endometriosis — Dining In + Dining Out

As you know, I started experimenting with some dietary changes back in April. And I haven't written an update since then, and it is already the end of July!

Time flies like money in an organic grocery store.

Since then, the way I approach eating to support my body has shifted and evolved. I've learned a lot. For starters...

I started planning my grocery trips around my menstrual cycle.

Yes, you read that right. If you're new here, you should know I am fully onboard the Womancode train. For instance, I try to plan meals that incorporate shellfish or pork during my period, make smoothies that include raspberries and strawberries when I'm ovulating, snack on chickpeas in my luteal phase. I started that about a month after I started using my antiinflammatory cookbook. It actually helped me branch out and try new recipes rather than making the same ones over and over (but WOULD I ever really get tired of coconut shrimp?).

Overall, I started to feel better immediately. Less sluggish, less bloated. It didn't help my period right away, but all my research said to give it three to four months, and I *have* noticed some exciting changes...

**It's not a full solution, but it's doing something.**

Not long after I started focusing on antiinflammatory eating, I noticed a pretty big change in the two weeks or so before my period (roughly the ovulatory and luteal phases). I did not see any hormonal acne. ANY. My skin looked better than it's looked in ages. It fucking glowed and I didn't use a single overpriced mask.

And PMS? My PMS comes in an unpredictable combination of three flavors each month -- a desire to punch everyone, a hopeless feeling of oppressive sadness that everything is just WRONG, and/or persistent paranoia that everyone I care about hates me or is angry at me. IT'S A GREAT FEELING. But before my last two periods, I didn't even notice PMS except for one mood swing featuring anxiety the night before each period. Mood swings are never pleasant, but one a month is quite a bit more manageable than feeling like the world is ending and I can't stand myself for about 10 days a month.

And interestingly enough, when I went to my last acupuncture appointment, my acupuncturist told me my tongue looks the best it has looked in THREE YEARS (the shape and color of the tongue can tell you things about the states of your visceral organs). I don't know if that has more to do with my eating, lifestyle changes, or stress levels, but it's a good sign nonetheless, and I am sure a healthy diet can't hurt.

The biggest goal, of course, is to get myself to a place where I have painless periods. Ah, my white whale. I am not there yet -- days 2 and 3 are SUCH a bitch. But last month I was able to manage only with Advil, essential oils, salt baths, and my heating pad -- i.e., NO prescription painkillers. HOLLA.

That said, it's damn hard to be perfect.

My goal is to eat in a way that supports my endocrine system and fights inflammation on weekdays and be a little more lax on the weekends. It's just HARD to stay totally on track when you're going out to eat, and I for one LOVE to go out to eat and try new things. So I guess this is the 80-20 approach (stay on track 80% of the time, indulge the other 20%). I don't go crazy, but I also work hard not to beat myself up if I have a drink or can't stop stuffing free dinner rolls into my face.

In fact, July has been hard. The Fourth of July was in the middle of the week, which meant drinks and picnic food, I transitioned to a new job which threw me out of my eating routine, and there have been a few social engagements involving alcohol and charcuterie. But I've actually learned a lot from this. The day after consuming processed meats and cheese from said charcuterie board, my skin showed it. Drinking more than usual has wreaked havoc on my sleep and therefore my energy. And junk food definitely has taken a toll on my mood -- PMS has *not* been a piece of cake this month.

I try not to beat myself up, but sometimes it's hard (especially when hormones are wreaking havoc on my brain). It's a vicious cycle to blame yourself when you already aren't feeling well, so I try really hard not to do that, and my partner and my best friends know to talk me down when I'm not feeling at my most rational. I try to limit stress because that has a more intense negative impact on my cycle than bad food does. And I try to remember that this is all helpful information; I know I don't have allergies or intolerances to gluten, processed sugar, or dairy, but I also know my body doesn't like them as much as it likes healthy produce -- as evidenced by my skin and mood.

Substitutes remain key.

I was overwhelmed when I started changing the way I eat. A long-time devotee of meal delivery services like Blue Apron and Plated afforded me the opportunity to not think about grocery shopping or plan ahead about recipes, so making the switch and learning what was and wasn't supportive of my body was a little bit of a process.

