A primer on how to feed your food allergic friends

***this is the post I have submitted to purely elizabeth  for their monthly newsletter! As always, this should not be considered medical advice as I am not your medical provider. I am an ambassador for purely elizabeth and they provided the cookie mix mentioned in this article, but it's actually one I use on a regular basis that I purchase myself. ***

After the question, “what can you eat?”, the second most common thing my friends and acquaintances want to know is how to feed me when I come to their homes.  And after a recent poll, this is the question they wanted me to write about next. 

            Recently, I attended a two separate parties at two different friends homes. Both bought gluten free goodies just for me because they are such great friends but in one case I got “glutened” and in the other I didn’t.  What happened? Well, the first friend bought a fruit and veggie tray and the dressing was GF.  I brought GF pretzels and she also bought some GF cookies from a local bakery so I could join in the festivities. Isn’t she so sweet?? I had a little bit of all of the above and had no issues. 

            The second friend bought some packaged GF crackers and chips but the dip she bought was actually from a buffet style service area at the grocery store and the snack mix which consisted of theoretically GF ingredients was also from a self serve granola bar.  Again I had some of everything but this time I had a reaction.  What happened?

            Well, the problem is that when you are dealing with food allergies or a disease such as celiac disease, contamination can be just as much of an issue as actually eating something that contains the offending ingredient.  So things such as bulk dispensers, while sometimes cheaper, pose a significant risk of contamination.  Most people are not aware of this and tongs get used from one item to another without thought to possible contamination.  Even bulk containers that empty at the bottom may be dangerous as they may not always contain the same item and may not be cleaned thoroughly in between.

            Another area of cross contamination occurs in the kitchen. It is always very kind when someone offers me gluten free pasta.  However, if you are using the same colander to drain both GF and regular pasta, it is likely being contaminated. Colanders are notorious for all of their little nooks and crannies, which make great hiding places for remnants of pastas past.  Plastic colanders are the worst.  Plastic and wood utensils are also great hiding places for gluten.  And stoneware baking pans can also harbor leftover gluten.  It can’t be baked away.

            So how do you cook for your friend with out causing them to break out, rash up, run to the bathroom, or turn blue??  First, your best bet is very well scrubbed stainless steel pots and pans and utensils.  And use a clean sponge when washing them!! Sponges harbor all kinds of stuff, including little bits of old food! (kinda gross really…I like to use a clean cloth each day) Plates washed in the dishwasher are fine or plates washed with a clean sponge work too.  New disposable plates and utensils are great, especially for outdoor affairs.

            The next area to pay attention to is the prep area.  The general rule of thumb is to start with a clean surface and prepare the allergen free food first.  This can largely eliminate the possibility of contamination when preparing different foods.  Placing a piece of parchment paper or saran wrap down on the counter can also lessen the chance of contamination.

           

            My biggest surprise was the coffee pot!  I have one friend who is so highly allergic to hazelnuts that I can’t make her a pot of coffee because I’ve made hazelnut coffee in my coffee maker and any trace of it will cause her to have an anaphylactic reaction.  Prior to my celiac days, I never would have considered that!

            Please also note, if you typically grill your buns or use sauces that contain wheat, such as regular soy sauce, don’t use your grill to cook for someone with wheat sensitivities or celiac disease without first placing at least one layer of tin foil between their food and the grill. 

            So now, what to serve them?  If your friend has celiac disease like me, they can’t have wheat, rye, barley and most oats.  Easy right? Not really because it’s the gluten that is the issue and gluten lurks in all kinds of products you would never suspect!  Canned beef broth? Yep, it’s in there! (my dad got me at Christmas with this one…)  Soy sauce? There too.  Ice cream?  Yes, unfortunately many of them contain gluten.  Flavored coffee?  Very likely.  Amazing isn’t it?

            Now that I’ve scared you, here’s a safe list for those with gluten “issues”(this list is NOT all inclusive):

All fruit

All veggies, including corn

All natural meats that do not contain injected broth, i.e., chicken, beef, pork, lamb, fish

Plain rice-white, brown, black, red, etc.

