Archive for March, 2013

March 31, 2013

What Can You Expect From a Gluten-Free Diet?

Now that you’re ready to go gluten-free, what can you expect?

Physical Effects

Some people feel a remarkable difference in a few weeks, but it takes a year to a year-and-a-half to heal much of the damage gluten has caused, so don’t expect a miracle cure.

If you suffer from dermatitis herpetiformis, you may continue to have outbreaks for years after eliminating gluten. As time wears on, the outbreaks will itch less and will not last as long. Iodine can trigger these outbreaks so be aware of your iodine intake from food or supplements.

As your body heals, you may feel better for a few weeks and then feel worse again. This can be because you have not eliminated all sources of gluten and need to review lists of foods to avoid. If you have reviewed and don’t think gluten is the culprit, take note of what you’ve eaten. You may discover that there are other foods you cannot tolerate well. Once you’ve identified those, you will feel better if you eliminate them too. A pattern of feeling better then worse can also be a normal part of the healing process. Have patience and stick to the plan. Keep a journal so you can review your improvement over a year’s time. If you are gradually feeling better and better, then don’t worry about momentary setbacks.

By the time you begin a gluten-free diet, your intestinal tract may have suffered so much damage that it needs to digest only monosaccharide carbohydrates in order to heal. If you continue to suffer from diarrhea and/or constipation after several months on a gluten-free diet, a change to the Paleo or Specific Carbohydrate diet will give your body a break and facilitate quicker improvement. You can follow one of these more restrictive plans for a few months, a year, or more. These diets eliminate all starchy foods that are difficult to digest and give your body the best chance of killing off any possible overgrowth of bacteria or yeast that may be complicating the healing of your gut.

When you begin the Paleo or Specific Carbohydrate diet, you may run a fever, have a headache, and feel bad for a week or so. This is normal for those who have excess yeast or bacteria. These organisms want to stay alive and you are starving them out. Essentially there’s a war going on in your gut. Fever tells you that your body is fighting to kill off the invaders. This is good. If the fever persists more than two weeks, visit your physician to make sure there’s nothing else going on.

You may notice that you no longer feel “tight” in your own skin as inflammation begins to disappear. Your achy muscles may stop aching. Your sleep pattern may improve. Your food cravings may lessen. Your stomach pain may lessen. Your bowel function may return to a normal pattern. Your strength may return. Your emotional state may improve. Your hair may stop falling out. It may become easier to gain or lose weight. You may have more energy.

Food Choices

You will still be able to eat delicious, healthy and traditional foods. Sometimes a substitution or two in a recipe is required, but that does not mean you should settle for substandard, tasteless, or unpleasing food. This is true even if you consider yourself a foodie!

Mac & Cheese

Mac & Cheese

Cheesecake

Cheesecake

 

 

 

 

 

 

 

 

 

 

In the beginning, old habits may cause you to feel a need for “replacements” for foods such as cereal, bread, crackers, cookies, and pasta. In order to keep things simple, you may choose to buy prepackaged convenience foods. These are readily available in the supermarket or online. It is good to be aware that gluten-free prepackaged convenience foods are still processed foods and may not be optimum for achieving your best health. As you get more comfortable with the gluten-free lifestyle, you can gradually phase prepackaged foods to a minimum. Your body will adjust and the desire for these items will diminish accordingly.

Prepackaged gluten-free foods are more costly than their gluten-containing counterparts. As you begin to feel better and have more energy, you may feel like baking more for yourself. This will allow you to have more control over both the ingredients and the costs.

Some gluten-free flours are more costly than wheat based flours. Shopping in ethnic grocery stores or online can help minimize these costs.

Gluten-free foods tend to be more dense and often contain more carbohydrates in one serving than wheat based products. If you need to minimize your carbohydrate intake, it is important to be aware of this difference.

Remember that meat, poultry, fish, seafood, fruits, vegetables, nuts, seeds, legumes, herbs, spices, and milk are gluten-free as are most yogurts and cheeses unless gluten has been added in processing. There are infinite numbers of delicious, satisfying combinations that can be made using these items. In addition, many of you will be able to tolerate other foods made from corn, rice, tapioca, arrowroot, or mesquite.