But after a few weeks of experimenting and restocking my pantry with healthier substitutes, I don't feel like I am on a "diet" per se. I don't feel like I've cut anything major out, and I don't feel restricted. I personally am skeptical of any diet that eliminates an entire macronutrient (whether it is carbs, fat, or protein), and eating in an antiinflammatory, endocrine-supportive way doesn't do that.

Mixed berry cobbler for July 4? Don't mind if I do.

My favorites are:

Coconut aminos is slightly sweeter than soy sauce, but the difference is hardly noticeable when you're dipping your sushi in it.
Who needs canola and vegetable oil when olive oil is already amazing and avocado and sesame oil taste equally great?
Oat and almond flour are gluten-free alternatives to regular flour, which is also more or less devoid of anything of nutritional substance.
Coconut sugar has a lower glycemic index than processed sugar, and I prefer the richer smell and taste (it reminds me of brown sugar). Raw honey and pure maple syrup are also preferable unprocessed sweeteners.
I think "zoodles" are trash, but I can't tell the difference between pasta made from chickpeas and regular pasta. And chickpeas are loaded with protein and antiinflammatory factors.

I won't lie to you though -- almond butter and cashew butter got nothing on peanut butter.

This microbiome shit is for real.

If you haven't heard more and more research coming out about the importance of your gut health, you will soon. I am convinced that sometime in the future, the microbiome (consisting of all the "flora and "fauna" that live in your gut) is going to be the answer to a ton of our problems and people will look back on this period of time like "Wow, I can't believe those people thought antibiotics were a good choice," the way we look back and think "Wow, I can't believe those people thought leeches were a good choice."

I am not a microbiome expert and I want to learn more, but here is what I do know -- a healthy microbiome is connected to damn near everything. It supports immunity and clear, healthy skin, and if you've ever gotten a yeast infection from antibiotics killing all the "good" bacteria in your system, then you know it means keeping certain systems in your body in balance. What I learned most recently from Womancode though is that the microbiome also supports your mood. Serotinin doesn't just exist in the brain; 50 percent is produced in the intestine. WHAAAAAAT?!

There are several ways to support your microbiome. The first is taking probiotics, but something that has been sitting on a grocery store shelf for who knows how long can only take you so far. I also support mine by trying to vary my diet as much as possible; one easy way to do this is to change up a smoothie every day with different fruits and vegetables.

I also started incorporating something fermented into my diet at least once a day. Fermented foods have live active cultures, reintroducing thousands of good bacteria strains back into your stomach. I love Baltimore's Wild Kombucha (that watermelon hops flavor tho) and Hex Ferments. Both have several awesome kombucha flavors, and Hex also makes a great chickpea-based, soy-free kimchi. This last weekend at the farmers' market, I also sampled Hex's "glow kraut," a turmeric sauerkraut mix I ended up buying. Noms.

Eating this way is self-care, even though it doesn't involve a #kbeauty sheet mask.

Inconvenient fact: Not all self-care is fun or exciting. Sometimes self-care means deep-cleaning your apartment so you can bask on the sofa in a clean space for like an hour before bed. Sometimes self-care means making your bed so that it's nice and tidy when you're ready for sleep. Self-care isn't always bubble baths, manis, and face masks. When you have chronic illness and a limited amount of energy, sometimes self-care is managing to just take a shower.

I never used to like cooking or baking, and I always thought I was *bad* at it. I learned a lot about cooking with the previously mentioned meal delivery services though, and I've come to enjoy the process of planning what to shop for each week and then preparing it for myself. As I ate that cilantro jalapeno hummus, I imagined all the good cleansing properties cilantro has for my liver, helping it eliminate the excess estrogen that causes me pain. As I snacked on that entirely vegan, antiinflammatory cobbler, I thought about the antioxidant, antiinflammatory effects of the berries. As I ate my chickpea pasta, I thought about how it would combat any inflammation in my body and help power my muscles.

When you have endo and chronic pain, a lot of it feels out of your control, but being mindful about what I put in my body gives me a sense of control and pride for treating it as something to be cherished and supported (rather than as the broken machine I usually consider it to be).

Bonus -- it was all fucking delicious.

xo,
S

I've never been one for dieting. Every time in my life that I've wanted to lose weight, I've either doubled down on working out or just complained but did nothing and continued to self-loathe.

