The Reckoning, part 7

9 Apr

As I continue with my recovery I realize it’s highly essential to continue the tale of woe that was October 2011. Where I left you last, I was just moved to a single corner room in the hospital, after I was almost discharged.

About half a week in, my mother finally made it out from Ohio. It was so relieving to have her there, both as a mom and an advocate. She would bring me non-hospital food and endorse me eating treats that I knew I shouldn’t be eating. But that’s what mom’s are for, right? They want to see you happy, if only while you’re chewing.

I had a hankering for a strawberry milkshake. It probably won’t take a genius to figure out that’s not a good idea for someone like me. But mama to the rescue! She bought me one from the Mickey D’s down the street. It was really tasty, I won’t lie. Even though I had looked up the ingredients and knew what I was getting myself into.

Oh the humanity...

In my new digs, I had new symptoms. The main one being gas. But when I say gas, I don’t mean farting. I WISH I meant farting. I mean trapped air; imagine one of those metal tanks of helium filling a mylar balloon, causing my stomach to expand to the point that the pain kept me from eating anything at all.

I’m not sure if it was the dairy, corn syrup or what, but it was agony. The first episode of this was for the 16 or so hours after blasted milkshake.

A weird phenomenon that happens with UC flares is that your digestion actually lulls. You’d think with frequent D that everything’s just running though you like a river. Not so, friends! It’s more like:

Minute 1: You’re pulling your hair out in a gridlocked traffic jam

Minute 2: You’re racing down the Autobahn, gripping the steering wheel for dear life

Very abrupt. So the gas was bad because, when I wasn’t on the toilet, nothing could escape.

Also, for the sake of transparency, when you do fart during a UC flare, the smell will honest-to-god kill a puppy. So, in the rare event that I was able to break wind, it was necessary to shield my innocent guests from Armageddon.

This otherworldly stomach pain hit at least every other morning. At 7a the residents did their rounds and they’d press on my belly with cold fingers and too firm of a touch.

If it seemed bad, I was sent down for x-rays. One time my least-favorite attending physician told me he saw the films, that I had some hole in my intestine, all hell broke loose and I might need surgery. All this dumped on me at once, without my mother advocate there – probably no coincidence as I’m 100% sure he was scared of her. Yet for how dire it all was, I didn’t hear anything about it for another 6 hours.

The surgeon who periodically checked in with me told me later that my attending had misread the films, there were no issues there.

The same surgeon came back to visit a few more times. I thought that was rather un-surgeon like, considering our first meeting he explained to me the cholestomy procedure I might need, and I since had no questions for him. I got to know him over the days and I was able to make the connection. He was a UC patient himself.

The Reckoning, Part 6

8 Apr

Mid October, 2011

I had a roommate in my first hospital room who was in pretty bad shape. She was only 40, but she and her husband were overweight and worn down; both easily looked ten years older. She had transferred from somewhere in rural New Hampshire to get treatment for a specific disease she was suspected to have. From what I could gather, her issue was that she had a uterine edema – tons of swelling in her torso tissues – the source of which was a botched ovarian cyst removal. The end result was that they put her on a very strict low fat diet to minimize the fluid retention.

Having had pancreatitis in the past, I’m no stranger to that kind of life change. But to overhear them speak about it – literally day and night it was the only thing they talked about – you would think it was as if her child was pulled for the Hunger Games or something. It was, to them, the most taxing life change they could imagine.

Shh baby... This low-fat diet won't win. We're gonna beat this thing.

But here’s the crazy part – when a physician says “fat is bad” or “dairy is bad” or “gluten is bad”, patients inherently want to do as little as possible to work within the confines of their restrictions. So, low fat means that anything labeled “fat free” is ok. Right? Standard logic. My neighbor received a gift basket from her sister which included things like baked Lays potato chips, fat free Ranch dressing, diet ginger ale, etc. Part of me sneered at those products, probably the same part that knows these are standard items in my family’s kitchens.