Social Adjustments

Some changes in routine may be required in order to maintain a diet that is free of gluten. Reading labels on packaged foods is a necessity. In the US, there is no standard for the amount of gluten allowed in a product that is labeled gluten-free. Rather than rely on that designation, it is imperative to read the ingredient list on any packaged items you purchase. You will find that this allows you to consume many products that are not specifically labeled gluten-free. Because formulations change, it is important to read the label each time you purchase a product. Once this becomes a habit, you won’t even notice that you’re doing it routinely.

Eating at fast food restaurants will be more difficult, but there are gluten-free options. Nutrition information can usually be found on the restaurants’ websites and some franchises will have the information available in the store. A shift to small locally owned restaurants can often fill this gap. Local proprietors often allow you to read the ingredients on the packaged food they use, and local chefs are able to adjust recipes to accommodate your order. While it is true that there is always an inherent risk of accidentally ingesting gluten when someone else prepares your food, there is no need to imprison yourself in your home in order to be healthy. Communicate well; use tools like our Server Card to assist you; frequent establishments where you feel comfortable, and when in doubt – leave the food on the plate.

Happy hour out may require an adjustment. If you’re a beer drinker, you may have to switch to wine or hard liquor. Few bars or restaurants stock gluten-free beer. Playing a tasting game until you settle on your new drink of choice can be a fun adventure.

To make things easier, you may want to carry your lunch to school or eat a snack before an office party. This will help keep you from being tempted to grab a piece of cake or a quick finger sandwich when those are the only things offered. Carrying fruit, nuts, vegetables, cheese, boiled eggs, or gluten-free protein bars with you will mean you’re prepared when plans unexpectedly change. Knowing you’re prepared can ease your anxiety and let you focus on making gluten-free choices while enjoying all your regular social activities.

You will learn to strike a balance that allows you to be respectful of well-meaning friends or relatives who try to get you to consume “just one bite” while refusing to harm your body. You will find ways to gracefully negotiate holidays and celebrations in a manner that leaves important traditions intact. Because traversing these negotiations can feel like navigating through a minefield, we offer numerous tips to help you here at Cooking2Thrive.

You may be concerned that maintaining a gluten-free lifestyle will take too much time. It is realistic to expect to spend more time planning meals, reading labels, and shopping for specialized products. This is usually balanced by additional energy and less time spent in the doctor’s office. When you no longer suffer daily physical pain, exhaustion, or distraction from the need to remain close to a bathroom, you’ll be amazed how much more you can do in a day. You’ll reap the benefits of feeling better at work, with your family, and in your social circle.

Once you discover that your child needs to be gluten-free, you will need to communicate with grandparents, extended family, teachers, and other moms in order to both educate them and to devise plans that accommodate your child’s needs without making the child feel like an outcast or other moms feel resentful. Compassion for both your child and for those whose assistance you need is a great starting point.

If your family is like mine, there will be some ribbing about your new eating habits and the implication that your disease is all in your head. Just let this annoyance roll off your back. You and I know that there’s a genetic propensity for gluten-intolerance, so rest assured that some of the current taunters will be eating their words instead gluten soon enough – or they’ll be suffering the consequences of their defiance.

Unless you live alone, it will be necessary to determine whether you will all eliminate gluten from your household, or whether you will continue to stock some gluten-containing items in the cupboard or refrigerator. I don’t feel a need to require others to follow my lifestyle, but this means we must be careful about sharing jams and jellies, washing baking pans, and keeping food prep surfaces separate. If you decide to have a mixed kitchen, it is a good idea to establish rules right now that will ensure the gluten-free items do not become contaminated in the future.

Emotional Adjustments

Facing the necessity of going gluten-free is important because a lengthy denial of your condition can lead to dangerous health consequences. A study of 9133 people over a period of 45 years cited in “Gastroenterology” in 2009 concluded:  “During 45 years of follow-up, undiagnosed CD was associated with a nearly 4-fold increased risk of death.” (1) A separate study cited in the “Journal of the American Medical Association” in 2009 found that those with intestinal inflammation, but not Celiac or latent Celiac, had a 72% increased risk of mortality. In the same study, the increased risk for diagnosed Celiacs was 39%.(2) A third mortality study published in “Lancet, Vol. 358, 2001”, observed the following: “We compared the number of deaths up to 1998 with expected deaths and expressed the comparison as standardised mortality ratio (SMR) and relative survival ratio. Findings: 53 coeliac patients died compared with 25·9 expected deaths (SMR 2·0 [95% CI 1·5–2·7]).”(3)

