Gluten Free Expedition

A New Test

Esophagogastroduodenoscopy - try saying that 3 times fast (hell I couldn't say it 1 time fast!) - is the technical term for the procedure used to visualize the upper part of the GI tract in order to obtain biopsy samples.  An edoscope, which is a long, narrow, flexible tube with a camera at the end of it (I'm simplifying) is passed through the mouth and down into the GI tract.  This allows the endoscopist (doctor that's manipulating the tube) to observe the different sections of the GI tract and decide if and where to take biopsies.  I had this done after my blood test came back positive for CD.  The biopsies are looked at under a microscope to see if the villi are flattened, or atrophied.  This procedure isn't as bad as it sounds; I got some good sedation, so I don't even remember it.  Actually, I don't remember much of anything from that afternoon/evening, so maybe you don't want to go by my recommendation!  Plus my dad told me I said the same thing to him 5 times in the 20 minute car ride - I'm sure I was great fun that day!

I was somewhat prepared for what was going to happen because I've seen several bronchoscopies done (similar procedure, only the bronchoscopist is going into the lung).  I was still nervous though; seeing and actually having it done are 2 very different senarios!  I can see how this procedure could potentially really freak someone out.  That is one of the reasons that doctors are studying the use of a new "pill camera" to see into patient's small intestine to diagnose CD.  This "pill camera" (aka capsule endoscopy) is simply swallowed by the patient and then it takes pictures with up to 8 fold magnification as it travels down the GI tract.

There are several advantages to this "pill camera", the obvious being it is minimally invasive and less scary to patients - it's just swallowing a pill, not a long tube.  Additionally, more of the small intestine can be observed so that even if the damage happens to be past what the endoscope can reach, it will be detected.  Also, it can be used to find if the patient has any long term complications from undiagnosed CD.  And since it is minimally invasive, it could also be used after diagnosis to track healing.

There are some disavantages too.  The procedure is relatively new, so many insurers will not cover it and there isn't a way to take a biopsy if needed with this camera.  But this procedure is a great advancement for the diagnosis of CD. 

A little off topic, but the thing I'm curious about - exactly how many people have a positive blood test, but negative biopsy?  I don't know and I'm not sure what those test results would indicate, but I would be interested if anyone has seen any research on this.

So You CAN Eat White Bread

It is amazing to me the number of educated people out there that don't know what goes into the food they eat.  When I tell people about having CD I usually name some examples of things I can't eat - bread, pasta, donuts, beer.  And I've gotten a few questions that seem rather silly.  Pasta has wheat in it?  You can't eat pizza?

I have yet to be asked the somewhat unbelievable "So white bread is OK, right?" that I have heard many Celiacs talk about.  Yes, that mysterious ingredient "white" is perfectly fine and in no way related to wheat.

Now, I admit I was surprised at some of the things that contain gluten.  I mean who knew that soy sauce is usually fermented with wheat?  And why does deli meat have wheat in it?  But, I think, in general I have a pretty good idea of the basic ingredients used to make most food I eat.

There is an interesting movement that is slowly making it's way across the US.  Slow Food USA is an organization that is trying to

"reconnect Americans with the people, traditions, plants, animals, fertile soils and waters that produce our food. We seek to inspire a transformation in food policy, production practices and market forces so that they ensure equity, sustainability and pleasure in the food we eat."

While I am the first to admit I don't make it a point to buy only organic, locally grown foods, and we have plenty of pre-packaged junk in our pantry, I do think there is a great idea in this.  People should put more consideration into where their food is coming from and what ingredients are in it.   

I have been doing a lot more of my shopping at the local co-op and the "health food" section of the grocery store, which I feel good about.  But just because something is labeled "gluten-free", "organic", or some other specialty label doesn't mean that it's automatically good for you.  There are plenty of high fat, high calorie items found in the "healthy" section or store.

I think the advice for new Celiacs to do most of your grocery shopping around the perimeter of the store is great advice for anyone.  And take it easy on those highly processed foods in the middle aisles!  One more thing I love - take advantage of your local Farmer's Market.  The one in my town is very small, but I stop there every Sunday to buy great, home-grown fruit, veggies and even meat (just pork products, I haven't been adventurous enough to try the elk yet).  The prices are always very reasonable and you will be supporting your community!      