Quinoa (keen-wah)

Nuts

Plain spices, such as salt and pepper

Fresh herbs and most plain dried herbs (avoid mixes)

Dairy (but some also have lactose intolerance)

Gluten free crackers (such as Crunch Master)

Gluten free cookie mixes (such as purely elizabeth oatmeal cherry chocolate chip – my favorite!) baked on parchment paper

            Your best resources will be your friend and Google!  Ask if they have a favorite recipe they’d like to share. Or, if they are coming to a party, ask if they can bring a GF dish.  Check out the recipes on this website or you can Google your friend’s food sensitivity for a recipe to try.  There are a zillion resources out there.  Most of us are so thrilled that someone would try to accommodate them that we are grateful for all of your efforts.  Ultimately, it’s up to the person with the sensitivity to ensure that what they are eating is safe.  And if it’s a child, it’s the parent’s responsibility.   It does make going out much more pleasant though if others are willing to change what they do so you can enjoy a meal together! So thank you so very much for caring and making the effort to include us at mealtime and celebrations!!

Gluten, Karma and Full Disclosure...

Not so long ago I was one of those people who became annoyed with food allergies.  I'd think, "good grief, you're overreacting. Get over it. What's wrong with everyone?" I dated someone with a tree nut allergy and I just didn't get it. Peanuts were ok, but walnuts aren't? Huh? And I'm a nurse!

If you think I'm a jerk, you're probably right.  I just didn't understand food allergies.  And there are still a lot of people out there who don't either. Take my dad, for instance. This last year, after being diagnosed with Celiac disease and explaining to my parents why I couldn't eat the turkey that was stuffed with bread, and that I would make the gravy because my dad only knew how to make it with flour and please don't double dip into anything and contaminate it...uuuuuuuhhhhhhh <deep breath>...my dad takes his ladle of gravy and drags it through his pile of stuffing and says "like that?" and puts it back into to ONLY gravy boat. I guess it serves me right.

Karma. I don't believe in it. I believe that we reap what we sow in a biblical sense, not a buddhist one, or whatever religion karma belongs to.  But if there was karma, I guess you could say I am experiencing it.  You would think I'd have been more sensitive to other people since I've suffered with lactose intolerance, allergies to my pets, intolerance to chicken, shrimp, raw anything, and heck, at one point I couldn't even CHEW bread!  But I wasn't.  I was a jerk.  Kinda like Martha Stewart.  But we won't go there....

My food intolerance journey began after my son was born in 1994.  I'd always just had a stomach ache as a kid. Then, after C was born, I started finding myself running to the bathroom every time I ate. I was losing weight and people at school were asking me if I was ok.  I saw my doctor for a sinus infection and told him about it. He said it sounded like lactose intolerance and to stop eating dairy.  So I did. And the symptoms went away. Two years later, by the time I was pregnant with my daughter I could eat dairy again.

By then, however, I also found myself allergic to cats and dust and rabbits.  I thought it explained my chronic sinus infections.  A few years later I started being unable to eat anything without being doubled over in pain. So I would go all day at work eating only a small piece of chocolate and drinking coffee because, somehow, these were the only things I could eat without doubling over!  Then I'd go home, eat dinner, and suffer for hours until I finally could "use" the bathroom.   I gotta say that my boyfriend at the time was saintly about this because let me tell you, that ain't sexy!

I went back to my doctor who had been diagnosing me with "colitis" and GERD, IBS, and even an ulcer.  He immediately sent me to a gastroenterologist who saw me the next day.  A minimal exam later and he said it was IBS,  gave my a prescription for dicyclomine and sent me home with no real guidance on what to do.  Of course the meds didn't work.  Do they work for anyone? Ever?

Eventually I figured out that shrimp, milk, and  raw food were bothering me.  I cut them out and things got better.  Then my jaw tightened up and I couldn't chew.  I was told I had TMJ.  <sigh>  I know there will be someone reading this someday who completely understands how I was feeling right about then.  It gets better.

Forward a couple of years and suddenly I couldn't eat chicken without pain.  Chicken? What is life without hot wings?  How is anyone allergic to chicken?  So I didn't eat any poultry for 2 years.  Then one night I ate some duck and was fine. I did a happy dance and started hesitantly eating poultry again.  Hot wings were once again on the menu!

Things weren't great in the GI arena but they were sort of tolerable for a while. Running to the bathroom midway through a meal was pretty routine for me so I didn't sweat it anymore.  Then I became pregnant with my twins.  Any woman who has been pregnant knows what kind of trouble pregnancy can wreck on your GI system.  Not pretty.  But once the babies came, it took a few months, but things got back to "normal."

