As far as I know, today went fine. I had lunch with family and got a scramble with eggs, vegetables, black beans, chicken and potatoes. As far as I know, all of that is fine. But I don't know if that's all that was in there. I didn't get the cheese or the sour cream or the toast. I didn't put creamer in my coffee or ketchup on my potatoes. I avoided everything I know I should, but I didn't ask exactly how the potatoes or chicken or eggs were prepared and whether it involved any milk or butter or something that could carry sulfites. Since any allergies I have haven't caused a serious, acute reaction so far, I'm not as motivated to seek out every single ingredient in everything I eat as I would be if there was a serious possibility of my airway closing. This is good, but it also means I'm not treating this like my life depends on it, and it leads me wonder whether I'm doing enough.
My breathing has been kind of cruddy the past couple of days. Not the worst it's ever been, but I'd say a 6 or 7 if 10 was the worst. There was a time a few weeks ago when I strictly avoided everything that could cause me a problem for about five days. By the end of that, I was feeling pretty good (which is why I tend to think food has something to do with my breathing in the first place). But right now, while I'm trying to avoid the potential problems while waiting to feel better, I'm having a hard time believing I'm doing the right stuff and that I should give it more time to kick in. Last night I was in Barnes & Noble looking at allergy books, and one had an elimination diet that's different from the one I'm doing, and another, written by an MD, sided with the allergist I saw and said that asthma is not related to food allergies. I started getting overwhelmed and wondering whether what I was doing was right, and I finally had to just put them all back and walk away. I really don't know if what I'm doing is going to help, but it's only temporary, and it's almost certainly not going to hurt, so I'm going to give myself until next weekend before getting concerned if I'm not feeling a difference.
Sunday, March 7, 2010
Saturday, March 6, 2010
Day 1: Warming Up
After throwing what was basically a food-avoidance temper tantrum and eating like an idiot for the past two days, today was day one of trying to really avoid dairy, wheat and sulfites, in addition to the soy and nuts I've been staying away from for a couple of weeks. I feel completely like a fish out of water, but I'm learning a few things.
1. Not surprisingly, eating a big lunch before going to a birthday party is a good idea. I met up with my cousin and his family for his daughter's birthday party. Before I went I had a huge bowl of brown rice, eggs, steamed greens and a sweet potato. That made it a lot easier to pick the pineapple out of the fruit salad and not eat everything on the table and wash it down with a glass of wine and half a tray of brownies.
2. I'm probably not ready to eat out. I met up with friends for dinner at a Vietnamese restaurant. I figured as restaurants go, Asian would be pretty safe in terms of dairy and at least navigable for soy, wheat and nuts. What I didn't think about is that I am not familiar enough with Vietnamese food to know what goes into everything and whether it's going to be a problem. Without thinking, I drank the tea they had on the table before remembering it's on the sulfite no-no list. I ordered a vermicelli soup with duck and shredded cabbage, but when it came, I just ended up really suspicious of all of it. Was the cabbage pickled? Was there soy sauce or something sulfitey in the broth? Were they really rice noodles? I ate it, and felt sort of vaguely guilty about it, like I should have been more careful. I didn't know for sure any of it was out, but if I'm going to do this, it's probably better to take the "guilty until proven innocent" approach to eating. I'm sure the combination of mentally putting my dinner on trial and also not being able to breathe very well made me a fantastic dining companion.
3. There are sulfites in Sriracha. That's messed up.
1. Not surprisingly, eating a big lunch before going to a birthday party is a good idea. I met up with my cousin and his family for his daughter's birthday party. Before I went I had a huge bowl of brown rice, eggs, steamed greens and a sweet potato. That made it a lot easier to pick the pineapple out of the fruit salad and not eat everything on the table and wash it down with a glass of wine and half a tray of brownies.
