Microflora and Neurology

Oh, I actually don't like "weighing in" on food conversations. I also don't like controversy. I know this is all ripe for debating. Regarding GFCF (Gluten-Free Casein-Free) and autism causation....

I'm not suggesting a causation. I am suggesting a connection. I am suggesting that if diet affects neurology then addressing dietary/digestive imbalances can have an effect on the neurological/sensory/inflammatory issues associated with autism. An effect. Not cure.

I hope the above is clear enough that instead of arguing that I'm somehow camped out on DAN blogs, I'm thinking about something that is only just starting to be recognized in the biomedical community, and integrated into various specialties, looking at the relationship to various conditions/diseases/states of being.

Anecdotally

I cannot eat dairy. I once found some amazing almond cheese. I ate LOADS of it. This resulted in bad diarrhea. Checked ingredients and discovered it had casein in it. Other foods with casein (the protein in milk) also affect me badly - cramps, pain, bad poops. Evil.

I have, despite cutting out dairy, major digestive problems. At the very least, abdominal pain and problems digesting and processing food makes it really really hard to focus on other things, because the pain is bad.

Another anecdote: When I was in the hospital and had to have surgery, I was put on fluids only. Y'know, the glucose bag. So. I had no food for days. I have outside verification that I was more clear-headed, communicative, coherent -- on narcotics, even -- than I usually am. I made some effort afterwards to avoid dairy, gluten and soy. It's hard, and I stopped. I still slip up on the dairy. Brain no workie. Stomach ouchie. Suffering. Yes, because of food. Not only because of food, but some because of food.

Now; if I had a healthy gut, I have no idea what I would be like. I do know that even if everything could be explained away by horrible stomach pain my entire life and the inability to connect to my peers because I was loaded up on dairy and other foods I couldn't digest, I would still be who I am if I healed my gut now. I developed in a certain way, and even if I change my neurology in the future I would still be who I am right now. Even if children get their guts in order through diet changes, I do not assume that all the problems go away. Understand that much.

And now, moving beyond anecdote...

Fact: Your brain is connected to your gut. You have nerves running to and from your organs and this is a part of your neurology.

Still really young, the study of gut microflora offers an interesting take on what diet might do for autism. But first take a step back from the label "autism". Take a step back even from notions of "disorder and syndrome" which are really interesting to pick apart (...there are no objective things in the DSM, no clear pictures, only sketches of checklists that provide a common and arguably useless language; ).

While this article deals with immunity and microflora (things like allergic response, which isn't far off topic from dietary issues), see what it has to say about how both innate and acquired immunity is related to other body systems:

Whatever influences, modifies, enhances or suppresses the immune response (at any stage or level) does not exist by itself, and is not going to have any effect unless it is harmonised, connected and influenced in two ways. One is by a number of other systems in the body, including first and foremost the central nervous system, which includes the mind. Second is the endocrine system, which creates and influences emotions.

So the nervous system, the nerves, indeed *neurology* is intertwined with immunity. This isn't, from what I'm reading, a one-way causality thing. Why should it be? Brain communicates with gut, gut communicates with brain. Signal and response. Gut affects nervous system??? Whoa.
Gut microflora is an acquired ecosystem, meaning, when we are born, we have no bacteria in our gut. Microflora consists of many many different bacteria. We actually contain these helpful bacteria in our gut, mouth, genitals, on our skin, really everywhere -- and the human body has more non-human DNA than human-DNA (isn't that fraakin' mindblowing?) :)

Total microbial cells found in association with humans may exceed the total number of cells making up the human body by a factor of ten-to-one.
-Wikipedia

So. What does this mean?

An Interpretation

The body's ability to deal with its environment, regulate the nervous system, emotions, sensory input, etc etc. is impacted by the balance of microflora in a person's gut (and other parts of the body). The more diverse the microflora, the better that ecosystem processes a variety of foods, and other potentially harmful and benign substances from the environment. If the ecosystem is less diverse, it may not be able to process some types of food.

