allergist

So I've been meaning to update recently, but have been distracted by real life stuff. What is it about life interrupting? ;)

The reason I wanted to update at first was because it was my two year anniversary of my diagnosis. It's around the New Year, so it's a handy thing to remember and mark. It's like the ultimate New Year's Resolution--a complete and utter change to the way you eat. And the way that I look at food.

It's completely true to say things that way too--I've basically become a foodie without really meaning to. I can talk food with real foodies--I spent the morning discussing gastropubs and the latest fads in food (does everything need to be garnished with bacon? I like it, but still! You take vegetarian dishes and un-vegetarianize them!)

It's also a mark for me this year of some big things. First off, a bit of de-vegetarianizing for me (yes, i made that word up and then proceeded to use it twice). I absolutely cannot have beef or chicken, but I'm anticipating some travel here--you may have seen that in the last post! Six weeks in Jamaica and twoish weeks after that in the UK. It greatly opens up possibilities to eat things like sausage and bacon. Also, in Jamaica--goat. It has to be a gradual process because my body no longer produces those enzymes and will have to relearn them. When I've eaten meat, it sits in my stomach--the enzymes aren't there to digest it. So a gradual readdition of some meat to my diet. It'll be temporary because when I'm back in the US, things are a little easier.

The other reason why I had held off posting with the New Year is because I knew I was going to see my allergist today. I didn't know what the outcome was but it is so interesting to talk to another physician on the same level, despite being a patient. He tried to convince me to go into allergy and I will not deny that I find it fascinating (for rather obvious reasons) but we did get down to brass tacks after a bit.

It breaks down to the fact that I was (apparently--and maybe that should be am, in the present tense) a genetic time bomb--my allergies were there and just needed enough exposure to be a problem. It's very common in women in their early twenties, apparently. It's also very much a matter of cross reactivity--I'd had so many seasons of doing fine, but then as another spring and fall passed, things started getting worse. Thus the time bomb analogy. It's also why they've been getting worse recently--more seasons have passed.

It was an interesting thought and it leads to some more interesting things to ponder. Which I will get to.

It was also funny to put more of the puzzle together--I knew that I couldn't eat beef or chicken and was told it was because of the moldy grains that they eat. It's also the reason why I can't eat a good number of grains myself--the molds. However, if you think that through, chickens eat corn. I'm not allergic to corn and it is, in fact a major staple of my diet. I am allergic to the grass smut that grows on the corn. Ta da! Answer for that. Also, allergy to chicken means allergy to eggs.

Mostly I'm allergic to summer grasses and fall weeds, with a healthy addition of molds to cover everything else. It's all cross-reactivity, which is the hot new topic in allergy research.

The good news is that there are ways to band-aid cover my allergies and worsening food reactions for now. Key being 'for now.' The ultimate end to all of this is desensitization or allergy shots, in the common vernacular. Which I have to say I saw coming and was in denial. Maybe not so much denial but in the can't wrap my head around the logistics of that right now so I'm ignoring it. The other thing about all of this is that because I've passed two years since my allergy testing, and the eight seasons that go along with that, I have to be retested before doing desensitization, to make sure it's done properly.

So there was both good and bad news, but I ultimately so enjoyed the conversation with my allergist and the frankness of the way that we can talk physician to physician, it's all good for now. Plus I flat out told him--I can't do desensitization right now. There are so many reasons starting with insurance and ending with I don't have time now. It would be of great benefit to be able to freely eat as I travel, but desensitization is a years long process so there's no benefit to starting before I go anywhere this spring. Plus there's other things going on in the next few months that mean desensitization is far from my mind.

In the meantime, adding some new medications and trying to patch things through here for a bit.

Detour: South Africa

So I'll take a little time away from my commentary on the food allergic life to share something else.

I have been planning a trip to South Africa, Cape Town in particular, for approximately two years. You see, being in medical school, I knew now would be a lovely opportunity to go before being bound down with contracts and job responsibilities after graduation. So I looked into my international rotation opportunities and quickly narrowed them down to Cape Town. (I don't speak Spanish, so that knocked out quite a few countries!)

So I've been working around Cape Town in my schedule for the longest time, it seems. Moved it around a few times based on testing schedules and interviews, but had it pinned down to the Spring 2014 for about the last year. It started to become more and more official looking as I got the paperwork sorted out for the school and my passport renewed. I also started to work on vaccinations, get travel insurance, etc...

As the autumn progressed, I was in touch with the school regarding the paperwork, for it obviously takes an extensive amount of paperwork to go abroad and practice medicine. There was a new administrator on the South African end which was complicating things, but we assuredly could get it done.

