The Curry Hurries

Today’s update comes to you courtesy of my love for all things curry.
Last week, I wrote a post about fructose malabsorption (FM), and the possibility that, because of FM, my love of SCD-legal sweet treats may be complicating or slowing my recovery. This is the first update on my FM experiment since I started minding my fructose, last Thursday (9/16/10). You should know that, at this point in my healing journey with the SCD, my bowels have settled to a range of 1-3 BM/day, depending on what I eat. They are normally 5 or 6 on the Bristol Stool Scale. 
I’ll outline recent events briefly below.
Morning, Day One: 
Do my usual morning stagger to the kitchen; lustfully look at the big bowl of green Granny Smith apples (I’ll take three, thanks) on our kitchen table and wonder, What the hell am I going to put in my yogurt this morning? I listen to the Siren-song of the honey in our cabinet (Tie me to the mast!), and grab the yogurt from the fridge. Ah! Bananas! I add bananas to the yogurt, scramble eggs with cheddar. Surprisingly, the yogurt wasn’t bad w/o honey, vanilla, and apple (my norm. I don’t like plain yogurt–too tart). Grab my low-fructose lunch, and head out the door for work.
Summary gut-wellness for the day? Not too much difference. Maybe–maybe less gurgly throughout the day.
Morning, Day Two: 
Stagger to kitchen for my low-fructose breakfast. Less desire for honey, but the apples are still there. Won’t someone eat those things? Grab my low-fructose lunch, and out the door for work. On my way to work, I had the constant feeling something was missing. Get to work. Ah, my (always, always at 6 am) morning BM! Where did it go? 10am. Ah, there you are. There was less gas, less gurgle with my morning BM; same story with my evening BM; no change in form, still semi-solid.
Summary Gut-wellness for day two? Noticeably less gurgle. Lots less gas. No change in form.
Summary Gut-wellness for days 3 & 4: Bowels very quiet. Very little gas, no gurgle. Only one BM, morning, both days. Hmm? Is victory looming?
That brings us to Monday—specifically Monday night. My wife, my primary caregiver, cooked a wonderful SCD-legal version of this Curried Carrot Soup from the Food Network. It was fantastic! The soup was so good, I ate my bowl, and both my children’s helpings too. I wanted to go back for more, but if I did, there would be none left for lunch. Fiddle sticks. What else can I have to eat? How about some apples? D’oh!…
She substituted SCD yogurt instead of sour cream, SCD chicken stock we had in the freezer, and an SCD-legal curry powder that I had made some months ago… At least I thought she used the SCD curry mix. Why wouldn’t she? We’ve been doing the diet for 15 months… D’oh! (again) Even old hands make mistakes. I normally tolerate home-made, SCD-friendly curry just fine, so long as it isn’t too strong (and this was just right).
That night, I felt a great fire begin to grow in my belly. I could feel the entire length of my intestine begin to ball its fists and compose me a howler. So, like a good chronically ill person, I curled up in bed, ignored it, and went to sleep. The next morning, the curry paid me back for that avoidance. I call it the Curry Hurries. I went four times on Tuesday, and am still recovering today.
There are two morals to this story:
  1. Be very, very careful not to let illegal foods slip into your SCD lifestyle. I’m living proof of the setbacks they can give you, even after over a year on the diet.
  2. We’ll have to wait until things settle down to resume reporting on the FM experiment. In the meantime, maybe I can have a few apples.

Onward to Health

Honey, You’re No Longer My Honey

   Today is a follow-up to my last post-slash-rant about my frustrations with the SCD. My symptoms have seemed to plateau recently. Although I still consider myself 90-ish percent healed, I’m impatient, and seeing the light at the end of the tunnel makes me want to run there faster than my body will go.
   The conversation I outlined in my last post really happened, and is really still happening. For about 36 hours I ate only these SCD-legal, SCD-prepared foods:
  • Chicken
  • Eggs
  • Cooked carrots
  • Yogurt
  • Beef
  • Small amount of Swiss cheese (because I can’t stand plain beef)