The simplest and best known example is yogurt. (Active culture) Yogurt is basically dairy that has live cultures which have partially digested it. It contains the bacteria necessary to digest it (albeit, not necessarily in enough quantities for someone like me to handle it). A home remedy for yeast infections is yogurt. A big problem is also candida, the overgrowth of yeast in the system. We're supposed to have yeast, but if we have too much, the system is imbalanced. Anything we eat with sugar in it will promote the growth of yeast, for instance. Reducing sugar can 'starve' the yeast.

This doesn't just apply to yeast. If any kind of bacteria gets too prolific it can make it hard for some of the other useful bacteria to do its job. We have some kinds of bacteria that are ok in small quantities but not in larger quantities. Some bacteria we don't know much about. We don't know what they do. We can't even culture some of them.

So a lot is not even known about this field, and while there has been scarce study of any microflora link to autism, there is also microflora research and anecdotal mention in relation to obesity and diabetes, MS, Celiac...

It doesn't seem like it's nonsense to make a connection between neurology and acquired immunity (which is what microflora is).

Restricted diets because of sensory defensiveness could affect microflora balance. So could a lot of processed food which is primarily sugar, corn and soy. I've read anecdotes that when a child is removed from one of the "offending foods" like sugar, corn, dairy.. they will have what might be called an 'adverse reaction'. I think if I were a bacteria colony and had my main source of goodness taken away, I would scream bloody hell. Donna Williams writes of a backlash reaction (too fatigued to cite, go see Donna Williams' articles on food intolerances and addictions in autism and her own experiences). We are what we eat and we eat what we are.

That isn't asserting a causation. This is not autism=bacterial infection. Nor is it vaccine -> kills gut bacteria = autism.

What it is asserting, however, is that balancing out microflora can affect mood and cognition. Mood and cognition can affect gut. Stress can create intestinal problems. What we think can influence neurology. Intestinal problems affect neurology.

If I can potentially address sensory problems like sensitivities or disregulation by altering my diet (adding foods that promote healthy microflora or eliminating foods that cause pain or promote bacterial overgrowht), I'll try it :)

And that is very different that saying I think I'll cease being autistic if I stop eating dairy and high fructose corn syrup.

I actually must thank my husband for his understanding of neurology, psychology, nutrition, and prolific research into peer-reviewed sources. This cobbled together post doesn't do his thoughts justice.

(I reposted this from my contribution at Autism Women's Network in response to The Myth of GFCF Foods)

Keeping a Diary

I saw my doctor today and she really does think I have IBS. She told me to do a bunch of things, one of them is to keep a symptom diary.

Okay. So in my life I have considered and even tried keeping diaries of various sorts. I kept a diary for a little bit when I was quite young, maybe 8. I kept a private blog for a little while that I still check into now and then. I've considered a mood diary, a food diary, a menstural diary, an exercise diary, a yoga teaching diary... feck it all, I said.

The main reason I rejected the idea of a diary is that, especially when it comes to mood and food, I figure that my obsessive tendencies would drive me over the edge and into the nutty realm of meticulous record-keeping.

So a symptom diary for IBS, which includes what I eat, when I poop, and how I feel at any given moment, that is an all-encompassing project. And for a whole month! I have already added in obsessiveness -- I am writing down the approximate amount of fiber each meal contains. Since part of my doctor's instructions is to get 25g of fiber a day (and at least 3 in any given meal).

I think I'm at about 6-8 grams today, that's not much. Can you tell I'm already obsessing?

Gut Problems

I won't get into gory details, but I'm pretty sure I have Irritable Bowel Syndrome or some such difficulty. I have had problems all my life with my stomach. Frequent stomach aches, and gory other things I won't talk about, but to say, it all hurts, is inconvenient, and probably means I'm not absorbing nutrients like I should.

