At my OCA meetings we talk about a concept called HALT; which stands for Hungry, Angry, Lonely and/or Tired. The acronym highlights common triggers that exacerbates OCD symptoms. The acronym serves me well as it reminds me that I’m human. If I’m hungry, ignoring hunger will alter one’s mood. Personally hunger isn’t much of a trigger for my OCD. The one that screws me up big time is lack of sleep. Not getting regular sleep will effect my cognitive abilities as well as my ability to recognize when OCD is becoming a problem. Well in this little post I want add a letter, another T for thirsty.

The past week has been awful for me and I have been in quite a bit of physical pain. I was extremely constipated and suspected I was developing irritable bowel syndrome IBS, in particular IBS-C (the c is for constipation). A little over a third of those with OCD will have IBS too. The pain that I experienced had happened before about 2 or 3 other times, but for 2 or 3 days at a time. This particular time it was ridiculous lasting about a week before I went to a doctor. The cramps and bloating was absolutely awful. Anyway, I was pretty sure I had IBS and was diagnosed with chronic idiopathic constipation (CIS) instead, since I lacked the diarrhea symptom for IBS. The doctor then prescribed an over the counter stool softener called Colace which is generic for ducosate sodium. This didn’t seem to help for 3 days and I had to start rethinking what the hell is going on.

At this point I was feeling anxiety, urinating constantly, cramps, bloating, constipation, distended stomach, and would wake up from the pain in my gut. The pain in my gut was about midway between my belly button and my giggle stick. I started to assume IBS and treat it that way so I started taking some supplements such as ginger root, artichoke extract, peppermint, NSAIDs and laxatives. There really isn’t any good treatments for IBS except for food elimination, supplements and laxatives I mentioned. Some people end up taking opioids to manage the pain, but these drugs also exacerbate the constipation. It’s a no win situation.

Two details I failed to mention, thus far, are a special headache I had and a really hard workout w/ diet change I had made about a week or 2 prior (I’m on the primal blueprint/paleo diet-ish). I’m usually pretty cool as a cucumber as I wasn’t feeling stressed out. My anxiety at the outset of my symptoms was low and the doctor ruled out IBS so I had to come up with some explanation.

My diet eliminates processed carbs from the menu. No grains and starchy veggies, thus is higher in fat. As some of you may know, metabolically speaking two things happen when switching to a high fat/low carb lifestyle. One needs more water to assist the liver in processing the fat and because of the reduced sugars in the diet, ones muscles are not as capable of storing water because of reduced glycogen (a stored form of glucose). And then I remembered that special headache. It’s hard to explain by if you ever worked out really hard and sweated a lot, you might get a head ache because of lack of fluids or electrolyte imbalance.  Since I supplement potassium I kinda figured I was starting down the road towards hyperkalemia. All of my symptoms matched with dehydration and electrolyte imbalance that was happening for about 2 weeks prior to my first symptoms. So I tested my hypothesis. If I drank a little bit (a few ounces) of water every 20 minutes and not supplement I should feel better and this should resolve within 4 days tops. Lo and behold 2 hours later my cramps decreased from 7s and 8s SUDS to about 5. The following day I was between 3 and 5; Third day 1s and 2s, and today back to normal. It takes three days for food to make it from one end to the other and since I was constipated I tacked on a day.

So, I was shocked to learn that I’m such an idiot that I forgot to drink water. I generally don’t drink much water. I had always heard that we need to drink 8-8 oz cups of water per day (64 oz), it turns out it may be more. I can tell you that I probably drank at most 32 oz a day. according to WebMD we need to drink 0.5 to 1.0 oz per lb of body weight. I weigh about 205 so I need to be between 103 – 205 oz of water. That’s a lot of freakin’ water. Anyway, my system is running back to normal and wanted to stress that dehydration can sometimes feel like anxiety, so stay hydrated; especially if one takes medication. Also, drink continuously and not in one sitting.

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