An article, and a trip down memory lane

This article - a great read - was in today's New York Times Magazine:

The Boy with a Thorn in His Joints

It's about a little kid who was diagnosed with juvenile idiopathic arthritis and assigned a battery of prescription drugs as treatment. When the pharmaceuticals didn't work, the boy's mom (who penned the piece) decided to take a more holistic approach and sought a supplemental, diet-based treatment. Six weeks after the little boy stopped consuming gluten and dairy products, his illness became inactive, and he was able to ditch the medication.

Of course, it's one kid. It's not proof that going GF cures autoimmune diseases. The author fully accepts this. But as she also points out, "Data on diet and supplements are lacking, at least partly because they are hard to get. It’s hard to design a great study around something with so many variables, like the food we eat. Pharmaceuticals, on the other hand, lend themselves easily to randomized, double-blind, placebo-controlled clinical trials."

With the exception of some brief and regrettable forays back into the world of wheat, I've been gluten free for three years now. To a significant extent, I'd forgotten why, exactly, I decided to alter my diet in the first place. So I went back and reviewed my journal entries from around that time. They helped me remember just how sick I felt (headaches, chest pain, acid reflux, sinus infections), and just how quickly relief followed the dietary modifications I made.

A few examples:

Dec. 15, 2009:

I told A. [a naturopathic physician] about my acid reflux issues and how I sometimes feel like my sinuses and throat get all swollen after I eat. She thinks I have a food allergy (maybe several food allergies). Apparently, GERD and food allergies are often related - though did my stupid doctor bother to tell me this during our 15 minute follow-up session this summer? No. (Not real happy with the general practitioners I've seen lately...) A. recommended that I try eliminating soy, wheat, dairy, eggs, and nuts for several weeks, then introducing them one by one. Blurrrrgh. She's right; I need to do it. But it's difficult, especially around the holidays.

I haven't been eating much wheat or soy recently, so I think I'll start with those. The food plan I was following at the end of November didn't include any wheat products, and I can easily substitute my soy milk with rice milk.

I'm pretty sure it IS an allergy, but it's so weird that it developed recently. I never had this issue when I was a kid.

Dec. 17, 2009:

I'm pretty sure I'm allergic or at least intolerant to wheat. I've been keeping track of what happens after I eat it, and usually my body responds in the following way (within 30 minutes or so of consuming wheat products):

-Sinus congestion

-Lump in throat/swelling of throat (isn't too bad, but of course this is a problem and I need to get it checked out!)

-Wheezing

-Headache

-Chest pain

I looked it up and - surprise! - wheat allergies CAN cause chest pain, which was the reason I went to the doc last summer in the first place.

You would think this would have been more obvious to me before now, but... nope. Once I was diagnosed with acid reflux, I just figured all of the above symptoms made sense.

I guess it could also be a dairy allergy (because I often consume cheese with wheat), so I need to experiment more. However, I've been eating cheese for breakfast on many days, and it doesn't seem to affect me.

I know I can give up wheat, so I'm kind of hoping I've pinpointed the problem. I'd rather change my diet than continue taking medicine that isn't helping. I guess I should contact my doctor and ask for a referral so that I can see an allergist in the new year.

Dec 20, 2009:

Eating has been a little tricky. I don't know what my deal is. I seem to be having weird reactions after I eat, but pinpointing what is causing them is tricky. T. made me an omelet yesterday morning before we left, and I felt HORRIBLE after eating it. I basically had an asthma attack. WTF. I've eaten eggs all my life and never had any problems with them. So... yeah. I'm limiting myself to fruits, veggies, and non-processed meat. And Enjoy Life snacks, which don't contain eggs, dairy, etc. I also tried some soy milk today to see if it affected me (didn't seem to, so maybe that's okay?). I don't understand why my body is freaking out on me. I know I need to see my doctor again - because what if it's not allergies? What if it's something else? - but she was such a butthead the last time that I don't really feel like giving her my business. She doesn't listen.

Jan 14, 2010:

Since right before Christmas, I've been avoiding wheat, corn, soy, and eggs. I'm almost certain I have a wheat intolerance. It's known to cause headaches and chest pain, both of which I often had before I changed my diet (I was diagnosed with GERD specifically because I had inexplicable chest pains). I haven't experienced either in the last few weeks. The post-meal throat inflammation is also gone. I had a really strange reaction after eating a couple of scrambled eggs right before we went to Chattanooga, so I'm off those, too. As for soy and corn, they're in so many processed foods that I decided to dump them as well. So far, I don't miss them - or any of them, really.