I definitely have a problem with dairy, and I am 90% successful at avoiding it. Recently I ate a whole Mac n' Cheese tv dinner, and I ended up going to the doctor because I thought I was having organ failure. I had my gall bladder removed in 2008, and depending on what sources I read, my diet should/shouldn't change to avoid fatty foods and I should take lecithin to replace bile salts. I don't bother with any of this. I don't know if I should completely eliminate other foods, though, and if anything I think I should focus on removing all processed foods from my diet. And probably butter (yes I avoid dairy, including stuff wtih casein or whey -- it's not just lactose -- and yes, I eat butter, because a nutritionist told me that was likely okay)

Having these issues impacts me socially:

I have many cravings, and many food aversions. So, I'm picky. Many people have dislikes, and so not everything I dislike is because of some neuro issue like sensory defensiveness, but it's hard to tell the difference sometimes.

Ordering at a restaurant is an exercise in running the server back and forth from the table to the kitchen to inquire about ingredients (some restaurants are amazing though, and accommodate "allergies" and have special menus, or can say exactly which items I could order).
Then, I often order something from a restaurant and then can't really eat it. I'll lose my appetite halfway through a meal, usually because the meal is too dry and I can't figure out how to remedy that (the only bbq sauce many restaurants have is steak sauce like A-1, when I need something sweet).

At home, I often go on spurts of wanting to eat the same thing over and over (most recently it was artichokes). I find it hard to cook for my husband and me, and provide the variety he probably wants, and make things he really likes while accommodating my own proclivities. I do not like most rice because of the texture. I love pasta, but I think (cooked) tomatoes bother my stomach. I started making olive oil & white wine pasta with some flax meal thrown in. I can sometimes not figure out what to make, and finding recipes is overwhelming.

Often I'll eat and during the meal or shortly after, I get a very bad stomach ache and have to run to the bathroom over and over. The patterns vary, but it can be a struggle to manage outings when I'm having episodes of this. Sitting through a movie, or going to a restaurant, or even worse, being out and about and suddenly needing a bathroom so bad that I'm worried about accidents.

This is embarassing. But I understand that it's not uncommon for people on the spectrum to have gut issues. See Donna Williams for one perspective on sensitivities and gut issues.

I went backpacking this long weekend and I'm really suffering - I think I ate too much protein and not enough of other stuff. My last day of hiking was really bad, I felt nauseous, hungry, but unable to eat. We went for dinner at Outback and I barely ate my food. I couldn't eat the steak I had ordered, only the shrimp, and bread, and a sparse bit of fries.. I took it home but it was embarassing and it annoyed my husband.

I really want to (and need to!) change what I eat, reduce stress, and figure out other ways to cope with this. I haven't addressed it completely in my first thirty years because in general, because I grew up feeling this way, it often doesn't occur to me that difficulty eating, nausea, severe abdominal pain and unrelenting irregularity just. isn't. normal. Or okay.

being in a relationship (and part of) the social world

I had a conversation with a new friend today, and it's really making me think. We talked about being out in the world and socializing with our husbands and what that is like. I really haven't done much going out with J, we have some friends of his that we hang out with, but we don't go to parties and at church it's been difficult to connect to people. 

My friend said that she isn't all that conversational with the people she and her husband gather with, in part because they have kids and she doesn't, or whatever else, it's like they don't have much in common, and so the conversations often fall flat, and she thinks that they perceive her as maybe immature or less emotionally adult (and she said this isn't incorrect, in a way), and that they wonder, 'what is he doing with her?'

Wow. Exactly. This reflects our/my experience and fears about being social in the world with my husband. I think that my friend accepts the reality in a way that I don't, and it she describes her husband as maybe not so concerned with the implications of people's perception that he is with someone who 'isn't a woman'.

Sometimes I don't feel like a woman. I don't feel on par with most 32 year olds. I don't think I am.