Chicken Souvlaki Wrap

The Husband's family is Greek; as in all 4 grandparents arrived on a boat straight from Greece to the US.  He grew up eating a lot of Greek food.  While I will admit, it's very good food, I refuse to make most of the recipes because they are so intricate and time consuming.  Whether it's working with filo dough or grape leaves, it just doesn't work into my busy life! 

However, while sampling Kate's (Gluten Free Gobsmacked - love that!) sandwich wrap recipe* I made for, uh, sandwiches I had a fantastic idea for a chicken souvlaki wrap.  This was Greek food I could really love - easy and delicious!  One note: I just throw everything together to taste, so all measurements are estimates.

Chicken Souvlaki Wrap

2-3 boneless, skinless chicken breasts
1/3 cup olive oil
1/4 cup lemon juice
2 cloves garlic - pressed or finely chopped
1-2 tsp dried oregano
salt to taste

Combine olive oil, lemon juice and spices; pour over chicken and marinate overnight.  Grill chicken and slice into strips/chunks.  Serve rolled in Kate's sandwich wrap with any combination of the following: tzatziki sauce (see recipe below), black (kalamata) olives, feta cheese, tomato slices, lettuce, cucumber slices, or anything else that sounds good!

Tzatziki Sauce

1 cup Greek yogurt or sour cream
1 small or 1/2 large cucumber, peeled, seeded and finely diced
1-2 cloves pressed garlic (depending on your preference)
olive oil to taste
salt to taste

Combine yogurt or sour cream, cucumber and garlic.  Stream in olive oil (I would start with 1 Tbls) while stirring.  Add salt to taste.

This was one of the first things I made with gluten free flours that the Husband thought was good enough to have again and again!  I make it for dinner about every other week.  The wraps are also good when heated in a pan and cut into bite size pieces to be dipped in the tzatziki!

I haven't yet tried the adaptations on the sandwich wrap, but I can't wait to do that!

*I actually used these changes that Kate did in her experimenting - no rise time and I've tried both sorghum and brown rice flour.  And Kate, a big thank you for the time you put into making this a big hit!

A Very Happy Anniversary

I had a really great surprise on Saturday.  The Husband and I decided to go out to dinner for our anniversary.  We're not big on gift giving, so we decided a nice dinner out would be perfect.  We had been to this romantic Italian place a while back, pre-Celiacs, and fell in love with it.  The food was delicious, the atmosphere wonderful and the wine list was perfect.  So the Husband asked if I would be comfortable going back there.  I decided to call them and see kind of response I got. 

Being new to this, I'm never quite sure what to say to the restaurant staff.  I nervously dialed the phone and when the manager answered I asked him if he had ever heard of gluten intolerance, aka Celiac Disease.  Actually, yes he had and they make everything to order, so it wouldn't be a problem to fix me a great (gluten free) meal.   

When we got to our table, I spoke with our waitress about my needs and showed her what I wanted on the menu - seared Italian-style tuna with tomatoes and polenta.  She assured me she would check with the chef to make sure all ingredients were gluten-free; they were.  The manager (owner?) came around after we ordered to see if everything was alright and to let me know that he checked the kitchen and they also have gluten-free pasta available.  I was really in the mood for the tuna, so I didn't change my order, but it was news that made me want to come back soon.  It makes me really happy to find a place that had thought about their clientele enough to see an advantage to stocking special pasta.  According to the manager, they had only used it about 3 times in 4 months, so it really is above and beyond for them to do. 

Ah, this is what all those people were talking about when they said "gluten friendly".  My dining out experiences, up until this weekend, have consisted of going only to a few chain restaurants that have gluten free menus.  I've had great meals each time, but we really like to go to small, specialty restaurants.  Given that I live in a small/mid size city in the Midwest, I was afraid places knowledgeable about CD would be few and far between.  Maybe I just got lucky on my first try, but I'm hopeful!   I also told the manager that I would let my local Celiac support group know about my wonderful experience and encourage more people to stop in for dinner.

