I grew up on the east coast of South Africa and enjoyed being outdoors from an early age. Most days were spent outside in the garden – running around and jumping in and out of the pool. My willingness to go to school largely centred around the opportunity to play sports six times a week. I loved my team sports, and being able to be active and outdoors made all the geography lessons worthwhile. By the time I left school I was the fittest I had ever been and was used to doing as little work as possible and playing as much sport as possible.
I went off to university and struggled to adjust to the change in lifestyle, suddenly I was spending most of my day sitting in lecture halls and in science labs, my six days of sport a week had turned into 2 hours of soccer a week and maybe a game on the weekend. On top of all that, I was losing weight rapidly due to eating the food provided at the university residence I was staying at. Long gone were the days of home cooked meals and a fully supplied pantry, I was eating mass catering every day and just couldn’t seem to eat anything healthy. One day, a friend asked if I could move some of his stuff out of storage for him, I tried to lift a box which unbeknownst to me at the time contained his weights set, I lifted the box incorrectly and immediately felt a tightness in my lower back. Being 22 and fit, I assumed that it would get better over a couple of days, but a week of pain later I was in the doctor’s office looking for solutions. The doctor did a blood test for BLA-H27, which came back positive, however, since I didn’t have any signs of arthritis, the doctor felt that I didn’t have AS and was given pain killers and sent on my way.
The pain did subside over the next couple of weeks and I was able to return to what felt like life as normal, but I just started to notice that it took me longer and longer to recover from exercise and I would often wake up during the night from stiffness in my back.
Eventually I moved out of university residence and into a house with friends, I was able to better control my diet and lifestyle and seemed to be doing ok for a couple of years. Once I finished university and started working, I suddenly found myself behind a desk, in front of a laptop for hours at a time, and I would go through waves of having back stiffness and back pain. Around 25 it all came to a head, when a few days after a particularly long run, I suddenly got incredible pain in my hip, to the point where I was unable to run. Deciding to give my self a few days to recover, I was shocked to find that my baby toe was suddenly also incredibly painful, then my elbow became sore. Feeling like my entire boy was crumbling around me, I was back at the doctor, who initially suggested seeing an orthopaedic surgeon, but then after doing some blood tests, suggested seeing a rheumatologist. By the time I saw the rheumatologist, I was barely able to sleep through the night, I hadn’t exercised in weeks, I was in constant pain and at the end of my tether. The rheumatologist did a great job at explaining AS to me, going through what my options were as well as giving me some hope for the future. At that stage, I was worried that I would be in pain for the rest of my life.
One of the main insights from the rheumatologist was that diet and lifestyle played a big impact on AS, and I was lucky enough to have a very supportive girlfriend (now wife) who decided to journey with me on my expeditions through diet and lifestyle management.
We did plenty of research to try and understand what was causing the inflammation, and to cut out as much as possible, things that my body didn’t handle well. I started taking anti-inflammatories as well as methotrexate – which helped immensely to get the flareup under control.
I also almost immediately I cut out alcohol and sugar, which was nearly impossible since I was in Cape Town at the time and a lot of my socializing was around going for beers with friends or exploring wine farms (although I did find that if you offer to be the designated driver, you get invited to wine farms almost every weekend). Sugar was harder to cut out since it was in almost everything I ate at the time – “healthy breakfasts” – loads of sugar, post-run steri-stumpie – loads of sugar, tasty chocolate after dinner – sugar. But as they say, the proof is in the (sugar-free) pudding, I was starting to feel in control of my inflammation.
I began experimenting with other foods to see what my body could handle, and found that bread particularly, but gluten in general was a big no-no, so that got cut as well. Eventually I was left with essentially a whole foods diet that had plenty of vegetables, some meat, good fats and no sugar or alcohol. I also found that exercise was crucial for my physical as well as my mental health, and initially took up low impact exercises like swimming and rowing, and eventually got back into trail running which is my big passion. I have since included cycling and surfing into my toolkit for managing AS.
I am now grateful to say that I am off my medication, successfully managing my AS through diet and lifestyle, largely due to the support of my wife and family, as well as other people in the AS community who have provided encouragement and insight.
I can still remember the day of the initial diagnosis and worrying that I would never be able to run again, so I am thankful that I can write this pain-free, having made adjustments to my diet and lifestyle that have made me fitter and stronger than I ever was.