I realize that development, achievement, and social connection are all diverse/variable things, and there isn't just one way to be in the world -- as if we all knew at 17 what we were going to do, and did it, and were successful, and we all fit some mold of what a 30-something person should be, or a 40-something person should be. It doesn't work that way. I sometimes think, with my friend, that if I can't connect with those people, then oh well, and it's not like they'd think me a bitch; I'm a nice person, and so I do have some challenges. Okay?

I'm an intelligent person, I'm a weirdo (in a geeky and sometimes good way), I am caring, I can have deep and soulful conversations with friends one-to-one but put me in a group/party and I don't do well.

But while I could say that the people who would judge me and J are idiots, the fact is that people can/do/will and I don't know how to feel about that. Or what to do about it, aside from hiding out and not being seen as a couple -- which is untenable.

I don't want him to be judged for seeing deeper than my not really holding a conversation well or sometimes getting overwhelmed or overloaded and having sensory problems. I don't want them thinking,

"Wow, she's ... not all there. Why is he with her?? I mean she's hot.. but she's kind of meek. Maybe he wants a frak-toy. Maybe he wants someone he can dominate. Or what's wrong with him, that he can't find some professional successful grown-up woman to be with?'

All of this smacks of BS, but there's some reality to it that means, somehow, our dealings in the world can't be easy, unless I learn some skills and develop emotionally.

This new friend and I are really appreciating each other and the potential for this friendship. I think we'll plan a foursome dinner sometime soon. I would really like to explore having more friendships as a couple with J.

I think he and I both need to gain confidence and feel like it won't just be a disaster. We were long distance for a long time, basically having identities that were as single people but in a relationship, a kind of nebulous state that was still really like being alone socially because it didn't involve negotiating social relationships as a couple. I think we just aren't known in the world enough together. I don't know how the people we do spend time with now perceive us.

I think the anxiety and fear of judgment is the worst part because it can lead us to not try and instead become isolated and that has consequences for our relationship with each other.

I'm not sure if this was coherent, but it's at least reflecting what some of my mind is doing with the really important thinking going on today.

slide.

Rachel Cohen-Rottenberg's post about self-worth touched a current in me that filled me with .. I don't even know. Thanks, alexithymia.

I've been married a little over three months. J is troubled about our lack of emotional connection. I am too. Every marriage faces challenges, but add autistic crap to that and it can feel potentially un-rescuable.

It isn't really un-rescuable, just like neuroplasticity means I'm not some static human who doesn't change, and potentially grow beyond social deficits.

When J shares how he's feeling in relation to me, (when anyone does, really), my response is most often disconnected from the person -- I just circle back into myself and blame myself and allow what they're saying to feed my empty sense of worth. I can sometimes be angry that they are blaming me for the whole situation, but I also somehow know that their assertions are true and I despair. J says he has trouble explaining some of where he's coming from and how he sees me because he senses that I won't understand. I accept this as true and I slide further.

I am doubting my ability to connect. I often just don't know how to respond to statements about feelings.

I feel pretty empty and boring and afraid to go into the world. I often don't go anywhere unless I've made a commitment to do so.

I am shutting myself off in self-protection.


Every week (when the stress gets too much to hold in), J raises the issues of our lack of connection and his doubt about us working, his uncertainty around me being able to be an adult with him in the world to socialize with average people, to be able to be at his level emotionally, get better at communicating. I agree that these are issues. I see that neither of us knows what to do about it. Not really. I can improve myself through various actions like being physically active and keep practicing connecting, working on auditory processing. It just feels like uphill, and I keep sliding.

I have two modes:

1. guarded defensiveness which includes bodily clenching and holding and hyper-sensitivity as well as emotional opacity and blunted perceptions of the social world. A kind of depressive sullen vacuous lump.

2. childish abandon which includes incongruent exuberance, strange voices and mannerisms, silliness, sometimes fake happiness, a level of emotional opacity and no awareness of the people in the world around me and where they're at. A kind of abandonment of the hyper-vigilance I usually maintain, the release valve if you will, the spastic.