I am shocked at how easy it's been to give up pastries, cookies (well - except for the Enjoy Life gluten-free cookies, but they're kind of pricey so I can't eat a ton of them anyway), bread, waffles, cereal, etc. It's amazing. Keep in mind that I am not a very patient person. I don't do well with cravings. If I crave something, I eventually end up eating it. But I honestly have absolutely no desire to scarf down processed carbs.

We're doing a lot more of our own cooking using whole, natural ingredients. What I've been eating:

Breakfast: Rice grits cooked with apples, bananas, or other fruit and drizzled with honey. That might sound gross, but OMG, it is so good! I've always had trouble stomaching oatmeal, but rice grits are easy. Sometimes I have a piece of cheese, too.

Lunch: Usually dinner leftovers.

Dinner: Meat and veggies or rice and veggies. We have had homemade beef stew (which was actually really good, though so filling that I felt stuffed for hours afterward), rice pasta and sauce (rice pasta is awesome - it doesn't get as mushy as regular pasta), soup, and chicken and veggies. Tonight, we made baked chicken with potatoes, celery, carrots, and red onion. SO DELICIOUS - one of the best meals I've made in a long time, and the only extra ingredients I used were salt, pepper, and a daub of A-1 steak sauce (which, yes, does have some corn starch in it, but which otherwise has a straightforward ingredients list).

Dessert: I'm eating less dessert than I used to simply because the meals really fill me up. When I do need a snack, I go for the afore-mentioned gluten-free cookies, Enjoy Life chocolate, or dried papaya.

Oh, and? I haven't taken my GERD medicine in a week. I have had a little reflux, but that might be because I can eat like a linebacker. I should be able to quell that by going a bit easier at the dinner table. Since the chest pains and throat inflammation are gone, I just don't see a point in relying on a prescription.

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Incidentally, as I was trawling for GF-related posts, I ended up digging through all my other journal entries, too. Just reading them exhausted me. I was an emotional wreck back then. Of course, sometimes I still am - but not the way I used to be. Now I have more good days than bad days. Three years ago? I didn't know what a good day really entailed.

Thursday Three

1. This bar is gluten free, vegan, and amaaaazing:

I woke up late on Tuesday and had to rush to get to my workout class (if you miss it, they charge you $15!!!). I had this bar and some OJ and was pretty much good to go.

What I like about the Bonk Breaker is the texture. It's not as gluey as other energy bars, nor is it as sweet as date-based bars.

2. We finally took down our Christmas tree yesterday. I wrapped up all of the ornaments and placed them in our Christmas decorations bin - the one piece of organization in my entire house.

Every year we get a new glass ornament. This year it was a snazzy red VW hippie bus:

I'm sad to see all the pretty lights and baubles go, but I'm glad I made myself do it. Around here, decorations are liable to stay up for months after the actual holiday.

3. What is up with this whole worst-flu-season-in-10-years thing??? 2/3 of my department are sick. Some of them have the flu and some of them have a stomach bug. Last thing I want is a stomach bug. I have a fear of puking. Like, a real fear. And so I try not to do it. My record for not puking is 13 years - between the time I got the stomach flu in middle school and the time I got food poisoning in grad school. I'd like to break that record.

Depression, etc.: How important is a diagnosis?

At my second therapy session three-ish years ago - right after Therapy Guy finished my intake questionnaire - I asked him what was wrong with me. I wanted a diagnosis. I'd already done my research and had narrowed down the possibilities, so I was quite prepared to handle whatever answer he gave.

"There is nothing wrong with you," he responded. 

Except that answer.

It pissed me off. A lot. How did he know? Had he lived inside my head for the past two decades? Nope. I knew something was not right. He simply didn't know me well enough. Because if he did, he would surely see that there was something very, very, very wrong.

Now that I am familiar with him and his compassionate, kind nature, I know that what he didn't mean was, You're making all this up. You're just some thirtysomething suburbanite with too much time on her hands, and you don't need to be here. Instead, what he meant was, You are perfectly fine and worthy just as you are - you just don't believe it yet. You may be struggling but you can make your life better. 

For a long time, he would give some version of the "There's nothing wrong with you" statement every time I asked him what my problem was. Even when I brought in journal entries that made me sound insane. Even when I cut myself. Even when I called him really late at night from two time zones away, crying into his voicemail. He always insisted that I was an acceptable person, deserving of concern and care, and that there was nothing innately wrong or bad about me.