Change is hard for many of us, especially when we feel as though we may be deprived, ridiculed, or labeled as “different”. Change is especially hard when we have suffered long-term pain. The exhaustion that results from pain isn’t just physical; it’s emotional as well. When you’re in a diminished or weakened state, you may feel as though you must hold onto as many traditions as you can to feel safe. These traditions often include family meals, family recipes, and comfort foods. The idea of changing even the most minute detail may feel threatening. If you feel your resolve to walk the gluten-free path begin to wane, keep in mind that with slight shifts, you’ll still be able to participate in family meal traditions, use your family recipes, and eat your favorite comfort foods. And the ingredient shifts don’t have to mean the food tastes inferior.

When you need support and encouragement, you can find help here at Cooking2Thrive.  We offer Essential Utensil Emotional Support Tools, Video Interviews with Experts, and videos on Gluten-Free Dating as well as Feeding Your Kids.  You can also join a local support group for those who are gluten-intolerant.

As you make good eating choices and your pain begins to diminish, you’ll begin to feel more positive about the changes you’re making. Feeling better makes the necessary everyday gluten-free choices easier and easier to make.

It is natural to have a few pouty moments during which you feel deprived. If you find that these are frequent or that you feel deprived in other ways as well, further examination of this trigger may be needed. Otherwise, embrace the feeling and allow it to dissipate on its own, then make your food choice. In the moment, it may help to write down 5 or 6 things for which you’re grateful. If you recognize you’re grateful you have a disease that doesn’t require surgery, then it’s easier to be happy about leaving a brownie on the plate. If you recognize you’re grateful that you don’t have to endure chemotherapy in order to heal, it is easier to be assertive with someone who continues to offer you a doughnut.

If you find you have a circle of friends that is not supportive of your dedication to your health, there is no need to feel guilty about minimizing time with them. You do not have to cut them out of your life unless you determine that’s the best path, but you may need to decrease the time you spend in a non-supportive environment. You will want to cultivate new friends who recognize that to be at your best you must stick with a gluten-free plan.

Sometimes the time we spend with medical professionals feeds our need for attention. If you do not currently have a supportive partner or family that empathizes with your struggles, this can be especially seductive. Somewhere down deep, you may fight eliminating gluten and allowing yourself to heal because you do not want to reduce your number of doctor visits. The best thing you can do in this case is face the truth, feel any fear that may be feeding self-destructive decisions, and give yourself a break.

All of us deserve to be healthy no matter what we learned in our family of origin. All of us matter. Each of us is an inherently important part of humanity. We all need compassion, concern, and empathy. When we begin to give it to ourselves, we put ourselves in a place to flex our receiving muscles. As we practice receiving, we will find support all around us that we never noticed before. This support helps us feel strong enough to make good decisions, and those good decisions allow us to achieve optimum health. Soon enough, our feeling of needing someone else’s attention to solve our problems will resolve itself with the best possible outcome.

Length of the Journey

Gluten-intolerance lasts a lifetime. It can require a full year of healing to repair the damage caused by a single ingestion of gluten. For maximum healing and optimum health, the commitment to a gluten-free way of living must be a lifetime commitment.

 Value of the Journey

Priceless. If you are gluten-sensitive, gluten-intolerant, or have celiac disease, eliminating gluten is critical for remaining or becoming healthy. Who doesn’t want to feel as good as possible, have as many years with our loved ones as possible, be pain free, energetic, and feel good? If these are your desires and you know that all it will cost you is occasional inconvenience, how can you make any other choice?

 

References

1 – RUBIO–TAPIA, ALBERTO, Robert A. Kyle, Edward L. Kaplan, Dwight R. Johnson, and William Page. “Increased Prevalence and in Undiagnosed Celiac Disease.” Gastroenterology 2009: 88-93+. Www.gastrojournal.org. October 4, 2011

2 – Green, Peter H. R. “Mortality in Celiac Disease, Intestinal Inflammation, and Gluten Sensitivity.” JAMA 2009. Http://jama.ama-assn.org/cg/content/full/302/11/1225. Web.