The above is too simplistic, but it's a rough idea of how I feel like I live in places that don't make sense when you look at them all together. It's like there's little continuity to who I am. Except, I can experience depression as a continuity. I can experience anxiety as a continuity, as well as the feeling like I'm not like other people and I feel alone.


I am going to find someone to talk to, who knows about issues related to aspergers.

A squirrel keeps scaling the outside of the house right by the window, and the cats are stalking 'im. Gonna try and snag a picture. Living in the little smiles helps a bit, as I try to deal with this current slide.

burnout and the long walk

Life and its complications unfold

• Moved to a new country and all the unknowns/changes/isolations
  
• Married to a wonderful American
• Reconnecting with the Aspergers Assocation of New England (AANE)
• Dealing with an entirely new health care system
• Unsure of how my Aspergers diagnosis will be affected by upcoming DSM change (and my hope that it just gets folded into autism, not wiped off the board as an irrelevant waste of funds and affirmation.
  
• Finding day to day tasks variously difficult
• Not having a heck of a lot to do that involves contact with other people

and the biggie

• Painful awareness of of my limitations with social relationships.

During a long walk in the woods my guy J and I talked a lot about what being weird means, and what challenges my autistic stuff has in our relationship, and how, despite my growing depression at realizing how much I haven't developed in the first 30 years of my life, there IS hope. It is possible to develop.

But it is a struggle. I get burned out. I limit J in his need to connect in the world as a couple. The difficulties we have with each other in communicating and connecting has placed a strain on us. Rachel at journeyswithautism.com talks a lot about how her husband supports her and also sometimes struggles with things. I perceive the fortitude required to be in relationship.

I feel empty sometimes. J wishes for more connected 'adult' communication, that isn't about tv shows or dinner (artichokes!), that isn't just endless amounts of silence that increasingly make him think that there really isn't anything going on 'in there'. My defense response is that OF COURSE there is. My defense response is 'but this is only really a strength, that zen-like ability to be only in the moment without monkey mind messing up the serene landscape of my being.

But all those defenses come falling down, and I'm left wondering -- am I really vacant? I know I have ideas and thoughts lurking in there. I know that in the past I experienced sharing them as an exercise in inviting sometimes ridicule, invalidation, being dismissed, or just alienated. I feel stymied. I married a skilled orator, in that he can formulate complex thoughts, hold a conversation, remember different threads and synthesize complex themes into original thought.

I have trouble tracking each sentence, struggle with object relations, use incomplete sentences and get lost when I'm trying to verbalize a thought.

I really understand his frustration. I understand his drift toward giving up because it requires a mountain of patience to slow down that much and even help me work out what I'm trying to say and say it in a way that makes sense.

Spending time with a friend recently, who has two kids, prompted a moment that brought this all into a broader light; we were sitting having food, the 3 year old, mom and me. The three year old suddenly asked her mom, 'why is no one talking?' Her mom explained that sometimes there isn't anything to say and there are pauses in conversations and there is no need to talk all the time. But I left that interaction realizing that while I can be quite content spending shared time in silence, not everyone feels the same way about that.

Later I told my friend in a somewhat apologetic way that I was aware I'm not always the best conversationalist. She responded reassuringly that another friend of hers talks non-stop and this is far more tiring and annoying than a relaxed quiet presence. This was helpful, but when I shared it with J it was also an opportunity talk about how we feel alienated from each other because I don't communicate much.

It's not just silence. It's not just me. He spends a lot of time lately on programming projects, and I hang out beside him doing my own thing. But what I'm doing isn't all that mentally stimulating. A lot of what I do hints at some absence in me of internal drive and an intrinsic desire to keep exploring and growing.

I want to learn social skills. But I'm increasingly becoming afraid and isolated, preferring to hide out that fraak up yet another potential relationship. They start off fine and then they fall flat. Because they never get past a surface level of positive interaction. Once a person wants something deeper, it becomes evident that I don't quite know how to do that.