Along with all this, I was reading books and watching assigned documentaries on HIV/AIDS in Africa. I set up a rotation in an HIV clinic in America, figuring it would be a good experience--and it was, undoubtedly. I know for a fact that I want to work with HIV patients. I got more excited about going to the forefront of the HIV/AIDS epidemic.

Then I get an email regarding flooding in Cape Town, had I seen it in the international news? You all know, I've been busy traveling and interviewing and while I kept up to date with the headlines (those mornings newspapers in the hotels helped), I had not seen it. I searched a little and hey, there it is waaaaaaay down on CNN. Okay, regardless, a hospital getting evacuated for flooding is a big deal. No need to push, I can deal. Plus if there's flooding, there's definitely not paperwork getting done for the international medical student. I pushed my dates back from February to the end of March, the latest I could go and still get my six weeks in just before graduation.

I even made my hotel reservation. Bought that travel insurance. Have the travel guide sitting there, read through it, got excited about Table Mountain and botanical gardens...penguins! Dolphins! The Cape of Good Hope! (History major here!) Let alone the whole apartheid and Mandela drama that had taken place in Cape Town.

Mandela. The man is most definitely a legend and when I saw the headline news of his death, one might say the writing was on the wall. Mix in another idiom, three strikes, you're out.

It actually wasn't his death that truly that did my trip in, but rather the upcoming elections. The politics will be dicier with Mandela even nominally in the picture. Things get nasty on the TV in the US, but in other countries, elections can be a much different story (eh, Arab Spring anyone?). Taken in combination, it's not a safe place to send students. I would probably be fine, but it's the whole 'probably' thing. While I would be staying in Cape Town, I would be travelling into the poorer areas, where it would be more likely that events could occur. Things were more likely to occur there regardless and I had been warned, so add in the furor over elections, things were not going to be pretty.

So that's that. It's saddening and quite honestly, a bit heartbreaking. I've been dreaming of Cape Town for about two and a half years. Add in my vacation to London (not only was I a history major, I focused in British history--London is my mecca) at the end of it and I've basically got my dream trip to get me through the next few years of residency.

I've spent a few days moping about it, cancelling reservations and making phone calls. I'm moving forward now. It's difficult for me to not be active about anything in my life, so I'm considering my options. There's about three months to get something together, and I doubt anything will live up to South Africa in my mind and heart. There's options in Ethiopia and Ghana, but I'm not sure if Africa is a good place for me right now; like I'm trying to substitute something in for my dream. There's a nice opportunity for HIV/AIDS outreach in Jamaica, which is probably the most likely option going forth.

And who knows, I may just go to London anyway. A Christmas present to myself.

progress

As you all are probably well aware, I have been quite busy these last few months. I apologize for the delinquency of my not posting, but I have fallen into very little cooking and experimenting for many reasons.

First off, I was busy on a surgery rotation where I was at home so not alone was I scarfing down whatever I could feasibly find in a period of time so I didn't get hypoglycemic in surgery, I had my mom cooking for me. We did find the glories of how to bind a black bean burger appropriately--I can't buy fake meat or anything frozen because there's generally yeast. For some reason, my mom tried black beans with couscous to bind it and it generally works. I have subsequently been glorying in the modified burger--a biscuit, black bean burger, a slice of cheese, and appropriately safe ketchup. I have missed burgers so this has become a new standard while I've been home.

The other reason I've been busy is that I've been travelling with interviews (thus the accident with the chicken--that happened at a pre-interview dinner). Getting vaguely nauseous eating McDonald's fries, making my car reek of bananas as I travel with banana skins, dripping honey from biscuits my mom sent me forward with...it's been an adventure.

Oh, and for people who want to know what I ate for Thanksgiving--mashed sweet potatoes, brussel sprouts, candied carrots, and green beans. Cherry tarts for dessert.

On an allergen front, this is the time of year that I really become retrospective. Both Thanksgiving and Christmas are heavily oriented around food. I have already become creative trying to avoid the nut-encrusted gifts that have been given to us in the office for the holidays. I pray daily about what will be coming in as Christmas approaches. Holidays that are focused on big meals make me confront the fact that I can't eat like everyone else. My family general celebrates with just us, so it's been doable but it's still up front for me.

And it's been difficult because I've had to come to grips with the fact that they're getting worse. Some things are getting better, so there is some good news, but for the most part, things are going downhill and rather rapidly too. I have spent far too much time recently with abdominal pain and the much more frustrating specter of nausea--can't move, don't want to go anywhere nausea. Standing next to the sink/toilet because I know I'm going to vomit. It has never been like this before. In fact, nearly two years ago, when I was diagnosed, I scoffed at the idea of food allergies--abdominal pain? Nausea? Vomiting? Not me!

