The Naughty Binge!
For a week I ate a small portion of rice and black sesame seed porridge in my mornings, kept surgery rice biscuits handy, and enjoyed chocolate with 50% to 80% cocoa. It was too many factors!!

The Peak of the Ride in Brimstone
My nine month flare hit its maximum w.r.t. to head, eye and neck pain. Interestingly it wasn't the worst sacrum and hip peak but my feet, knee and hands were effected more than in the past nine months probably due to gradual tissue changes due to chronic inflammation and repair.

The TOO Rapid Retreat
I over-reacted and went back to a strict NSD diet with a heavy load of antimicrobials like clove, cinnamon, ginger, etc. It seems that going immediately into an antimicrobial treatment is not wise. It felt like a smail Herxheimer reaction combined with AS activity. Perhaps that is an exaggeration but the antimicrobials gave me gut pain. I should have just went to the NSD diet for at least a week, then perhaps a fast, then to the antimicrobial treatment. I guess that the order of the last two can be swapped. But I speculate that if I combined a fast with herbal antimicrobials then I would have been in agony from the gut pain.

The Moral of the Story
The moral of the story is make slow and small changes to avoid painful shock. Same goes for introducing new foods.

Could Combining Fasting with Borage Oil be better than Herbal Antimicrobials?
I am a bit concerned with combining antimicrobials while on a fast since the antimicrobials could irritate and inflame the gut too much while it is trying to heal. Perhaps EVOO or borage oil is the best thing to supplement with while on a fast. I know.... I should read the "Important AS Resources."

I speculate that herbal antimicrobals interfere with healing and so the "weed and feed" concept needs to constantly be rotated; i.e. Space apart the use antimicrobials and healing compounds like probiotics. But perhaps it is sensible to take borage oil, fish oil and other anti-inflamatories while using herbal antimicrobials.

Unfaithful: Forever a Sinner and Repenting
BTW: I cheated two nights ago and had three handfulls of pecans and walnuts followed by a rich ice cream bar (of course all wisely before supper!). I didn't notice a serious change in feeling the next day but sixteen hours after that snack treat my head and neck started burning, however that is common when I am fatigued since I had not slept well the night before. It seems that I can cheat a little one day a week without a major increase in pain (probably depending on the food and current state of rest) but if I have a decent dose of starch every day then I am asking for a build up of pain!

Finding a Team of Doctors that have Bigger Guns
Even strict NSD hasn't been enough and I think I have infectious obstacles that herbal antimicrobials can not conquer! They could be: a chronic nasal and sinus infection that has spread (likely). An ancient mould colonization from 30 years ago while living for nine years in a mould contaminated home (possible). A persistent gut infection from NSAID overuse three years ago that wont allow parts of my gut to heal??? I have a plan to get all these ideas tested but doctors do not cooperate and try to direct me to a psychiatrist. A private clinic out of my pocket is best -- I'll probably get them to do anything in their power to keep me as a paying customer (and I have insurance to make them happy). I will be seeing an internal medicine doctor at a private hospital that I hope is open to my ideas and can plan and coordinate other doctors; for that is their job! I must be crazy doing this in Shanghai but my country of birth is even more impossible.

Help make a Miracle Happen
Pray to the cosmic singularity for me! Wish you all the same.

Sorry to note about your flare. My Prayers for a quicker remission.

Probably, you should have gone for a stricter NSD than for a doses of anti microbes.

Jay

Thanks Jay, but I ate the starch in the name of SCIENCE! And I gave in to my desire to be a real boy -- I'm tired of being a wooden puppet.

I understand the monotonous feeling in following diet. But AS sufferers if they have relief with diet, there is limited choice.

Jay

Hello, Robin_H:

Yes, the best decision I ever made was to combine antibiotics with NSD; I worried for years that NSAIDs permanently wrecked my gut but it eventually healed enough. I am a firm believer in "clearing the slate" with the big guns and starting over (probiotic yoghurts, sauerkraut, kommbucha, etc--all in moderation). But I *believe* (based upon my keen powers of observation) that I had some severe SIBO that was a primary factor in my AS. And removal of this is the reason that I am almost totally starch-tolerant today. So that is the best update not yet included in my "Important AS Resources;" I do not need to wait for more time and data!

I was never convinced of the Herx reaction related to AS; there are myriad other explanations for increased disease activity specifically related to antibiotic usage.

FASTING is always good, and I never liked to take any pills during a fast because afraid it would cause me to break it by increasing stomach activity. After 3 days everything is shut down and it is best not to "tease" those lions.

Good Luck and keep experimenting but just remember that our AS has multiple long and short cycles, so our time horizons should be much longer than the average person. For example, once a flare has begun due to the increased numbers of IgA-Kp (this immune component has a half-life of about 100 hours), it can take quite a while for the flare to die down.

HEALTH,
John

The herx reaction, it might be real for syphillus patients, but when I eat a food such as wheat and it causes pain the next day , it feels the same as when I take antibiotics.The antibiotics hate me, cause my joints to flare up and swell. I kept trying antibiotics for 6 months striaght but felt worse and worse, I think people think it is die off when it is really a side effect or bad reaction like when you eat a food that causes you to flare.

I've been finding the same thing lately: I can manage a single big starch cheat with little impact the next day. But daily starch for a week and my pain and stiffness come back full force.

Overall, this is a huge improvement. In the early days of NSD I found I had to be very strict. Anything over 2g a day and the pain and stiffness came back immediately. Since strict NSD is really hard to stick with, it's been nice to have an occasional cheat (popcorn! dark chocolate! toast!).

I did, however, recently get a bit carried away and did the same thing you did: high starch foods daily for almost a week. The pain, swelling and stiffness in my fingers all came roaring back. Now I am repentant and back to my no starch ways!

(at least for now....Xmas will be a challenge)