You Can Go Home Again

So last weekend I went to my parent's house for the first time since my diagnosis.  They couldn't have made it easier!  My mom went shopping at Cosco and found that they have all sorts of gluten free delights there.  I think she was really excited because she came home with a whole bunch of goodies just for me to take home.  The Mrs. Mays Naturals crunch snacks are great to keep stashed at work for that mid-morning hunger attack!  I tried to go do my own exploring at Cosco on Saturday, but they were already closed.

Mom had called me last week to figure out a tasty menu for dinner on Saturday night.  We were at the State Fair during the day, so dinner and Sunday morning breakfast were the only 2 meals she had to prepare.  I had talked to her earlier about breakfast - she was thinking she had to get some special pancake mix - I reminded her that eggs are both delicious and gluten free!  She ended up sending my dad to the grocery store to buy Kinnikinnick bagels so I could have a carb fix also (they needed eggs too!)

The dinner was wonderful!  Then again, just about everything my mom fixes is delicious.  She did try to make a packaged gluten free bread mix.  It was fine; the olive oil dipping helped.  Everyone agreed it had the consistancy of a cornbread.  I'm sure that was due to the rice flour.

I was a little worried about going to the fair.  Most of my favorite fair foods are now off limits - corn dogs, gyros, funnel cakes, beer (OK, so that's not a food, but we love to sit in the shade of the bud tent and have a nice cold beer on a hot August day!)  But with a little thought I was able to find things I can eat - pork chop on a stick (everyone knows the best fair food is on a stick), kettlecorn, ice cream, margarita (also good for drinking in the shade!), and my all time favorite is still on the OK list: cotton candy!

My mom's favorite animal is the cow, so we always have to go see the cows at the fair.  The Girl especially loves the baby cows because you can get real close and pet them.  My mom also likes the calves because they remind her of her childhood at her grandparent's farm.  Spend enough time with her and you'll eventually hear the story about her pet calf "Suzie", probably a few times!  So we went through the cow barn and the horse barn and saw the baby chicks - another favorite of the Girl since she got stuffed peeps at Easter.  We also saw the clydesdales pulling the Budweiser wagon with the dalmation riding in it. 

Spot the Error

My husband has been the one to go to the grocery store on Sunday almost every week since the Girl was born; probably so he could get out of the house.  This arrangement has worked well up until my diagnosis.  I am the one who does the research about products and labeling, etc.  So, this is how we work it now - I put specific brand names on most of the products that I know are most likely to be gluten free (still checking those labels before I consume though!).  For example part of my list looked like this: light sour cream - AE, brats - Johnsonville, deli turkey - Hormel Natural Choice, tortilla chips - Melina's... So this works pretty good and if he has a question he'll call me and sometimes even read the ingredient list to me.

As we were unloading the groceries from the sacks, I pull out the brats to see what flavor he decided on and started laughing.  He was back outside getting more groceries, so I went out to see if he could tell what made me laugh.  I held up the package and asked him if there was something wrong with this picture.  The flavor - beer!  Yes, beer brats for the Celiac, not a good choice!  We had a good laugh over his failure to think; he says it was because there were too many choices calling to him!

Fear not, you can still make your own beer brats - just boil them in gluten free beer.  I've tried 2 - Anheuser-Busch's Redbridge and Bard's Tale Beer's Dragon's Gold.  Both are made from sorghum and both are good.  The taste, to me, is similar to a Killians.  Although I really like them, I would like to find a lighter beer, something more thirst quenching for those really hot summer days! 

Between the time of my blood test and biopsy I had some time to think about what it would mean to go gluten free.  I was talking to my dad about it and we were both trying to be very positive about it.  He thought it wouldn't be too bad, no wheat bread or pasta, but you could surely find substitutes for those.  Then I mentioned that beer too was made from wheat and/or barley.  His answer to that?  Well, if there wasn't a good gluten free beer out there, we could brew some ourselves!  You see Dad, Husband and I all went to the same college and we all still live fairly close.  So we get season tickets for the football games, and what is football without tailgating?  And to tailgate you must have beer!  At least until it gets really cold and then you're drinking hot chocolate in your car!