Last summer, however, I got a new job.  Sure I was nervous and I always considered myself to have a "nervous stomach" but it was getting ridiculous. I also couldn't understand why even though the babies were now sleeping through the night, I was feeling worse and worse.  Then I stumbled upon a chiropractor who gave me information on an anti-inflammatory diet that talked about wheat and gluten causing  the symptoms I was having.  And my new doc said she would test me for Celiac disease but that I should try an elimination diet first.  So I did. And the test was positive.

So as you can see, I kind of deserved this.  Perhaps God is trying to make me more sympathetic toward others with food allergies?  It is certainly an effective method of convicting you for being a jerk and straightening you out!  Score one (million) for God.  I was wrong.  I apologize.  In fact, I'd like to help.  Just please don't send me down to live with the pygmy's in Borneo. Ok?  Karma. Don't believe in it, but certainly living with it.

Sunday Afternoon and the Hot Dog Argument

Probably most people with celiac disease, wheat allergies, or any other food allergy live with someone else who doesn't have the same issue(s).  Some homes are allergy free, others coexist.  Hopefully if you live in a home that coexists, you have food rules that you follow.  Rules such as not double dipping into jars. Cleaning off countertops after preparing food. Not using stoneware, wood utensils, or cutting boards for allergens.  Keeping allergen containing foods in a separate cabinet below non-allergenic food. The list goes on. There are many ways in which you can arrange your kitchen to maintain safety.

In our home, my husband said "your disease is my disease" and we replaced all of my precious Pampered Chef stoneware that was blackened by age and perfect seasoning. We tossed all of the wooden utensils and called Pampered Chef again.  Out went to old cutting boards, wood or plastic and I bought new bamboo boards. I cleaned out cabinets and declared gluten free zones. I always try to clean as I cook, which makes after dinner clean up easier too. I also tossed the old plastic colanders and bought new stainless steel ones that can be scrubbed well.

But "my disease is your disease" does not, apparently, pertain to hotdog rolls.  My husband makes a valiant effort at looking at most labels to check for gluten ingredients or a gluten free label.  But he doesn't believe a hot dog can be served adequately on a plate and must be ensconced in bread. Wheat bread. The stuff that makes me break out in hives and destroys my intestines.  You know, the ENEMY.

So yesterday he wanted chili dogs. I bought grassfed, organic, uncured hotdogs and a can or organic vegetarian chili because it was the only gluten free soy free one available.  I didn't think about getting hot dog rolls until on the way home. I am programmed to not even think about buying bread so this was not on purpose.  I didn't make a second stop because I felt we could just put it on a plate. I was wrong.  My husband ate his hot dogs just fine but was decidedly disappointed. So disappointed that he stopped on his way home last night to buy Hormel chili (it's gluten free after all!), Bar S (yes, Bar S) hotdogs, Nathan's hotdogs (also labeled GF), and HOT DOG ROLLS (definitely NOT GF).  He said he had a "bachelor moment" and also bought a few cans of, God help me, Chef Boyardee ravioli.

It's not that I am even tempted by this stuff.  I get heartburn just thinking about eating it.  And the idea of sticking a Bar S hotdog in my mouth knowing what happens to those poor animals makes me gag.  It's the principle of it.  And the fact that "your disease is my disease" does not extend to something like a hotdog.  It rubbed me the wrong way. And then.

And then I came home from church this morning to the announcement that my husband had made chili dogs for everyone for breakfast. Ok. The kitchen was cleaned up and looked as good as I left it.  But when I went into the fridge to look for my own hot dog, I found the Bar S package in the same baggie as my beautiful grassfed, organic, uncured hotdogs. Pools of God-only-knows-what from the "other" hotdogs swirling about in the bottom of the bag, contaminating my potential meal. "Just wash it off."  Can you see the steam that came out of my ears??? If you are as vigilant about what you eat as I am, I'm sure you can. Especially if you can also imagine being hungry because you haven't eaten all morning and it's after noon.

If there is one thing I despise fighting about, it's food.  There are so many out there without access to ANY food, let alone healthy organic food, that it seems ridiculous to allow this to cause an argument.  But it did.  I suppose I could just give up eating hotdogs all together and then it wouldn't matter what is in the bag.  A hotdog is, after all, a hotdog.  No matter how it's raised, it's still mainly leftover bits. What doesn't become hotdogs becomes bologna.  I'd rather have a steak anyway.  But still.