Does anyone honestly think that you will heal yourself on a diet of Kraft products just because they’re labeled ‘low fat’? If you think so – head down to your local grocery and check out the ingredients in Fat Free Half and Half. It’s a joke – it’s just high fructose corn syrup. Not to get overly incendiary here, but they just sub out one poison for another.

True story: top 3 ingredients are sugars!

If you are buying something that is traditionally pure fat, but labeled as 'fat free', do yourself a favor and don't.

NEWS FLASH, ya weenies: If you are put on a low fat diet, and you eat processed foods labeled “fat free”, you’re increasing your sugar intake. What does excess sugar conver to? Fat. Interestingly, some cardiologists argue that low far diets have never been the appropriate course of action for treating congestive heart failure. It’s further argued arterial plaque buildup is triggered by low-fat (read high carb) diets.

Jordan and Steve at SCD Lifestyle put together very interesting read on why packaged foods labeled “Gluten Free” are sometimes just as inflammatory to people with GI issues as foods containing gluten.

Restrictive diets infer that if a patient finds something that’s pre-prepared and flagged as not containing the bad ingredient, then it couldn’t possibly be bad. Let’s face it though, if you’re sick, no matter with what, you should probably be eating home cooked food and still keeping as balanced of a diet as possible.

Chances are your grandma's soup is healthier and tasier than Progresso's.

Rather than a restrictive diet, what if a physician recommended “you are only allowed to eat things prepared from scratch”. How about “The only fat you are allowed to cook with is olive oil.” Why can’t it be done? Granted some savvy person like me would find a way to fry donuts in olive oil (look like Giada beat me to it), but isn’t it usually better to tell someone what they can and should have as opposed to what’s off limits? At least from a psychological perspective, to keep people from feeling they’re an outsider to the rest of the world?

On a related note, why can’t physicians tag team with nutritionists at patient bedside? Why are they always separate entities entirely? I spoke SO much to my physicians about my diet, about what triggered symptoms and what didn’t. Not a word of it in my patient notes. Not a mention in my discharge papers.

Seeing my roommate allowed me to commit to cooking for the rest of my life. I will keep good habits for myself and set good ones for my family. If you start to slack and rely on pre-prepared items, it’s a slippery slope that takes it’s toll in more ways than one.

Hallelujah

3 Apr


So it’s been a few since my last post. As a general update I AM IN REMISSION.

Jesus has risen!

Seriously though, a modified SCD diet has been doing me wonders. For the past few days I’ve not had any cramps, they’ve steadily decreased over the past month. Yes, those bastards do take their time. But overall my bathroom habits have returned to normal, have been for at least 2-3 weeks. It is sheer bliss.

Also, I am officially off cyclosporin, pictured below.

Pretty much true to size

Yes, they look like horse suppositories, but I actually took 3 of these twice a day with meals by mouth, chased with Zofran to suppress the nausea they caused. I’m dabbling with cutting out Asacol and Imuran as well. Don’t tell my doc, but (fingers crossed) I don’t think I need any meds anymore. As long as I stay grain/dairy/refined sugar free, I’m 95% confident I will be healthy.

Over the course of this past month, I have slowly introduced more ingestables.

Fruits

At around 1 month, I started to introduce raw fruit (outside of bananas). Be advised if you’re sensie to sugar, bananas are chocked full of them, so maybe start with half of one in the first few weeks of the diet. For a while the only fruit I was eating was raw bananas, cooked apples and cooked peaches. When I started to expand, I did so mostly with little chunks from fruit salad.

Just loving life
Any antioxidant berry I went really slow with, I wouldn’t eat blueberry skin for a while. Yes, I looked like a weirdo, eating one blueberry at a time, slyly spitting out each wrapper. But antioxidants are unusually hard to digest, so take ya time.

Now I have fruit smoothies pretty often, or a couple dried dates as a treat.