I've always loved food too much to restrict myself, and since I know myself well enough to know I am a bit on the obsessive side, I know counting calories and reading nutritional labels constantly could lead me down a potentially unhealthy spiral.

The one time I tried a diet honestly doesn't even count as trying. One year in college when the Atkins diet was blowing up, my roommate bought the South Beach diet book, and I read a bit of it. I decided to try it with her in solidarity and lasted approximately one hour before I decided I wanted a chocolate chip cookie and simply could not go without one.

Willpower has never been my strong suit.

I ate pure garbage throughout college and never gave much thought to it. After school, when I was cooking for myself for the first time in my life, I started to pay more attention to what worked for my body and what didn't.

Like many women, my focus in my 20s was more on how I looked than how I felt. I never went low-carb again, but I did discover that eating a lot of protein made my workouts stronger and made me leaner. Because I hated grocery shopping and meal planning, I started getting meal kit deliveries. I'd focus on eating relatively healthily during the week and then eating (and drinking) whatever I wanted on the weekends. I'd say this worked relatively well for my physique, but over the past two years especially, how I look has taken a FAR backseat to how I feel.

It seems stupid looking back on it now, but until I really began to learn about my endometriosis and its pathology, I really never made any connections between it and the food I put on my body. When I thought about how food made me feel, I thought about it more in terms of "When I drink I feel like shit for two days," or "When I eat a full meal of fried food, I get heartburn and want to die." It never occurred to me that what I was eating could be exacerbating my endo symptoms.

But I've since learned there are two main tenets of how to eat while keeping my endo in mind. The first is to avoid soy, since it contains phytoestrogens (plant estrogens) that alter your body's natural estrogen balance. Since estrogen is directly tied to endo symptoms, this is obviously something I'd want to keep in a healthy, natural balance. The second is to avoid foods that cause inflammation -- sugar, dairy, processed foods, alcohol, etc. -- since endometriosis is an inflammatory disease and inflammation = pain.

So I'd say I started down this antiinflammatory path on a soft rollout. As it is, I am already not a big drinker; I probably only have two to three drinks per month, if that. I started making lunches more often than relying on Lean Cuisines which are easy and low-calorie, but processed. Rather than buying canned soup, I started making my own (partly because I got an Instant Pot for Hannukkah, and it is AMAZING and I want to use it all the time). I looked for some of the "cleaner" recipes available through Blue Apron.

But then this month some flip switched in me. After experiencing a particularly painful March cycle, I decided to just go full out and try some new things with the start of my next cycle. A wonderful friend of mine bought me an antiinflammatory cookbook for my birthday, and as I read through it, I learned more and more about not just what to restrict to avoid inflammation, but what to ADD into my diet to to reduce it. Some things might seem obvious, but here is what I've discovered over the last week and a half.

First of all, this book is awesome.

It is not specific to endometriosis, and I have more research to do on that, but I've learned a lot from this book, and the recipes are legitimately good.

I've had some hits and misses (the misses are more likely due to user error, not the recipes themselves), but it is true, these recipes are actually doable inside of 30 minutes and are really good.

What I like about these recipes is I don't feel like I'm missing out on foods I like because there are substitutes that actually taste great. For instance, I cannot taste the difference between the processed butter I grew up on and ghee, which is clarified butter.

This antiinflammatory banana oat pancake brought to you by coconut oil!

Coconut is quite the renaissance man (nut?).

So you know how I said soy is an absolute no-no with endometriosis? This was a real mindfuck for me for a while. Like during a particularly sensitive moment before my last endo surgery, I actually broke down into tears to my boyfriend at Bonchon over Korean fried chicken because of soy. It's not that I love soy milk or tofu or any soy products like that, but I do really, REALLY love all manners of Asian cuisine, and I really didn't want to give it up knowing soy is used in preparing quite a lot of it.

My boyfriend found liquid aminos for me as a substitute for soy sauce (he even bought me a bottle of a sriracha-flavored one to go with my birthday gift...awww). And Given's cookbook calls for coconut aminos in multiple Asian-style recipes. So I bought a bottle of it, and I think I actually like it more than regular soy sauce! I personally think it has more of an umami flavor rather than straight salt. It is delicious, but comes from coconuts rather than soybeans. I am probably now going to be one of those people who carries a bottle of sauce in my purse, especially when going out for sushi.