For example, I have been able to eat eggs and know the reaction I would have to them--so I could safely anticipate what was going to happen. I cannot predict it anymore.

I have had days when I have eaten nothing allergenic and still had problems.

I have been getting more rashes on my face--a known reaction to rice, but not to rice in these instances (The other discovery? Sometimes they're scarring, which almost made me cry last night).

I want oh so much to be in denial about this, but I can't. I will soldier on, but it will be difficult. Especially considering in the upcoming weeks, I will turn to preparing to leave for South Africa where I will be less stringently vegetarian and also have to start from scratch with knowing brands' ingredients.

So there it is. Things are not all on the up and up and I'm struggling. But whoever said life was fair?

sprouts!

I am a very delinquent blogger here. apologies. i have been traveling and not cooking, resuming my hospital cafeteria salad diet so there haven't been a lot of new recipes to share. there is something i am about to try, and one thing i have been recently exposed to while traveling--brussel sprouts.

I have a feeling that will get a very mixed reaction from y'all but hear me out--i feel that sprouts have gotten a bad reputation. They are actually quite delicious when cooked properly and also very nutritious! Wikipedia tells me "They contain good amounts of vitamin A, vitamin C, folic acid and dietary fibre. Moreover, they are believed to protect against colon cancer, because they contain sinigrin." Thomas Jefferson himself grew them at Monticello. With a recommendation like that...

Cut the sprouts in half. Get a frying pan good and hot and add oil and brussel sprouts flat side down. Let them brown nicely on that side. Shake them around and good a while longer. If they need to, you can ad a tiny bit of water, put the lid on until they are eating consistency. Season with salt, pepper, garlic powder, thyme if you like. 

They really do need to be browned and crispy otherwise they're just soggy cabbage.

I challenge those of you who have never tried Brussel sprouts and have avoided them based on reputation to try them. Maybe you'll change your tune.

accidents

So sorry, y'all, to NOT be posted. but there hasn't been a lot to say! I've been really busy with work/school stuff and subsequently haven't been cooking. All of this is also happening while I'm staying with my mom, who has been doing all the cooking and grocery shopping. We can find some cool stuff, but mostly it's nice because i thoroughly detest grocery shopping.

In good news: my mom has perfected the yeast-free black bean burger, which was an accomplishment. It's very difficult to find something to bind the black bean and corn together, but somehow couscous works. Also, it was a good time to find out that couscous is not an allergen. I had it sometime in the last two years, but it was one of those super-organicy places, where I took it out of a barrel. There are so many potential allergens within that--the barrel, whatever the scoop had last been placed, poor storage allowing microscopic mold to take hold, etc. So I've been enjoying actually being able to have a burger again--in my own way. We take a Pillsbury biscuit, slice it in two and hope it doesn't crumble up too much, put the burger on it, cheese, and a dab of ketchup (we found a safe brand). It is a similar enough experience to the real burger that I have been eating these fairly regularly recently. It's amazing the craving for a burger that hits sometimes--there are so many occasions in America that call for burgers.

So the other news is that one of the reasons why it's been almost a month since I posted anything is because I've been travelling rather extensively. It's funny enough travelling by car and unloading in a hotel room: garment bag, suitcase, purse, bag o' food. The fewer meals I eat out, the better. And even better: flying. I always wonder about the TSA and what they will let through. I didn't have any problems this time, but all I took was the vanilla cupcake graham goldfish and a sleeve of shortbread. delicious, but even my sweet tooth was down and out after a few 'meals' of this. Flying in the morning means all the restaurants are serving bacon, eggs, and biscuits. No fries. I can do fries. And then I flew back late, so places were closed. I texted my mom that I was almost home and please can i have something warm to eat, since i was subsisting on shortbread.

Overall, the reason I'm writing this now is to make an accounting for a recent event--I was out to dinner with a group of applicants pre-interview and we'd ordered some appetizer plates. I didn't know what was on each one, but the one in front of me looked like fried shrimp and some quesadillas. Nobody had touched it yet, in a polite, etiquette kind of way, so I went ahead and got things started. Except as I bit into the shrimp, I realized--NOT SHRIMP. CHICKEN. It was a very odd looking wing. And of course, not a wing, with no bone. Regardless, chicken! Chicken! It sounds so stupid--I accidentally ate chicken! but it's wholeheartedly true. I avidly avoid the meats I'm allergic too, and for good reason. Besides my anxiety ticking off the charts at that moment, knowing that my H2 blockers aren't going to be powerful enough to combat chicken, I knew I had to a) finish getting through the dinner and b) I still had my interview the next day. Luckily, I was able to order some scallops seared with lemon butter that was totally safe, and a safe dessert also. Sometimes when I eat something I shouldn't, I'll try to overwhelm my body with other, safe particles. Doesn't work always, but sometime it'll mitigate things. At the very least, dessert makes me happier.