2. I'm probably not ready to eat out. I met up with friends for dinner at a Vietnamese restaurant. I figured as restaurants go, Asian would be pretty safe in terms of dairy and at least navigable for soy, wheat and nuts. What I didn't think about is that I am not familiar enough with Vietnamese food to know what goes into everything and whether it's going to be a problem. Without thinking, I drank the tea they had on the table before remembering it's on the sulfite no-no list. I ordered a vermicelli soup with duck and shredded cabbage, but when it came, I just ended up really suspicious of all of it. Was the cabbage pickled? Was there soy sauce or something sulfitey in the broth? Were they really rice noodles? I ate it, and felt sort of vaguely guilty about it, like I should have been more careful. I didn't know for sure any of it was out, but if I'm going to do this, it's probably better to take the "guilty until proven innocent" approach to eating. I'm sure the combination of mentally putting my dinner on trial and also not being able to breathe very well made me a fantastic dining companion.
3. There are sulfites in Sriracha. That's messed up.
The Good, the Bad, and the Challenge
Keeping the food log last week was helpful. Because I was keeping track of everything and knew someone else was going to look at it, I ate pretty well, avoided soy and nuts (well, except for some cashews on a salad...). In my first visit they said that wheat and dairy can promote inflammation and probably aren't helpful, so I largely avoided them, too. And then Wednesday night happened. Wednesday night I went to a wine tasting with friends. It was lovely. Eight wines with bread and four or five cheeses and a platter of chocolate to match. I had some of all of it, and then Thursday couldn't breathe very well. So of course on Thursday I had more wheat and dairy, and made matters worse. When I went in and reported all of this to my naturopathic friends on Friday, they suggested I do a challenge diet to figure out what's going on. As part of the challenge diet, they have asked me to completely eliminate certain foods for two weeks, watch my symptoms, and then introduce one category of food at a time, every few days, and to see how my body reacts. This sounded challenging, but reasonable enough, until I started to take stock of exactly what they asked me to eliminate: dairy, gluten, and sulfites.
The dairy I expected, and I can do. The hardest part of that is giving up the half and half in my Americanos. I can avoid cheese and drink black coffee for two weeks.
I was expecting them to ask me to avoid wheat. I can handle no bread, tortillas or crackers temporarily. But in researching it further, avoiding gluten also means no oats or barley (aka beer). That's a little harder, but alright. That brings me to sulfites... I had never heard of sulfite allergy until yesterday. I had never thought about sulfites and what they might or might not be in, but it sounds like they're in all kinds of stuff, and some of it I like. Like wine. I like wine. Unfortunately, I won't be drinking it for at least two weeks. Sulfites are also in dried fruit. And shrimp. And guacamole. That's kind of a low blow. Add to that the soy, peanuts and tree nuts that I'm already trying to avoid, and things are getting really tricky really fast.
So far, here's what I have...
The GOOD (foods I can have):
fruits and vegetables - especially dark leafy greens, sweet potatoes, tomatoes, oranges, and broccoli)
whole grains with no gluten - brown rice, quinoa, and some others I've never tried
beans
corn
fish, chicken, turkey and beef (assuming they don't have sulfites)
eggs
olive oil
The BAD (out for 2+ weeks):
Soy - tofu, edamame, miso, tempeh, and everything else that uses it
Nuts/Legumes/Seeds - peanuts, almonds, hazelnuts, other tree nuts, and sesame seeds
Dairy - milk, cheese, cream, yogurt, cottage cheese, butter, chocolate etc. etc.
Gluten - wheat, bread, pasta, oats, beer, gravies, custards, ketchup, soy sauce, malt vinegar, cereal, cookies, cakes, what am I missing...?
Sulfites - baked goods, soup mixes, jams, canned vegetables, pickled foods, gravies, dried fruit, alcohol, beer, wine, vegetable juices, bottled or canned juices, tea, condiments, shrimp, molasses
Where does that leave me? Sort of overwhelmed. And hungry. And open to suggestions. Any ideas for foods or recipes that don't use any of the eliminated foods are greatly appreciated. As are thoughts of things I can eat when I'm out and about, because I don't have the best track record of making all of my own food ahead of time.
