by the time I get home. Even when I was living in England with Mum cooking for me, there were days when I had to be bullied to eat and other days when I just gave up. I hate those days :-(
And the side-effects from some of the drugs can make eating unpleasant. Tramadol was great: no swallow reflex! Yeah, that makes eating easy :-(
no subject
Date: 2010-12-22 12:17 am (UTC)I'm of the firm belief that cajun seasonings or lemon pepper makes everything better.
For me it's a problem of getting involved in what I'm doing and not stopping to eat. I admit to a lot of pasta (usually with canned or jarred sauce (sometimes with homemade if I've got the energy) and often with parmesan cheese) and toasted cheese sandwiches. I try to keep a package of rolls (from the bakery at the supermarket which is very good at breads) on hand, so that if I'm not up to anything else, I can grab a roll and eat it plain or with cream cheese.
What I should eat more of is salad - I always have it in the house for the buns, but I rarely eat it myself.
I've got my first orthopedist appointment tomorrow. Wish me luck.
no subject
Date: 2010-12-22 12:32 am (UTC)I try to make sure that I eat supper before I get involved in anything because I'm also good at getting involved and forgetting to eat. So I'm usually trying to start cooking by six-ish and carry my timer around with me everywhere so that I don't burn things.
Good luck with the orthopedist! That's one route that I haven't tried yet. I'm sticking with the doctor's plan of physio before I start looking elsewhere. I'm also a bit nervous about manipulation with my wonky joints :-(
no subject
Date: 2010-12-22 12:40 am (UTC)Unfortunately, my meal schedule is wonky. I eat lunch around 1pm or later, and I get home around 6pm but I'm not really hungry for real food until 9ish. It's also a blood sugar thing - if I eat around then, I don't wake up starving/light-headed.
Yeah, joint problems have their own issues. I don't even know yet if this is chronic, or a minor injury that I keep aggravating before it heals. In the past with stuff like this, it's been the latter and the moment something else changes (usually the weather) everything rights itself.
no subject
Date: 2010-12-22 09:03 am (UTC)no subject
Date: 2010-12-23 09:49 am (UTC)I know only too well the feeling of being too unwell to eat. Thankfully my tube negates pretty much all of that problem these days, but I remember it well from earlier this year. Gentle hugs. xx