Why share something like this? Because I figure if we go through this, other people must also.  I can't imagine there is anyone who has not fought some kind of food battle since being diagnosed with an allergy.  My husband has been able to embrace almost all of the changes in our diet since my diagnosis, especially because I do most of the cooking.  But we still argue over hotdogs. Some of your battles may be with the school snack policy, or in the workplace fridge, or, as in my case, in your home. But,  to me, the battles at home are the most personal because the people you live with, probably your family, should care the most. Right?  Or wrong?

What are your battles?

Liz
And no, I don't get any kick backs or any other kind of profit from mentioning any specific companies.  Names are used only to make my point! ( and hopefully I don't get sued...)

Autoimmune disease "relatives" and a little help from a friend

Ever wonder if autoimmune disease comes in "clusters" or how it relates to inflammation? Or what about comorbidities (ugly word for "things that go along with or affect your disease)?  Or how common is this stuff, really?

Well,  I was reading an online CME (continuing medical education) activity on psoriasis and rheumatoid arthritis tonight and was struck by a few things. I thought I'd share a couple here.  And yes, there is something about celiac too!

First, psoriasis affects about 2% of the population in the US. It seems like more than that to me but I work in rheumatology so my view is a bit skewed.  The inservice I read said that about 70% of people are undertreated and only receive topical treatment for the disease.  Moderate to severe disease is related to an increased risk of cardiovascular disease and metabolic disorders.  There is also a relationship between psoriasis and an increased risk of lymphoma, squamous cell skin cancer, Crohn's disease, multiple sclerosis and Type 2 diabetes.

The same mechanism for the development of psoriatic plaques (the scale-y stuff you see on someone's skin who has psoriasis) is also responsible for the development of atherosclerosis. T-cells in the lymph nodes travel to and adhere to blood vessels and produce chemicals called cytokines and chemokines that induce inflammation.  This results in plaque formation. Hmm. So inflammation=atherosclerotic plaques building up in your arteries contributing to cardiovascular disease. Well, what about cholesterol? (I think I'll talk about that elsewhere, but think about it.)

Next, rheumatoid arthritis (RA) affects approximately 1% of the US population. It too carries an increased risk of lymphoma.  Both are aggravated by stress, smoking and obesity. RA is also  inflammatory in nature and carries increased risk of cardiovascular disease. 

So, how many people do you know with RA? And how many people do you know with psoriasis? Approximately 1% of the US population is believed to have celiac disease. That's the SAME AS RA and half the rate of psoriasis. How many people do you know with a diagnosis of celiac disease? Before my foray into being diagnosed with celiac disease last year and working in rheumatology I knew precious few people, maybe 1, with celiac disease but many many more with psoriasis and RA. That's because up to 70% of people with celiac disease are undiagnosed.  They are hanging around with a label such as irritable bowel syndrome, lactose intolerance, "colitis," depression, arthritis,  fibromyalgia, etc., when really what they have is undiagnosed celiac disease or non-celiac gluten intolerance.  And it carries what all of the other false diagnoses don't-and increased risk of lymphoma and osteoporosis, anemia and vitamin deficiency, and inflammatory damage to your gut!

My first thought was, wow, there are the same number of people with RA as there are with celiac disease.  And second thought is something like, if our rheumatology practice thrives on patients with RA, doesn't gastroenterology thrive on celiac patients? Based on my experience it does not. My first experience with a gastroenterologist 10 years ago gave me a diagnosis of IBS and sent me on my merry way. My second experience last fall gave me my diagnosis, but no follow up has been recommended.  I was essentially sent back to primary care who, in my case, was really not up to date or educated about celiac disease.

Luckily, I'm also a healthcare provider and a voracious reader. I could spend hours researching online.  I was able to settle into my new gluten free existence without too much fuss especially because I have been tweeking our eating habits for the past two years and going gluten free wasn't quite the hurdle it could have been.  But what about all of the "lay people" who get diagnosed? No one even recommended I see a dietician and the nutritionist I saw was completely unhelpful.  She just wanted me to take a bunch of supplements that conveniently she sells at her store. That didn't settle too well with me.

After months of consideration I've decided that I want to be the help and support for those newly diagnosed or those who think they may need to get diagnosed as well as those who have been doing this for a while and just want some more support working out the kinks.  Yes, I am an Arbonne consultant as well, but I'm not doing this to sell anyone anything other than my knowledge and experience.  I want to be a supporter, encourager and partner in your journey to gluten free-dom.  Need help? Contact me at glutenfreenp@yahoo.com.  Let's see what we can do together for the "health" of it! :)