Dear god, help me.
The dairy I expected, and I can do. The hardest part of that is giving up the half and half in my Americanos. I can avoid cheese and drink black coffee for two weeks.
I was expecting them to ask me to avoid wheat. I can handle no bread, tortillas or crackers temporarily. But in researching it further, avoiding gluten also means no oats or barley (aka beer). That's a little harder, but alright. That brings me to sulfites... I had never heard of sulfite allergy until yesterday. I had never thought about sulfites and what they might or might not be in, but it sounds like they're in all kinds of stuff, and some of it I like. Like wine. I like wine. Unfortunately, I won't be drinking it for at least two weeks. Sulfites are also in dried fruit. And shrimp. And guacamole. That's kind of a low blow. Add to that the soy, peanuts and tree nuts that I'm already trying to avoid, and things are getting really tricky really fast.
So far, here's what I have...
The GOOD (foods I can have):
fruits and vegetables - especially dark leafy greens, sweet potatoes, tomatoes, oranges, and broccoli)
whole grains with no gluten - brown rice, quinoa, and some others I've never tried
beans
corn
fish, chicken, turkey and beef (assuming they don't have sulfites)
eggs
olive oil
The BAD (out for 2+ weeks):
Soy - tofu, edamame, miso, tempeh, and everything else that uses it
Nuts/Legumes/Seeds - peanuts, almonds, hazelnuts, other tree nuts, and sesame seeds
Dairy - milk, cheese, cream, yogurt, cottage cheese, butter, chocolate etc. etc.
Gluten - wheat, bread, pasta, oats, beer, gravies, custards, ketchup, soy sauce, malt vinegar, cereal, cookies, cakes, what am I missing...?
Sulfites - baked goods, soup mixes, jams, canned vegetables, pickled foods, gravies, dried fruit, alcohol, beer, wine, vegetable juices, bottled or canned juices, tea, condiments, shrimp, molasses
Where does that leave me? Sort of overwhelmed. And hungry. And open to suggestions. Any ideas for foods or recipes that don't use any of the eliminated foods are greatly appreciated. As are thoughts of things I can eat when I'm out and about, because I don't have the best track record of making all of my own food ahead of time.
Dear god, help me.
Trying Something New
I think I understand why the allergist says that he doesn't think food allergies have anything to do with my asthma, but there's a reason I disagree. It's true, I don't typically have anaphylactic-type reactions to foods. Soy milk (not edamame or tofu--just soy milk) makes my throat swell and my mouth itch, but other than that, I don't have acute reactions to things I eat. What I have noticed is that it is not uncommon for me to be breathing pretty well before a meal, and then to be gasping for air shortly after eating. To me that says there's something going on with the food.
Because I want to figure out what's going on that is making my body so mad, last week I went to a naturopath. Actually, I went to the teaching clinic affiliated with the major natural medicine university located outside of Seattle. I met with two advanced students, supervised by a naturopathic physician. The students were great. They spent an hour and a half with me, got a really complete medical history, asked about my symptoms, how long they had been occurring, what else was going on in my life at the time and what my home and family life were like. They explained what they call the bucket theory, that you can think of your body as a bucket with a spigot at the bottom. Stressors fill up the bucket, and your body eliminates them through the "spigot" of your lungs, skin and digestive tract. If you take on more than your body can eliminate, things get out of whack. That made sense to me and seemed like it could be consistent with what I'm experiencing. Even if I'm not "allergic" to certain things by the allergist's definition, maybe I'm sensitive to things and my body is overloaded and staging an immune response unnecessarily. The students and their supervising physician prescribed me a couple of things to help bring down inflammation and asked me to keep track of what I ate for a week and then to come back for a follow-up visit to figure out what's next.