3 – Corrao, G., G. Corazza, V. Bagnardi, G. Brusco, C. Ciacci, M. Cottone, C. Guidetti, P. Usai, P. Cesari, and M. Pelli. “Mortality in Patients with Coeliac Disease and Their Relatives: a Cohort Study.” The Lancet 358.9279 (2001): 356-61. Print.

Server card ad

 

March 20, 2013

Inspiring Lessons of Connection from Parents with Critically Ill Children

The past few days, I’ve had a chance to see both the best and worst of humanity. The stark contrast presented by a unique week of interaction has me pondering the importance of connection, personal power, fear, and our contributions to our own misery.

Okay, admittedly that’s a lot of territory so, for now, let’s look at the best and see if there’s anything we can learn that will help us improve the quality of our lives so that our families can thrive.

My week started with a photo shoot of several families who have children that are critically ill, injured, or have recently received a transplant. As I asked each family if they were having a good day, I received varied answers. One family’s son had just had his chest tubes removed after his third open-heart surgery. He is three. The mom told me that she was grateful to have learned it doesn’t matter what color your skin is. When you are told your child may die, it only matters who you are and what’s in your heart. A family that had arrived in town because the mom went into labor on an airplane and we had the closest airport, moved carefully because of her recent Caesarian. Her new daughter is still in NICU, she is having to shower in a communal bathroom, and her husband has been unable to start his new job. She calmly instructed her 3-year-old son who has to wear his blue sweater several days per week because there’s been no chance to locate other clothes. She wasn’t much for talking; her quiet smile said it all. One young mom wrestled her 4-month-old son who recently had a heart transplant. He has gorgeous red hair, a feeding tube, a mask over his face, and he cries incessantly. He was frightened by the photographer’s strobes. As he wriggled and screamed, his young mom remained relaxed and gentle with him. Her unflappable serenity shines through in the photos.

All day long, I kept expecting to see people at their worst – exhausted, frightened, struggling, hopeless. What I kept discovering was that I was seeing people at their best. They may have felt exhausted, frightened, and helpless, but what I experienced was calm strength and total presence in the moment. Without time or energy for the usual niceties or pretense, connection was natural, easy and inspiring. Over and over again, I felt an immediate connection. With each meeting of our eyes, each smile or look of empathy, I knew my presence made a difference. I felt honored, humbled and powerful.

For these families, life has been stripped down to the absolute essentials. Their challenge is to embrace each bit of kindness, joy, or relief that appears while surrounded by the most difficult of life’s realities. If they choose to spend five minutes wondering why their child must suffer when others don’t, they know that’s five minutes they aren’t fully relishing the time they have with their child. What a choice!

It’s easy for most of us to draw a contrast between our everyday lives and that of these families, but maybe there’s something we can learn from them and apply to our everyday interactions:

Because these families are painfully aware that the time we get in this life is limited and uncertain, they focus on making the most of each day. We can all benefit from this type of focus. Our priorities will then allow us to rid ourselves of the activities or friendships we have chosen that do not feed us or contribute positive energy to our lives.

While they have real reasons to worry, these folks recognize that worry is a distraction that keeps us from being present in the moment and thereby prevents us from fully connecting with each other. It is through this connection that we can give and receive empathy, care, comfort, and love. 

Although presented with heart-wrenching circumstances, the families I observed show up each day to face the situation and make difficult choices. We too are faced with everyday choices that affect our health and quality of life. Do we choose to cower in denial or do we gather our courage and make the choice that best serves our overall well-being even if that’s not the easiest choice?

In the role of parent, the adults recognize that they must function as adults. If they weep and wail and act helpless, their children will become frightened. If they are disrespectful to the nurses or staff, they may inadvertently jeopardize their child’s care. If they decide that they just can’t handle the stress of the hospital, their child will be left alone. These loving parents do not choose to burden their children with adult matters so they summon their best selves and find the strength to cope with each difficult day. How often do we fail our children by neglecting to summon our inner strength to set and enforce limits on sugar consumption, screen time, rude behavior, or frivolous spending?

