A while back I told you about my endeavor to begin managing interstitial cystitis (IC) in addition to endometriosis.

I had been ignoring my IC for a while and taking only minimal steps to counteract the symptoms, which include bladder pain and bladder frequency. Inevitably, doing the minimum wasn’t enough, and IC began threatening my well-being in significant ways.

I finally addressed the truth I had been avoiding: I likely would have to do a real elimination diet. Yet I’m not here to report that the elimination diet went well or that I ended up enjoying it. I haven’t even started a full elimination diet. Nevertheless, a lot has changed.

I hired a nutritionist, which I’d been desperate to do but hadn’t been able to afford. I still can’t afford it, but I’m lucky my nutritionist offered me a good discount.

We’re not only focusing on my interstitial cystitis, but also on optimizing my well-being. While most of my endometriosis symptoms are under control, I feel like fatigue is always a step behind, and I must work hard to ensure it stays there. My nutritionist will work with me to ensure that I absorb nutrients properly to eliminate any intolerances or sensitivities that might be causing further gut issues, to optimize energy production, and to address anything that aggravates my bladder.

Before we went further in considering an elimination diet, we had to understand what we were dealing with.

My family has a high incidence of autoimmune conditions, and my brother has type 1 diabetes triggered by celiac disease. Many of my symptoms, such as constant thirst, fatigue, and frequent urination, point toward the same. Our first step was not only to check my blood sugar levels, but also to check for antibodies found in someone with type 1 diabetes.

The good news is that the results were normal, but my white blood cell count is slightly low. I’ll be tested for that again in six weeks. In the meantime, my nutritionist asked for lab tests to determine whether I’m correctly absorbing nutrients, including protein.

Lab tests are expensive, but it’s crucial that I invest in getting to the bottom of this mystery. I already have done much to transform my health, so why stop here? Especially since in January, I’m launching an endometriosis health coaching program now that I’m a qualified women’s health coach. I want to be as energized and as healthy as possible for my clients.

You also might remember that I started a challenge that involves eliminating each month one food group that isn’t serving me. The first month I eliminated tea, including decaf. I found that my bladder pain and bladder frequency were dramatically reduced.

In November, I eliminated cacao, which I had been eating nearly every day. I didn’t notice a huge difference with this one, so I hope I can keep it in my diet. However, I will have to be careful about portions, as I notice pain when I eat a lot of it.

I’ve also been doing physiotherapy. The combination of physiotherapy and tweaks to my diet has motivated me to avoid some of the common foods that aggravate my bladder, based on a list my physiotherapist provided me. I am now certain that citrus fruits, tomatoes, sourdough bread (even gluten-free), and sauerkraut trigger me almost instantly. Because I’ve been feeling so good, when I’ve had even a small amount of these foods I’ve noticed a significant flare-up of pain, which has often cost me several nights of sleep.

I don’t think I’ll have to avoid these foods forever, but I do think I need to address healing the bladder lining first. Physiotherapy helps, but it’s clear that internally, a lot is going on. As a result, I must ask: Is it time for a cystoscopy?

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