Because I want to figure out what's going on that is making my body so mad, last week I went to a naturopath. Actually, I went to the teaching clinic affiliated with the major natural medicine university located outside of Seattle. I met with two advanced students, supervised by a naturopathic physician. The students were great. They spent an hour and a half with me, got a really complete medical history, asked about my symptoms, how long they had been occurring, what else was going on in my life at the time and what my home and family life were like. They explained what they call the bucket theory, that you can think of your body as a bucket with a spigot at the bottom. Stressors fill up the bucket, and your body eliminates them through the "spigot" of your lungs, skin and digestive tract. If you take on more than your body can eliminate, things get out of whack. That made sense to me and seemed like it could be consistent with what I'm experiencing. Even if I'm not "allergic" to certain things by the allergist's definition, maybe I'm sensitive to things and my body is overloaded and staging an immune response unnecessarily. The students and their supervising physician prescribed me a couple of things to help bring down inflammation and asked me to keep track of what I ate for a week and then to come back for a follow-up visit to figure out what's next.
Background
In spring of 2007 I started having trouble breathing out of nowhere. It wasn't a crisis, but I just couldn't get a good, deep breath. I was diagnosed with asthma, given an albuterol inhaler and referred to an allergist. Based on skin-prick tests I was told I was highly allergic to soy, peanuts, peas, lima beans and almonds, and a little less allergic to rice, lobster and navy beans. According to the skin tests, I was also allergic to cats, most trees, grasses, weeds and house dust.
I gave up all of the foods I was told I was allergic to, cleaned up my apartment and got an air filter, but the breathing didn't get any better. I was cranky from not being able to eat so many things I loved, so I chalked the breathing up to the bad air quality in Los Angeles, and that's where it left off.
Since then I've moved from LA to Seattle and my breathing has gone through phases of being being fine and phases of being difficult. Lately, it's been difficult. When I couldn't handle 10 easy minutes on the stationary bike because I couldn't get enough air, I decided it was time to finally handle this for real, so I went back to the doctor, where I got referrals for another round of allergy testing and a lung function test, and a prescription for an inhaled medication used for COPD patients. According to the recent skin test I'm still highly allergic to soybeans, peanuts and almonds, and he added hazelnuts and sesame to the list (and, of course, the dust, the trees and the cats). The allergist doesn't seem to think the food allergies have anything to do with the asthma (I don't necessarily agree). He prescribed a different inhaled medication for COPD patients, along with an EpiPen, in case any of my allergies go anaphylactic. According to the lung function test, my lung volume and function are good, but according to the tech there's something about the ratio of the two that is not right and points to an obstruction. I haven't had a follow-up appointment to know what the pulmonologist says.
So far I know the following:
1. Something (or things) makes my body mad
2. It's not in my head (thank you, respiratory tech)
I guess it's a start...
I gave up all of the foods I was told I was allergic to, cleaned up my apartment and got an air filter, but the breathing didn't get any better. I was cranky from not being able to eat so many things I loved, so I chalked the breathing up to the bad air quality in Los Angeles, and that's where it left off.
Since then I've moved from LA to Seattle and my breathing has gone through phases of being being fine and phases of being difficult. Lately, it's been difficult. When I couldn't handle 10 easy minutes on the stationary bike because I couldn't get enough air, I decided it was time to finally handle this for real, so I went back to the doctor, where I got referrals for another round of allergy testing and a lung function test, and a prescription for an inhaled medication used for COPD patients. According to the recent skin test I'm still highly allergic to soybeans, peanuts and almonds, and he added hazelnuts and sesame to the list (and, of course, the dust, the trees and the cats). The allergist doesn't seem to think the food allergies have anything to do with the asthma (I don't necessarily agree). He prescribed a different inhaled medication for COPD patients, along with an EpiPen, in case any of my allergies go anaphylactic. According to the lung function test, my lung volume and function are good, but according to the tech there's something about the ratio of the two that is not right and points to an obstruction. I haven't had a follow-up appointment to know what the pulmonologist says.
So far I know the following:
1. Something (or things) makes my body mad
2. It's not in my head (thank you, respiratory tech)
I guess it's a start...
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