When parents are separated for days or weeks by taking shifts to provide a continuous presence in a child’s hospital room, the importance of adult time to connect without the children cannot be taken for granted. Are we remembering to value our connection with our partner? Do we make time and space for connection on a regular basis? Do we present a united front to our children?

As days turn into weeks and the world begins to shrink to the size of the hospital room, these parents must find small ways to care for themselves and keep a connection with the larger world in order to remain inspired. There is no energy to feel guilty for a few “selfish” moments; in fact, there’s a realization that feeding their own spirit is not just important, but critical. Some of them make sure to take a walk and watch the sunrise or sunset. Others read a book that allows them to empathize with the characters. Some schedule a meal out once a week so they can get out and people-watch. Some moms just take a long bath and a nap or get a massage. Do we measure our worth in self-sacrifice that causes us to lose our identity or feel guilty when we take care of our spirits?

This week in the midst of tragedy, I had the privilege of seeing the best. I also had the experience of seeing the worst. This contrast reminded me that life-changing events are a chance for people to reveal their real character. Sometimes you learn that your partner, sister, aunt, mom, or dad is too fearful to be supportive, too needy to put another’s interests first, too interested in comparison to have compassion, or too threatened by real connection to let down their walls and be there for you. Can we have compassion for their weakness and the courage to let go of our expectations of more from them so that we can recognize and be open to receiving what we need when it presents itself? 

When we allow ourselves to see the truth, we may be faced with other difficult life decisions. Can we be grateful for a chance to face our fears, embrace grief, loss, and change in order to move forward and heal ourselves?

While we may never have a critically ill child, we will all face trying circumstances. Some of us will choose to live in chaos, pain, worry, and dissonance without ever recognizing that we’re making a choice. If you are struggling at the moment, can you tell yourself the truth and begin experimenting with tiny changes in your behavior? Can you take inspiration from what resilient parents have learned? 

 If so, are you willing to share your story? We’d love to hear it.

March 8, 2013

Take Candy from Strangers, then Why Not Juice?

Since we’ve broached the subject of taking food from strangers, I’d like to share another recent travel moment. Two weeks ago, I traveled to Raleigh, North Carolina where I took these photos of Historic Oakwood Cemetery.

Oakwood

My flights in both directions were rescheduled, rerouted, and delayed by several hours. As you may have guessed from reading our Travel Tips, for convenience I always carry gluten-free food with me when I fly.

Over the past couple of years, I’ve had to move my meals closer and closer together in order to keep my hypoglycemia in check. I can no longer wait until I feel hungry to eat, but have to consume at regular intervals in order to maintain my energy level and feel my best. This requires that in addition to carrying food, I must look at the schedule in advance so I’ll know if I need to eat a snack on the plane in order to keep my blood sugar level even.

On this trip, I followed my normal procedure and arrived at the airport feeling prepared. I sailed through security with my plastic containers of food and headed for the gate. As a flight delay led to late boarding, followed by sitting on the tarmac for an hour, followed by taxiing back for more fuel, I found myself captive on the plane without enough food to last until we reached the next destination.

As we began our descent, I was hoping to avoid the point at which my blood sugar drops so low that my hand starts to tingle, my lips get numb, and I feel overwhelmed and groggy. I started a mental inventory of my options. Was there time to investigate and consume the $11 snack boxes sold on the plane? Should I ask for a coke? I could already feel the anxious tension creeping from my shoulder blade to my neck. My mind was whirling.

About that time, a young man sitting across the aisle and one row in front of me opened the can of apple juice he’d been staring at for almost an hour. He filled his plastic glass then looked at me with a knowing look and asked if I wanted the rest. His offer was unexpected and the perfect solution at the perfect time. I accepted with a nod and a smile. He smiled back. I quietly offered a thank you.

That was the extent of our interaction. We had not been conversing and we didn’t begin to at that point. This man was simply attuned enough to recognize my need and I was willing to accept his gift. It was the kind of powerful everyday moment that can feed our hearts, mind, and spirits when we allow our minds to be open and our hearts willing to receive.

Taking the apple juice from a stranger allowed me to finish the flight with no ill effects. For that stranger, I am grateful. For that juice, I am grateful. For that moment, I am grateful.

Oakwood 2Server card ad