J and I have developed a deep connection over 3 years. He's sympathetic to a lot of what I'm trying to sort out. He's even sorted out some of the same autistic issues I'm dealing with. He can be a guide, breaking down some of the rules and directions/opportunities for learning. He can also get tired. Or wonder, how much is he supposed to just accept it all and forget about me changing, and how much can he push me toward change? Is he allowed to feel lonely, and angry about feeling alone?

I think he is. But my own tendency to take all of this insight and become overwhelmed and lost and then isolated, further pushing myself into a vacant place of understimulation and depression, means that our desire to hold hands for this long walk is perhaps waning. Our fear that we will be unable to prevent a kind of drift apart until our marriage is just an empty series of motions, that we aren't peers but roles, of functional male and helpless hapless female who is never sure of what parts aren't disabled, whether any direction that pushes beyond the safe borders of autistic comfort is even worth trying.

Burnout makes me scared.
The path -- the long walk -- makes me hopeful that there is somewhere to go.

I'm having a bout of debilitating pain that rules out doing much of anything.
I'm looking forward to a support group on Thursday (the pain should be gone by then)
For it's a group of other women with AS and generally I can relate with them and find useful insights that help me with some of the more troubled thinking above.

I'm not there at acceptance. Neither is my partner. I'm not sure I want to just accept everything (in the sense that none of it can change). I think some things can change. They have to change. They don't work. Like, pretending to hear someone when I haven't, just doesn't work.

I'm lost.
not so joyful, I guess.

Autism and Who I Am

I posted this in an email group I belong to for women with Aspergers and thought I'd share it here.

I agree that a focus on specific challenges that need to be addressed is the most effective way of helping people instead of obliterating them.

In my opinion parents who (seem to) want to obliterate autism (and autistic people) are wanting their child to have an easier/better life, but also on some level they don't accept not having a normal child. There is such a pressure to conform, it seems, such faith in the technological fix, an expectation and entitlement to "happiness" in some cultures in North America.

Recognizing the potential for even non-verbal people to advocate for themselves and agree or not agree with specific treatments. An AS friend of mine had ECT that did yucky (understatement) things to his memory and affect.

Neurological change CAN happen, though, but it does take work. There's no pill for that which does any good for the real challenges of autism (unless there is a comorbidity which is extremely hard to tease out). I see some "treatments" like ECT, drugs, or other more brutal therapies as something like gastric bypass surgery. Yes, most people CAN, through effort, help themselves heal. There can be social supports to do so. But understanding what the problem is, is huge.

Again with the empathy question. People, including Robison, seem to be saying 'you can't make generalizations' but then make just that when it comes to ASD ability to empathise. Sigh.

The disability/diffability question of what makes us who we are is such a fundamental argument to all of this. There are the people who think that the autism is keeping people from being who they are (or could be), others see that autism has shaped who they are and is inextricable from that. I'd kind of say that I see it both ways for myself.

People in wheelchairs can simultaneously wish their legs/balance worked better, and believe that being different from most people around them has given them strength, empathy, an understanding of the human condition that makes them who they are today. And if you took away their difference, who knows what their perspective on the world would be?

And I feel that way -- growing up different/odd/eccentric has involved pain, suffering and isolation, but has also made me very concerned with social justice, not quick to dismiss people and treat them badly because of their difference, not assume the meaning of behaviour in an individual. Aspergers is not necessary to having these qualities, but in my case, I think my differences because of aspergers has shaped who I am, and I like who I am.

But I do NOT like having problems with executive functioning, anxiety, or sensory processing. I do NOT think that I need to eliminate all the features of aspergers to have less difficulty with those things. Sensory processing disorder has shaped the way I see the world. I think there are valuable things about the way I see the world. I paint, and the way I paint is shaped by that. I see colours a certain way, I discern shapes and understand objects in ways that informs my art. I would NOT take that away. It makes me cry to think I would lose that.