Therapy Guy is not a big fan of the psychiatric diagnostic manual. He views it as a collection of symptoms ("experiences," he calls them) packaged in a variety of convenient ways. Patients in the mental health system are typically labeled with one of these "experience packages," even though everyone's set of experiences is unique, and even though the labels are often given for the primary purpose of appeasing insurance providers. That is why Therapy Guy doesn't deal with insurance companies, and why he treats the individual, not a diagnosis. I see what he means: looking at the diagnostic manual, I could probably give myself a whole slew of labels, and yet none of them would really fit exactly what I deal with.

On the other hand, his reluctance to offer a diagnosis has always bothered me a little, and when I finally did receive one from my psychiatrist early this year, it was kind of a relief. I deal with symptoms of depression. I deal with symptoms of PTSD. And while that doesn't mean I equate them with who I am or the change I am capable of, yes, it's really nice to have a framework of reference from which to work. (I now realize that Therapy Guy was already working within that general framework, so it's not as if I was totally off track in terms of trying to get better.) My psychiatrist's choice of antidepressant - Zoloft - was based on research indicating that it is effective for PTSD. That's why she picked it as a starting point for me. Pharmaceutically, it gave us a place to begin.

Moreover, it's nice to feel that I am not alone. When I hear someone say that they struggle with depression or PTSD, I know that even though our experiences aren't exactly the same, we share some common ground. I can relate to the challenge. It's comforting. The label - while limiting in some ways, and inadequate - creates a sense of community, and for people like me who often feel isolated and different, that sense of community is meaningful to me.

The important thing to realize about mental health diagnoses (as with many physical health diagnoses) is that they aren't necessarily permanent. Mental health is a fluid thing, and our personal choices play a big role in it. Most psychiatric conditions are treatable. Doesn't mean treatment is easy, but it's possible. So even though I was diagnosed with PTSD in February, I may not always have PTSD (there are many, many excellent treatments for PTSD; with enough time and support, people do recover). And even though I may have a genetic predisposition to depression, I may be able - with help and vigilance - to avoid the worst relapses. 

As Therapy Guy likes to say, People have an immense capacity for change.

Re-establishing the gluten-free habit

I got glutened this past weekend during a camping trip for a class that I'm teaching. Or rather, I glutened myself, which is a much more accurate way of putting it. And I have felt unwell ever since.

We were in a rural area with few food options. We made a delicious, GF (gluten free) camp meal the night we arrived, but I'd forgotten to bring lunch or any truly substantial snacks for the next day. We got up early and drove from stop to stop, and I quickly felt my stomach begin to gnaw on itself. I had an apple handy, and a Larabar, but these were no match for the bottomless, insatiable pit that is my stomach.

By lunchtime I was beginning to feel dizzy and cranky. I could feel the hangriness coming on. So when we stopped at McDonald's (don't ask, not my choice but the only restaurant option where we were), I threw caution to the wind and ordered a snack wrap, fries, and a soda.

Thing is, I've started to wonder recently just how intolerant I actually am to gluten. I've never been officially tested for Celiac disease. After three years of following a GF lifestyle, I've been thinking that perhaps I made the whole thing up just to ride along on the now-crowded GF bandwagon. And I decided to test that hypothesis at a notoriously unhealthy fast food joint... while hundreds of miles from home... during a trip where I was responsible for driving and relaying information to 20 students.

Did I mention that I washed down my lunch with a pack of peanut M&Ms?

Clearly it wasn't just the gluten - McD's is probably tough on even the hardiest stomachs - but I now recall WHY I went GF in the first place. Part of it is the whole bathroom situation. It's partly the really odd, inappropriate gurgling sounds reverberating throughout my belly. Part of it is the fatigue. But another big part - the part I'd completely forgotten - is the feeling that my abdomen is swollen. It's like my insides are sore and inflamed. It's unnerving, and it can last for several days.

I haven't been eating all that well for about a month now. Training for a marathon means that I am hungry all the time, and I've been traveling a lot, which means that I've relied fairly heavily on high-sodium restaurant food and "healthy" snacks from gas stations and airport kiosks. Seeing friends whom I haven't seen in a long time at conferences means that occasionally I've consumed more alcohol than I normally would. So even without the gluten, my digestive system has been suffering. This was just the final blow.

But I'm back on the GF track now, and I'm going to be very careful - especially in these weeks before the marathon - to eat what I know my body likes. Also, I'm going to have to be more diligent about preparing myself for situations where healthy food options might not be readily at hand.

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Tonight my son and I made brownies for his school's bake sale tomorrow. They're gluten free, dairy free, and oil free, and based on the little nibble I had, they're pretty darn good. I hope they sell.