Dried fruits have been surprisingly well tolerated, I started with dried mango at around 5 weeks.

There was no noticeable effects, even when I ate more than my fair share. I think I’m going to switch to freeze dried fruit as it has a different but still awesome texture that’s less heavy and contains MUCH less sugar. I’ve noticed that an increase in fruits/honey in my diet causes breakouts, a little reminder that, even with SCD-allowed sugar, there is still such a thing as too much.

Veggies

I started with pureed carrots. Sauteed spinach was one of the first things I expanded to at around 4 weeks. Diced Eggplant sauteed with mushrooms was found to be super easy on my system as well. For the next two weeks I didn’t really discriminate, I would eat most veggies as long as they were cooked thoroughly. I had my first salad at around 6 weeks. At about 7 weeks I introduced cabbage – the MegaGod of difficult veggies.

I was probably polish in a past life.


I sliced it super thin and partially sauteed it with butter then covered to steam it until it became super soft. No problems, to my delight! I just bought brussel sprouts, so here goes nothing.

In general I still haven’t roasted many veggies, simply because steaming/sauteeing locks in more water to soften the veggies, making them easier to digest.

At this point (I’m almost 2 months into it) I’m able to tolerate all fruits and vegetables.

Not to be a General Mills Cereal commercial or anything, but I love me some Fiber.

Fats

I’ve been slowly able to introduce nuts. Mostly in lara bar form, as they’re softened by the surrounding dry fruit. I might make a loaf of my banana bread (bottom of the page here) soon, but I usually eat too much of it at once…

Avocado is my number one contributor to healing. It’s my favorite food and has been there for me when I can’t indulge in any other way. Luckily tomatoes have been ok for about a month, so I’m often making a guacamole or a chunky avocado salad for dinner and just living the dream. I just wish I lived in CA where the taste/price ratio was much higher.

I’ve also gained a huge appreciation for cooking with coconut oil. I used to just use it to make homemade chocolate and occasionally stir fry – but any frying with coconut oil is DELICIOUS. SLightly sweet, amazing. I made tilapia files, eggs, even almond flour-crusted porkchops. It always comes out amazing.



A version of the SCD diet called the GAPS diet promotes the use of fats, and I think in my case they’ve certainly helped. I’m not sure if it’s good to ingest too much fat at the early stage of the diet (I’m told they’re harder to digest), but the only time I had a problem was when I deep fried with 50/50 canola and coconut oil.

Also if you are frying and drinking alcohol, don’t combine them. That’s bad news bears. I advise to stick to sauteeing/pan frying if cooking with oils, and choose butter, olive oil, or better yet coconut oil (much more heat resistant) rather than canola or veggie oil.

Another thing awesome about the GAPS diet is that it allows you to fool around with cocoa powder and peanut butter. I don’t know if I’m ready for either, but I’m salivating at the idea. I found a GAPS friendly recipe for peanut butter banana cups using coconut oil. Click the image to check it out:

Peanut butter banana cups. Do these not look AMAZING?!

Also, folks over at Our Nourishing Roots have finally found a way to make a GAPS compliant, honey-sweetened chocolate. There’s also a recipe for chocolate peanut butter cups. Yum-a-lum.

Peanut Butter cups made using GAPS honey sweetened chocolate. Oh mama.



Alcohol

SCD-guru Elaine (Breaking the Vicious Cycle) says vodka is ok in small amounts. I’ve found that soda water still causes me a little bit of turbulence, but I was able to tolerate a vodka soda after about 1 1/2 mo on the diet.

She also says that and very dry (0 – 4g sugar/L) wine is ok. Can I just say it’s ridiculously hard to get a quantitative amount of the sugar content of wines? I checked with a knowledgeable Whole Foods staffer and was surprised at the thoroughness of his response.

His answer? French Bordeaux blends have the least sugar content, specifically blends that are dominated by Cabernet Savignon or Merlot grapes.