   Before I start, I should point out that I stopped tracking, in detail, my daily food intake, and I stopped filling in my symptom charts about six months into the diet. After about six weeks of recording food and seeing no real changes for the worse in my symptoms, I got lazy. I know! I know! Practice what you preach; track your stuff and maybe figuring this out would be easier…see my posts on tracking diet and tracking symptoms. My dad used to say to me, “Do what I say, not what I do.” I’m a work in progress.
   The above food list is not exactly the beginning diet (pretty close), but it was all I could muster, and I did it for as long as I could stand it. See, I’ve had suspicions that certain SCD-legal foods have deleterious effects for me, but as of yet I haven’t been able to pinpoint what it could be.
   Let me give you an example. I love apples. If I were still eight years old, someone would tell me that if I ate any more apples I might turn into one. I have eaten cooked, peeled apples fairly regularly since about the 2nd or 3rd month of the diet. But what I really crave is the cool, crisp crunch of a REAL apple—none of this soft, mushy, tell-myself-it’s-just-as-yummy crap. So, I added them into my diet about four months ago with success (yea!). I limited myself to one per day. I noticed that on days I ate crisp, raw, juicy, gorgeous apples (peeled of course) my gut seemed happier…And then one day my gut wasn’t happy. To my knowledge nothing else had changed. I ate two apples—still not happy. I ate three apples. S**t.
   Such has been life now for about three months. I have had the same experience with other foods too, and I eat SCD-friendly fruit pretty freely. All the while I keep hearing my wife’s voice, “Maybe it’s not something you can figure out; maybe it’s not something you can control.” Control. Why did I ever allow her to know me so well?
   If I could have a nickname that described me, it would be control. However, since no one has yet given me that nickname, and since I’m not willing to hand my colon to fate just yet, onward I press, to figure out why my stools have loosened (more) over the past two months, why my gut seems to be as disgruntled as department of motor vehicles worker.
   I have to say, I didn’t know where to start until I read about fructose malabsorption from the guys at SCD Lifestyle. See their post here. The idea is that there is only so much fructose that a person can absorb in one go, and the rest is fermented by colonic bacteria or excreted. This fermentation might just cause some extra gas and soften the stool in a gut-normal person; however, in those of us with injured colons it spells trouble. Those sort of fun, fermentable foods are just what the SCD tries to avoid—it’s anathema to the SCD as a treatment for IBD.
   Ding! Now there’s an idea! So I did a little research and some consumption reflection.
   The one food that has been ubiquitous in my SCD adventure, my one constant companion, my counselor when others are eating chocolate—the one food that has greeted me in the morning, and tucked me in at night has been (wait for it…) HONEY.
   It turns out that the symptoms of fructose malabsorption (FM) are similar to what I’ve been feeling. It also turns out that there are dietary guidelines for people with FM, and that reducing fructose intake has demonstrated positive effects in people with IBD. Hmmm?
   Do you know which, of all the SCD-friendly foods, has the highest fructose content? You got it—HONEY.  Honey has a fructose content of 40.9g fructose/100g honey, while one serving of apple has only 5.9 g fructose/100g apple. I eat a lot of honey. See my post on handling cravings for a good example.
   It could be that as I got better and better, and as I ate more and more (in quantity and variety) fruit, that I crossed the threshold of absorbable fructose, how much my body could process, and now the leftover is feeding the bad bacteria in my colon. Maybe that’s what has kept me from reaching the end of the tunnel. S**t again.
   So I’m going to try it. I’m going to cut out the honey for a week (to start), cut my fruit consumption to two pieces a day, and make sure that I eat only the FM recommended fruits and veggies. I’ll keep you posted.
   Below is my list of SCD-friendly, FM friendly foods to which I’ll stick, according to the FM guidelines. This list is not exhaustive, but is nuianced towards the fruits and veggies I like and eat regularly.
Apple (sad)
Green or honeydew melon
HONEY (so sad)
Red Ripe Tomato
Peaches (peeled)
Strawberries (caution b/c seeds)
Oranges of all types
Ripe banana
Onward to Health.

From Walking the Ledge to Running a Marathon

What do you mean I have to share my feelings?

Last night I was chatting with my wife about the sheer and utter joy I experienced reading a new blog I found, Organically Autoimmune, a blog-journal by a woman with UC who decided to try the SCD for 365 days and write about it on the way. You know what she said to me? “You should share more on your blog.”