Another coconut substitute I found? Coconut sugar. It is still sugar, yes, but from what I understand, it has a lower glycemic index than the regular white sugar we're all used to. Also! Coconut oil. Because coconut oil is high in saturated fats, it's a good fat for your heart (it lowers cholesterol). Hot tip though -- if you buy it unrefined, it tastes and smells like coconut. That might be a plus for you, but as much as I love coconut, I actually prefer the triple-filtered coconut oil from Trader Joe's which is virtually flavorless.

This poke bowl is truly the best thing I've made (possibly ever), but I don't even want to tell you how much money I paid for the Wegmans sushi-grade Ahi tuna.

Buying organic requires a new way of food shopping (at least for me).

In the quest for antiinflammatory foods, organic is king. So as you might imagine, you want to get as many fruits and vegetables into your diet as possible. I have found that Given's recipes make that surprisingly easy.

What isn't easy for me are grocery stores.

Holy shit, I do not like grocery shopping. With the exception of going to Trader Joe's, which is a true wonderland, grocery stores, especially massive ones like Wegmans and Whole Foods, give me anxiety. Of course, places like Wegmans and Whole Foods are where you'll find the best selection of organic products, and organic products = antiinflammatory.

So what to do?

Since I was in the neighborhood of a Wegmans a couple weeks ago, I decided to give it a shot. Granted, I went on a Sunday, which was of course a poor choice, but I thought I'd only need a few things.

I was so overwhelmed, and everything was SO expensive.

I did get some great organic produce and proteins, but honestly, I don't want to ever go back. So when I can't make it to Trader Joe's (which is far from where I live), I'll be aiming to get my produce from the Baltimore farmer's market (now open, yay!), proteins from Target (which shockingly has a good selection of quality organic meats and poultry), and everything else from Thrive.

Both Given's book and another antiinflammatory cookbook I paged through recommend Thrive. For an annual fee, you can get organic items at steeply discounted prices (cheaper than Target, even with a Red Card).

I did the first month free trial and found it so much easier than trolling the aisles of Wegmans since obviously you can just type and search for what you're looking for, then compare prices side by side. I've done two orders so far and everything came very quickly, so I think when my free month is up, I'll be paying the subscription fee.

Every day is taco Tuesday, let's be real.

Finding balance is going to be a work in progress.

During the week I was so pleased with how well things were going. I was genuinely enjoying cooking and eating, and was pleasantly surprised to find that the heaviest day of my period not only didn't require a prescription painkiller, but I didn't even need Advil! This could have been a coincidence...but maybe not! Who knows? We'll see, and I'll keep you posted.

But by the end of the week with weekend plans looming ahead, I started to stress about how to tackle eating over the weekend, particularly when eating out. I have no intention of giving up going out to restaurants and trying new foods. It's too great a joy in my life.

So I did what any good millennial would do, and I took to Instagram to find out what everyone else does. I got a lot of great tips about balance -- cheat meals, 80/20, be good during the week and do whatever you want on the weekend, etc.

When I went out for Mexican, I thoroughly enjoyed my tacos. Were the flour tortillas antiinflammatory? Doubtful. Was there soy in my Korean shortrib taco? Probably. But I had an awesome meal and a great night out.

I felt like crap for a few hours afterward, but if I'm being honest, that was probably a result of the amount I ate rather than the particular foods I ate. It is impossible for me to stop eating tortilla chips when they are right in front of me...even if I'm already full.

Now I'm in Florida visiting my boyfriend. He's been supportive, looking for ingredients he can substitute for some of the more harmful ones, but since I'm only here for a few days, it's not like I'd want him to overhaul his pantry with coconut products.

This weekend will probably be a bit of a challenge since we do love the occasional all-pastry breakfast from the local bakery, and we're also planning a theme park day. And who doesn't want a drink on the beach? What I keep trying to remind myself though is that this lifestyle change isn't just about what I'm cutting out, but what I'm adding in, and that makes it much more manageable in terms of balance.

So come find me on Instagram and tell me about your own food journey. This is new for me, and I want to know what other people have discovered. How do you stay balanced? Are you on the endo diet or an antiinflammatory diet? FODMAP? Gluten-free? What makes you feel good?