No-nos: He specifically warned against ANYTHING from California, most Spanish and Argentinian wines, though he did say *potentially* Northern Italian blends might be ok.

I did a little Wiki research, and French Merlot is slightly sweeter than Cab, and left bank Bordeaux blends tend to be Cab Dominant, whereas right bank Bordeaux blends are Merlot dominant. So I’ve been sticking to French Bordeaux blends from Medoc, and it’s been gravy.

Pretty sure this particular bottle costs $150. But you can get Bordeaux Medocs for as cheap as $10.



I recently had my first episode of day drinking in two years, and so far no detrimental effects. It feels good to be a wreckless 20-something again. On the weekend at least.

Caffeine

Coffee was introduced at about 1 and 1/2 months, and unsweetened is better than sweetened with honey.

All in all, it’s a process. As with anything, I try not to get carried away. But damn, does it feel good.

Sweet Nectar of the Gods… Sugar is the Enemy

14 Mar

I grew up a relatively poor kid. The community pool was my babysitter each summer. I’d spend early mornings carefully pouring pennies into little maroon sleeves and use the 50 cent rolls to buy skittles at the pool snack stand. They loved me there. I was the weird 5th grader who obviously made a run to the bank between the mushroom fountain and snack hut. Once I even bought a $10 gift basket from the drug store with coins. Unrolled coins. It was all I could scrounge up from home; foraging for my own allowance.

As you might expect, I have a fondness for super cheap candy and processed desserts.

I have a big soft spot in my heart for gummi orange slices. Just the notion of them takes me back to simpler times. Dad picked them because they had a good “pricepoint”.

Slow Pokes and Blow Pops were my back ups when I was on a budget.

Consuming popular 1950's candy in the 1990's... Hipster and I didn't even know it.



And if I needed a little enriched wheat with my sugar, I opted often for a Little Debby Snack. My favorites include Nutty Bars, Oatmeal Cream Pies, their after-midnight version Fudge Rounds, hell I even liked the brownies. Little Debby got me.

I wonder how many quarters I spent on these between the ages of 4 and 14.

If you can eat these, God help you, try out the recipe linked to the photo.

Fudge Rounds - the illegitimate cousin of the Oatmeal Cream Pie.


My all time favorite treat was the Hostess Pie. If you’ve ever done an Iron Man, this I think is a suitable reward. Filled with generic fruit pie filling, the crust is was makes these things great. It’s a super dense enriched-bleached-wheat haven covered with a light confectioners glaze. The ends are crimped sealed so that each corner is a trifecta of dough that gives you the densest, most delectable bite of anything I’d ever encountered. At least, that was my impression as an eight year old.

"Cherry" Pie

At 480 calories a pop and chocked full of sugar and saturated fat, these things are so unhealthy that even if I *could* eat one I would not. I’d be overwhelmed at the sweetness let alone the nutrition facts. But it does speak to our culture. Many kids, when left to their own devices, would choose a snack like this. Many still do. In their purest, most innocent form, kids will choose sensory pleasure, read: sugar high. We learn to masque this behavior later in life with refined $5 pints of gelato and the like, but the truth is still there. Many of us undeniably have a sweet tooth.

Nevermind the nation, it was literally killing my body. So I’ve opted to consume some less-terrible sugar. Ones in fruit, nuts and honey. Like my very own gluten free banana bread!

Pictured with carrots

Gluten Free Guilt Free Banana Bread
(SCD compliant, to have after ~2 mo on the diet)

2 ripe bananas
1/2 cup honey
3 large eggs*
slighty less than 3 cups almond meal*, **
1/4 tsp salt
1/2 tsp baking soda
1 tbsp ground cinnamon
1/2 tsp ground nutmeg
1/4 tsp ground allspice (I usually don’t measure the spices, so this is a rough estimate)
1/2 tbsp butter or coconut oil to grease a bread loaf pan, or if making in a muffin tin omit butter and use liners.

optional: chopped walnuts or pecans, chocolate chips, whatever you fancy!