“You like it so much when others openly share their experiences. You gripe every day about how people only write about their successes, how great natural treatments are, and how when you feel like s**t those things don’t help at all. So, you should share more about your experiences.” 
Okay, so in the interest of keeping my marriage solvent (deep breath), here goes: 
I wish I could go back and journal about my SCD journey, because there is so much to share. Maybe I’ll go back through my symptom charts and talk to my wife (because she’s so helpful–Share?–in directing the content of my blog). That will dredge up helpful content good stories for sure.
I’ve been on the SCD now since June of 2009, about 15 months, but I never did the math so for the past two months, I’ve been telling people I’ve been on the SCD for 18 months. The diet helped from the start (read my story). But it’s been an up and down journey, and I resolve to write some about it on a regular basis, starting now.
Throughout my time on the diet, I’ve been through ups (Yea, I’m cured!) and downs (My life is hell. What did I eat? Why did I ever do this?). The inspiration for this post comes from a recent, my life is hell, moment in my newish SCD lifestyle.
I take probiotics along with the SCD as treatment. Recently, I got the bright idea to stop the probiotics. I needed to see if it was the diet or the bacteria that were helping me. 24 hours after I stopped ingesting glasses full of bugs twice a day, I got the normal die-off D–one extra time a day for about three days. OK. This is normal. Let’s see what happens next. If only I could stay that rational. Now, a month into a probiotic-free life (I still eat SCD yogurt) my stools are still loose, and my gut groans and gurgles like a mistreated septic tank. Crap. Literally. And emotionally? Same thing: I’m gurgly.
To top it off, I just found out (don’t ask me why I didn’t know this before) that the OJ I have been drinking for the past 15 months, the kind I love with Calcium added, is illegal. Oh, and the applesauce I thought was legal? Also illegal. Oh, and the organic salmon I crave weekly? Also illegal. Where’s my research assistant? He’s fired!–Oh, wait. It’s me.
So in a gurgly, anti-diarrheal fury, I announced to my wife that I was going to start all over. I had been on the SCD for 18 15 months, and it hadn’t done a thing! (So was the thinking at the time.) That’s right I was going to go back to the beginning and wait for Vicinni–back to a diet of chicken soup, eggs, farmer’s cheese, meat, juice, and…well that’s about it. My wife looked at me like she had just eaten grass. It took her almost half the day to talk me off the ledge. “Why do you have to be so reactionary?”
Reactionary? No! This is assertive. I’m going to conquer this thing, this damn disease–figure it out–by myself. I. Me. Me. I…I just don’t want to feel sick again. I don’t want to go back there. Don’t make me go back. Don’t. 
“Why do YOU have to figure it out? What if it’s not something you can figure out? What if your body just needs some time?” Time. “Maybe you could just eliminate some of the suspect foods, and see if that makes you feel better.” Okay. That seems reasonable.
Then I read this, from Breaking the Vicious Cycle:
“…Many cases of celiac disease, spastic colon, and diverticulitis appear to be cured by the end of a year. Other disorders such as Crohn’s disease and ulcerative colitis take much longer with a minimum time of two years on the diet. A rule of thumb is to stay on the diet at least one year after the last symptom has disappeared…” p. 70
And I remembered that Elaine’s daughter was on the diet two years before her symptoms were gone. And I remembered the days when I nearly pooped my pants. I remembered the days when I didn’t have the energy to walk a flight of stairs without rest. I remembered going to the bathroom 24 times a day. The point is I had to remember those things–they’re not a part of my life now, and that’s because of the SCD. 
So, there’s one thing I keep coming back to: My last flare was uncontrollable–until I started the SCD. After a month, I was on my way towards a regular (pun intended) life. After 18, no 15 months on the SCD, while I’m not entirely normal yet (about 90% of the way there), I’m running a marathon this December. That says something.
Onward (through ups and downs) to Health

Recipe of the Week, Persimmon Pudding

This is an SCD friendly recipe that is like a drug for me. So, SCDers be careful! If you eat too much at once, it could trigger symptoms. If you’ve never had a persimmon, or don’t know what they are, you’re missing out! Look them up here and here. They’re a fall fruit so look for them after summer is done.

This recipe was given to me by one of my favorite professors in grad school. He and his wife called it “Never Fail Persimmon Pudding”. We’ve modified it here to make it SCD friendly. This version is a bit more firm, like a moist cake rather than pudding. Be careful, the first time we made this I ate half the pan by myself!