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The marathon is a week from Sunday! I'm so excited. As the event approaches, I'm sure I'll also feel a bit nervous. But mainly I am looking forward to being in Florida with my family and tackling this challenge with my friend.

Forced rest and spicy carrot-bean-garlic soup

Every now and then, it's almost a relief to be well and truly flattened by a seasonal illness - because then I am forced to slow down, regardless of all the things I think I need to do or how far behind I think I'm getting or what a lackluster parent I think I'm being. A minor cold, random stomach issues, a persistent cough - I can work around those things, even if I feel really bad. It's only when I can't get out of bed that I have no choice but to stop and give in.

Wednesday morning, my nose was runny and my eyes were watery, but ragweed levels in our area were high, so I thought that was the culprit. I took some allergy meds and waited to feel better. Nothing happened. Wednesday afternoon, I started coughing. Wednesday night, I felt feverish.

Thursday morning, I stayed home from work and went in only to teach a lab. I thought about asking my advisor (who teaches the lecture counterpart of the course) to take over for me, but he's not one for excuses. Being that I was upright and could drive, I figured he wouldn't be all that sympathetic. During lab I was so wrecked that I wanted to crawl under a table and take a nap, but the students in the class were so pleasantly determined, enthusiastic, and interested in what was an admittedly challenging set of activities that I rallied and tried to meet their level of energy. Did that happen? Not exactly. I sensed that they were taking some pity on me. I must have looked like roadkill by that point.

I slept for a total of maybe three hours on Thursday night and by sunrise I could barely sit up in bed. I ended up working from home and took frequent rest/nap breaks. Normally I'd feel guilty for not going to work, but I realized that I was in absolutely no shape to get behind the wheel, drive 20 minutes on the highway, and communicate with people in a functional manner. Plus I would have passed on this flu to my colleagues.

I'm still feeling exhausted today. I'm also dizzy, but I think that has more to do with me forgetting to take my Zoloft yesterday and this morning (classic symptom of antidepressant withdrawal, according to The Google). Hopefully I'll continue on this upswing and be ready to get back to work, running, and more energetic mothering come Monday morning.

All that said? It does drive me crazy to not be able to do what I want to do, especially run. But I know from past experience that if I try to run while I'm still congested, this thing is just going to drag on.

I did have enough energy to make something yummy and healthy for today's lunch: a spicy carrot-bean-garlic soup. It's a spinoff on one of Marlow's recipes over at Gluten Hates Me (I love that blog - go check it out, even if gluten loves you. She has great recipes.)

I heated oil in a saute pan and added 1/4 an onion and two cloves of garlic. When they were soft (~5 minutes), I added a few handfuls of chopped spinach, a can of garbanzo beans, and ~1/4 cup black beans, stirring occasionally until they were warm.

I also added several dashes of cayenne. Anything to help clear my sinuses.

Once the bean/spinach mixture was hot, I poured in one box of Trader Joe's carrot-ginger soup and let the whole concoction simmer on medium heat until it was steaming. I LOVE this soup. It's delicious - tasty, but not salty or overpoweringly ginger-y.

The result:

I've already had three bowls. Moderation is not my strong suit. But then again, don't they say to feed an illness? I can handle that.

While recovering, I'm reading triathlete Chrissie Wellington's book A Life Without Limits. It is truly inspiring. Of the three running-related books I read this summer - the others being those by Rich Roll and Scott Jurek - I think this is my favorite. Although it's about her life and accomplishments, it's also clearly about the reader. It's making me think about my own perceived limits and the importance of testing them, seeing how far back I can push them.

Her take on rest and recovery: "The idea of rest flies in the face of every value I have lived my life by. I should be the last person to preach downtime, having indulged in so little of it during my life before triathlon, but I am fully converted now. I realize it is not the actual sessions of swim, bike and run that make you fitter, it is the periods you spend recovering in between, during which your body adapts and regenerates. That's why I say I train 24/7 - recovery is training. It's the most important part of it, in fact."

Well okay then. If Chrissie says so, I will go back to sitting on the couch.

Sickie sick

I'm not sure if this is related to the workout-palooza I've been on for the past couple weeks, the start of school and the bringing together of lots of different germs, or my ragweed allergy (likely some combination), but I feel like crap. Stuffy nose. Inflamed sinuses. Watery eyes. Sore throat. Postnasal drip. Yum. Skipped Xtend Barre last night, skipped running group this morning, probably won't work out at all today.