By Bev Laumann
Since my diagnosis of IC, I have to admit I don’t look forward to the holidays in the same way I used to. In fact, I sometimes wince at the thought. I know that the hectic pace of this month will make my diet and medication schedule more difficult to manage. I’ll need more sleep and need to do more advance planning for my activities. And I wince knowing that I’ll probably need to lay in some extra supplies of my “emergency” medications to handle a stress-induced bladder flare.
I’ll have to say “no thanks” more often when my body’s needs for rest or food conflict with the social expectations of others. Yes, once again I’ll endure some incredulous stares and disapproving looks from the uninformed. But each year I flat out refuse to stay home and help the IC do its dirty work of isolating me. The IC has deprived me of enough. No way am I going to duck out on the holiday celebrations I’ve always enjoyed out of fear of a symptom flare-up.
For those of us with IC, holiday parties and family gatherings can be a big stressor as well as an opportunity for fun. And a big part of that stress will be struggling with food-related dilemmas. At every occasion this time of year temptation looms in the form of chocolate treats, alcoholic beverages, or unfamiliar foods that have who-knows-what in them. Do I relish a taste now and possibly suffer later? Or deprive myself now but be able to function later?
Here are some ideas for managing at least some of the diet-related anxieties associated with holiday parties and gatherings:
The dinner party
Consider communicating your dietary situation to the host or hostess well in advance. Chances are if they care enough to invite you in the first place, they’ll be happy to make some reasonable accommodations to help you enjoy yourself. Give them the opportunity to be sympathetic and helpful. No need to go into medical details. Just ask what they’re serving and tell them your doctor has you on a diet that avoids hot spices and certain foods. (I find it helpful to draw an analogy between my situation and that of people with diabetes, stomach ulcers, lactose intolerance or food allergies– food- related problems that people are more familiar with).
I try to think of these situations as an opportunity to educate others about IC as well. You never know, the hostess may know someone else who suffers from the same symptoms you do but hasn’t been lucky enough to get it diagnosed. Sharing your experience may help another person, and isn’t that what the season is supposed to be about?
Parties where alcohol is served
- First of all, remember that alcohol doesn’t mix with many painkillers, antidepressants and antihistamines, so check with your doctor or pharmacist if you plan on drinking. If drug-alcohol interactions are not a problem for you, here are some other facts to keep in mind:
Histamine adversely affects mast cells, and mast cells in the bladder tissue are thought to be involved in IC symptoms. Beer and wine contain histamine. Red wine has much more than white wine. Alcohol makes the situation worse by impairing the body’s ability to break down and get rid of the histamine.
- Beer and wines also contain a substance called tyramine which, like histamine, is a monoamine. No one’s sure exactly why, but many high-monoamine foods exacerbate IC symptoms. Among other things it does, tyramine closes down the arteries, decreasing blood supply to tissues and increasing blood pressure. (I wonder if perhaps less circulation may mean less opportunity to “wash out” any inflammatory substances in the tissue). Beer and red wine are especially high in tyramine. All aged cheeses like bleu, roquefort, edam, brie and cheddar are high in tyramine, as are smoked meats and fish. Beware the double whammy of consuming these foods together with wine or beer.
- Wines are also acidic. Champagne and sparkling wines are the most acid of all wines and they also have a higher alcohol content.
- Most wines have at least some naturally occurring sulfites, but wineries may add more. Sulfites are known to cause allergic reactions in many people, whether or not they have IC. Some IC patients’ bladders cannot tolerate sulfites. In general, red wines tend to have more than white wines. (Onions, dried coconut and dried fruits may also have sulfites. Beware of the cumulative effect of drinking and eating foods containing these).
- Very cheap wines may also have the preservative, potassium sorbate. Sorbates are used to preserve candied fruits too. Some IC patients say they are sensitive to sorbates.
- Drinks with whiskey, gin, or vodka may have less tyramine per ounce than many wines, but more alcohol. The tradeoff may or may not work to your advantage, depending on your body’s pattern of sensitivity. Beware of acid from fruit or carbonation in mixed drinks. (A pinch of salt can “flatten” carbonation– a helpful trick for some people).
Of all the problems with alcoholic beverages, acidity is probably the easiest to deal with. Try taking an acid-neutralizer like Tums before drinking. Eating foods containing egg whites or baking soda with your drinks may help curb the effect also. While many IC patients can’t consume any alcohol at all (except when used in cooked foods), a few find they can drink limited amounts of certain things. Everyone’s different. You could start by experimenting with these wines that some ICer’s have successfully tried: Muscatel, Semillon, Tokay, sweet white dessert wines, or non-alcoholic beer (which still contains monoamines, by the way).
The office party
If you don’t want your co-workers to know you have a medical problem, you may have to explain or draw attention from your food avoidance. Here are some explanations other IC patients have given:
- I have food allergies.
- I ate before I came.
- I’m trying an oddball diet and I won’t know whether it will make me lose weight if I “cheat”.
- My spouse (or girlfriend/boyfriend) and I agreed I’d be the designated driver for tonight.
- I’m taking an allergy/cold medication that doesn’t mix with alcohol.