*if you want to make this recipe vegan, increase to 3 bananas and add 1/2 cup of applesauce. Haven’t tried this option yet but it should work fine.

**almond meal is sold at Trader Joe’s for relatively cheap.

***can sub 1 cup of almond meal with 1 cup of shredded carrots

Preheat oven to 350F.
Grease bread loaf pan with butter, I usually use a paper towel to smear it evenly on the surface, making sure to go all the way up both sides and get in the corners.
Combine dry ingredients in a bowl large enough to hold everything – almond meal, salt, baking soda, and spices. Mix and adjust spices to taste if needed.
Whisk the eggs in another smaller bowl.
Mash the bananas with a fork in another small bowl.
Mix eggs, honey and bananas in with dry ingredients. Batter should be the consistency of cake batter, or slightly runnier – this is why I use less than 3 cups. The wetter the batter the moister the loaf.
Add any other saucy ingredients you’d like to add some chunk factor.
Pour batter into greased pan. If using a muffin tin, you can pour the batter relatively high (~3/4 of the way at least) with no worries of it overflowing as it bakes.
Bake at 350F
if using a loaf pan, bake for 50 minutes total. At 30 minutes, pull out and cover with aluminum foil for the remainder of the time. The top will brown pretty intensely but it ends up tasting awesome.
if using a muffin pan, bake at 350 for about 20 – 25 min total.
Enjoy!

“Are you sure it’s not all in your head?”

5 Mar

“The first wealth is health.” – Emerson

You tell it, son. Ever since I read The Secret a few years back, those are the two words I occasionally remember to chant in my head. Health and wealth, health and wealth.


Rhonda Byrne, the author of The Secret, suggests imagining yourself as an energetic transmitter of the things you want. I imagine myself as a big radio tower, sending thoughts of what I want out to the world. I was advised, however, that *anything* you think of will be transmitted out as something you want to attract, so I try to keep thoughts about debt, singlehood and ASPCA commercials to a minimum.

I’m your average 20-something college grad who paid for school myself. Out of curiosity, I signed up on Mint.com and found

My net worth = a whopping -$60,000.

It actually feels good saying that. Debt is just a number, right ladies?!

I didn’t even go to grad school, mind you. I just had to get that swanky biomedical engineering degree at a private university. It ain’t no thing though; if you are lucky enough to earn an income, it’s easy to put things like student loans in the back of your mind. Direct deposit paycheck in, auto debit loan payment out – like the money was never even there. Blind faith it’ll all work itself out someday, even if the break-even point is in 2030.

The health piece, on the other hand, is harder to be so confident about. With every cramp storms a flurry of questions: “what was it? What WAS it?! The bananna, the smoothie? Were the carrots not soft enough? That one felt a little crunchy… I shouldn’t have trusted my teeth to puree it enough… stupid, stupid, STUPID.” It’s an anxious person’s playground.

And of course we never know the answer. That’s the beauty of all of this. Who knows what could have caused it. Sometimes, I swear to God, I have a cramp free moment where I’m thinking “Man, don’t I feel great when those blasted blasters aren’t here” and then BOOM, immediate onset. Dear ole Rhonda Byrne would say just the thought brought it on.

Which might be partially true. The gut has its own neural network, first described in 1921 as the “enteric nervous system”, which secretes neurotransmitters such as serotonin on its own. Like everything else in the body, it’s connected to the brain’s neurological system too. An October 2011 article in the NY times discusses the question of which comes first in GI disorders: the actual pathology or the neurological psychology?

Anyone who has a GI condition knows that mentality plays into it 110%. And that’s what this article says.

“Clinicians are finally acknowledging that a lot of dysfunction in GI disorders involves changes in the central nervous system” – Gary M. Mawe, a professor of anatomy and neurobiology at the University of Vermont.