I woke up the next morning and felt like I had done an intense abs workout, how sore my abdomen was. Luckily I was also suffering through a sinus infection, so my meds had kept me mostly knocked out and unaware of what I know is crippling abdominal pain.

And I made it through my interviews just fine. :)

I was also recently eating apple pie, which seems to be just fine...not exactly easy for me to distinguish, because at the same meals I had other allergens present so I couldn't sort it all out, but it was interestingly a very minimal reaction so we'll see...

And then there was the Greek food yesterday I was presented for lunch...I could not identify a single thing on the plate besides the grape leaves...always a pleasure to be eating out and have no say in my food.

But then there are occasions, like where I got to order the vegan creme brulee, made with avocado and coconut milk and something else, topped with raspberry sauce--it was amazing. AMAZING. makes up for some of the other stuff.

Never a boring day in my life with food.

chocolate chip banana donuts

I have finally wrested control of the kitchen back from my mother this weekend. It involved getting up and started before she did and also had me going, "mom, where's this? and then that?" because she's reorganized the kitchen in the years while i've been gone. But i have persevered to the delicious smelling house that generally indicated a recipe well done.

and the best part? Mom's allergic to bananas so this recipe is all mine!

Chocolate Chip Banana Donuts

·        1 cup Mashed Ripe Banana (Roughly 2 small bananas)

·         1/2 cup Raw Cane Sugar

·         1/2 cup Fat Free Greek Yogurt (I use 0% Fage)

·         1/4 cup Unsalted Butter (Melted)

·         2 Eggs (Room Temperature)

·         1 teaspoon Pure Vanilla Extract

·         2 cups Spelt White Flours (You can also use AP Flour)

·         1 teaspoon Baking Powder

·         1/2 teaspoon Baking Soda

·         1/4 teaspoon Salt

·         1 cup Chocolate Chips 

1. Preheat the oven to 325F

2. Using your electric mixer with the whisk attachment, add the mashed banana, sugar and greek yogurt. Mix until incorporated.

3.Add melted butter, eggs and vanilla extra and mix.

4.Add flour, baking powder, baking soda and salt to the batter and mix until just incorporated. Do not over mix!

5.Using a spatula, fold in the chocolate chips.

6.Scoop the batter into a zip lock bag and seal shut. Using scissors, snip the bottom corner of one side of the ziplock bag to create your homemade piping bag.

7.Grease your doughnut baking pan and pipe 3/4 full the batter into each doughnut mold.

8.Optional: Sprinkle cinnamon and sugar mixture on top of each doughnut batter before baking. Or you can dip the doughnuts once baked in the cinnamon sugar mixture. You may need to paint melted butter on top of each doughnut before dipping the doughnuts in the sugar mixture to allow them to stick. Both options work perfectly.

9.Bake for 12 to 15 minutes. Remove from the pan and allow to cool before eating.

(http://janieskitchen.com/2012/12/03/banana-chocolate-chip-baked-doughnuts/)

It was interesting--the first time i'd cooked with greek yogurt. Really not a big component at all, but a new thing for me. Also, i think using real eggs in this would be a big plus over my powdered-add-water-egg-replacer because the dough ended up being a little-to-a-lot dry and difficult to get into the pan, but you lose that nice eggy quality with the thickened paste of "egg" that I add. I have a container of egg whites currently in this kitchen (in the land of non-allergic people) but I still chose to use the powder. I've been having problem with egg whites recently so we're not going there.

So they do make your place smell delicious! Always a plus. And generally, these are the ingredients you probably have at home. I was surfing my pinterest recipes this morning, craving to make something new and this caught my attention--yes, i did have two bananas, and greek yogurt (it was banana flavored, but that would obviously work) and the rest is basic kitchen requirements.

they're rather good. Particularly when still warm and the chocolate is gooey. Mine were a little dry which I think is because of the lack of egg, but they're a nice way to wake up on Saturday morning. :)

A warm breakfast on a chilly morning.

pumpkin cream cheese

Voila! Quick and easy, though I recommend using honey instead of maple syrup. We didn't even try the maple syrup--it's not a staple in this house and considering that the whole concept of maple means it's from a tree and has its own subset of allergens....we stick with honey. nice and creamy on a piece of toast!

Also, I'm not sure what my mom ended up using instead of the pumpkin pie spice, but probably just some nutmeg and allspice. Balance to taste.

Happy fall y'all!