Persimmon Pudding

3 eggs
¾ cup honey
2 cups persimmon pulp (5-6 ripe persimmons)
1 cup SCD yogurt
¼ tsp salt
½ tsp cloves
1 tsp nutmeg
½ tsp ginger
1 tsp cinnamon
3 tsp baking soda
1 stick real butter
2 cups almond flour

Beat the eggs until light and fluffy. Add honey, persimmon pulp, yogurt, salt and spices. Beat until smooth. Add the melted butter and baking soda. Beat again until smooth. Fold in the almond flour with a spatula. Pour the mixture into a 9”x13” glass pan. Bake at 350 40-70 minutes until a toothpick comes out clean. Take caution not to over bake! Check them often as oven temperatures and cooking times vary.

I break this post into three parts, mostly because that’s what makes sense to me. I’m linear.

Almost two months into the SCD, I went with my wife and two children, to visit my parents. The buzz around our house was, How do we explain this to your parents? How to we help them cook for me (my parents love to cook for me)? Almost a year, and several trips later, here’s how we do it. We use largely this same approach with friends too.
Describing the SCD to extended family:

This will depend on what your relationship is like with family members, but I have a good relationship with my parents and, lucky for me, they were interested to learn and support me. At the beginning, I tried to get them to read Breaking the Vicious Cycle, but that didn’t take. So, I tried to get them to read some good SCD websites, but that didn’t happen either. So finally, I printed the “legal/illegal foods list” for them. Boy, did that inspire questions. So I explained the diet in intricate detail, because I love details. So should they right? Wrong. Eyes glazed over, and I lost them after about 90 seconds. We tried all sorts of different approaches. My dad began to get it when we started cooking, TOGETHER. My mom just kept asking questions. So you can’t eat red potatoes? What about rice? For the third time, no and no.

Bottom Line Learning: Describe the diet in terms of what you CAN eat, not what you can’t. You’ll save yourself time and frustration. When people ask, I tell them I eat: Lean Meat; Fruit; most Veggies; most Nuts; Real butter; Olive Oil; Aged Block Cheese; I make my own Yogurt; and I don’t eat any additives or sugars except salt and honey. They inevitably ask, “So, what about agave?” or something like that. Nope, just what I listed. Nothing more. Of course there is more, but too much detail at once and I usually get confused looks. Hey, I still ask my wife, Can I have…?

Helping Them Cook for You
There’s no better way to do this than to dive in with them. I bring my two favorite SCD Cookbooks (here and here) and some recipes I am working on, and we dive in together. I tell them not to go to the grocery until I get there, and we’ll go together (this has turned out to be a blessing. I get quality time with the family member I go with, and they get hands-on learning about the diet while we’re there). I try to go with a different family member each time. The best way to help extended family members cook for you is to do it with them. Now, almost a year into it, we’ve built stronger relationships with my parents, and inspired them to healthier cooking. Not bad. Not bad at all.

Bottom Line Learning: Dive in and cook with folks. There’s no better way to teach them the diet, and to help them feel like they are contributing to your progress (i.e., let them help to be a part of your healing process). You’ll build the relationship(s) along the way.

How They Can Support You
I think the best way extended family can support you is to advocate for you and make sure you have your needs covered. Wherever the context, be it family gatherings, restaurants, traveling–family can help ease the burden of haranguing another waiter, or going hungry at a Thanksgiving because there weren’t enough SCD-friendly foods there for you to eat. For example, at family pitch-ins I’d ask them to bring SCD friendly foods. My family has been really helpful by just letting me have the run of the kitchen when we swing through their neck of the woods. I make oodles of food and put it in the fridge. That way whenever I get hungry, I’m not tempted by the bagels on the counter. If you’re having a really hard time, you could consider asking them to try eating like you do while you’re there. I have to be honest with this one: I can’t even get my wife to do that, so you can try, but don’t get your hopes high.

Bottom Line Learning: Family can help relieve some of the work associated with the SCD by advocating for you, and including you in gatherings. They can do this by intentionally cooking SCD friendly, and reminding the rest of the family of the diet. I told my mom once, Just ask a simple question: Is there food here that my son can eat? If not, then she could help me by making some.

Onward to Health.

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