Here the west, we’re inclined to say “Sorry Charlie, a gut disorder must be triggered by something you ate. External input renders an internal problem. End of story.” But this is valuable information, the gut and the brain could just play into each other in a vicious Kurt Cobain and Courtney Love kind of way. I’d certainly believe it.

If I had to choose, I'd say Kurt represents the Brain and Courtney is the gut.

And with that, I’m done thinking about this shit for today.

The Conundrum

2 Mar

Since my last update things have been reeeeeal up and down. But I guess that’s the nature of life. The SCD diet provides you with little guidance after the 3-4 day intro, so from my own experience here are some things I’ve noticed:

1) Nut flour = hard to digest so soon. I’m thinking they are something to introduce after a month or two on the diet.

Be weary. Be very weary.


2) dairy = no good for me. SCD yogurt = no go, aged cheddar didn’t work either. I am bummed to say the least.

3) cooked apples and peaches = delicious but far too easy to eat too many. I have yet to try making applesauce, maybe that’s where I should have started.

5) Sliced bananna with honey is a nice dessert, but I’m weary of bananas being so high in sugar, so I haven’t been foxing around with them too much.

6) Bolthouse Farms smoothies – strawberry banan in particular – seem to be ok, though who knows what “natural flavors” consist of.

7) Orange juice needs to be seriously diluted. I need that Vit C as a co-factor for the iron I take 2 x a day, but damn is it hard on the stomach.

8) I love hamburgers, partially because I have to. That is a fact.

Minus, you know, all the fixins.


9) Homemade mayonnaise is hard to make. I’m currently 2 for 4. I have a recipe I will share, I think I finally know what the determinate factor of success is.

10) Still up in the air on eggs. SCD says not to eat if you have D, but I’m not sure if they trigger my symptoms or not.

I will say that I found an SCD legal brand of olive oil mayo from Spectrum, and it is the bomb. Far better than any other mayo’s, let alone one I make myself. As a child of the midwest in the 80’s, you can imagine I was all about the Tangy Zip of Miracle Whip. This spectrum mayo has all of that deliciousness with none of the Monsanto-injected poisons.

Condiment Queen

I’ve also been all about the honey + brown mustard combination since that too is SCD-legal.

As of late,
the biggest challeng has been dealing with prednisone-induced acid reflux which is compounded by all the protein I’m eating. I wonder if increased acid production causes D? For the past three days, here’s the cycle:
1) I get bad heartburn at night, followed by cramping and D the next morning.
2) I feel super rotten until 10a, at which point I feel great.
3) Reflux resumes after dinner.

I feel like this recent diabolical trend is not typical for my UC, but a result of the heartburn. Who knows. Avocado and banana seem to be good buffers to heartburn, I’m going to try pureed cooked carrots as well. I also take protonix twice a day. Last night I took baking soda with water per the instructions on the box as a SCD-legal remedy for heartburn. Worked pretty well but I woke up with chipmunk cheeks – when you’re on prednisone, Sodium intake is what causes moon face… so cut your salt and you get your cheekbones back.

In terms of my long term healing plan, I got a 2 stage approach figured:

Step 1: Go on SCD to get symptoms under control.
Achieve a realistic remission (no cramping, no urgency, normal relief patterns, etc) for a certain amount of time.

Step 2: Undergo 5-10 Human Probiotic Infusions (HPI) per the at-home instructions from Dr. Borody, one per day.

It seems that Step 1 is going to take some time. I’m gearing up for a trip to Germany at the end of April. In an ideal world I’ll do the HPI’s before then so I can hopefully tolerate a wider variety of foods. But we’ll see. In the meantime look out for SCD recipes!

I’m the Winner!

23 Feb

It’s with tears of joy that I officially report I am on the mend. It’s been 11 days since being discharged with full strength medication and 10 days on the SCD diet and I am finally able to say I’m getting noticeably better. It’s profound how a lack of pain can translate into such euphoria.

SMILE