Defining the Problem

Just what is Celiac Disease?  It is an autoimmune reaction to gluten, which is a protein found in wheat, barley and rye.  It can also be found as a cross contaminant in oats, so those with CD either stay away from oats, or only eat certified gluten free oats.  When gluten is ingested the Celiac's immune system responds to it by damaging the finger-like projections called villi in the small intestine.  When the villi get damaged, or destroyed they can no longer absorb nutrients and the person can become malnourished.  Celiac Disease is also genetic; it tends to run in families.  Although my parents and I cannot think of 1 person in our family that has had any types of CD symptoms.  Some people have symptoms since birth.  In others, there is something that triggers the disease in adulthood.

In the past Celiac Disease was thought to be a rare condition, however, recent findings estimate there are 2-3 million Americans, about 1 in 133 people, with this disease. 

The "gold standard" of diagnosis is a small intestine biopsy - a small piece of the bowel is taken during endoscopy and the villi are checked under a microscope for damage.  Most of the time people have a simple blood test before the biopsy is done.  If the blood test comes back positive, then the doctor will usually do the biopsy.  This is what happened in my case.  My doctor, as an afterthought, threw in the blood test for CD since I was already getting a blood draw.  And low and behold, that's the one that came back positive!

So, what's the treatment?  Stop eating gluten, of course!  No more wheat, barley, or rye.  Easy, right?  Not so easy, these 3 grains are found everywhere!  They are used in processed foods as thickeners, emulsifiers, flavorings, stabilizers and texture enhancers.  You have to learn how to read and interpret labels. 

Of course there are quite a number of foods that are naturally gluten free - plain meats, fish, poultry, rice, veggies and fruit, but sometimes you want something to go on those!  There are also a huge variety of flours to use for baking.  I like to bake and experimenting is fun, so I have several different kinds of flours now.  I use different mixtures of flours for baking different things, so I haven't bought any of the pre-made flour mixes, but I hear they can be good.  In my house currently I have: brown rice flour, white rice flour, sweet rice flour, sorghum flour, millet flour, buckwheat flour, sweet potato flour, chestnut flour (this was bought especially for a graham cracker recipe), tapioca starch, potato starch, cornstarch, flax meal.  I also have xanthan gum - a necessity to gluten free baking.  I also have a number of recipes printed off the internet that require more unique ingredients that I'm waiting to try. 

There are several companies that sell gluten free food and the gluten free market has grown very fast in the last few years.  I have heard from several people that it is so much easier to find good tasting products today than just 5 years ago.  Hopefully with increased awareness this trend will continue!   

You've Got to Start Somewhere

I guess this is it. 

I'm not new to the blogging world - I've been reading them and leaving comments here and there for several years now.  However, I've never been sure that I'm witty enough to write my own!  I was recently diagnosed with Celiac Disease and while delving into this particular blogging world, I've decided to try my hand at writing one of my own. 

Celiac Disease, while a little sad at times (I miss French bread!!), isn't the worst thing that could happen too me.  I've decided in these past 6 weeks that I'm going to look at it as an adventure, an expedition into a new culinary world!  I've rediscovered my love of cooking because, let's face it, convenience foods weren't made for those of us living gluten free! 

I have gotten quite lazy in the past few months after having a baby (he's 10 months old now), already having a 3 year old and then returning to work.  We have a wonderful business in our town that you pay to make dinners for you.  24 yummy frozen dinners per month you pick up from them ready to be thawed and baked in the oven or thrown on the grill for an easy dinner in no time.  It was too easy to order those month after month and not have to really think about dinner!  But alas most of them are made with gluten containing ingredients - wheat flour to thicken the sauce, bread crumbs to make the meatballs, soy sauce from unknown origins, the list goes on.  Since that is no longer a choice I'm cooking again.  And it's fun!  I'll admit I do miss those days when I could just pop the dish in the oven and play with the kids until dinners ready.  But now I can get them involved.  The 3 year old (the Girl) is mommy's helper; she can stir and pour.  The 10 month old (the Boy) is our taster.  He eats just about anything you put in front of him, unless it's green, he doesn't like green!

And I have a new secret to quick dinners - my crock-pot!  It's gotten more use in the last few weeks than in the last few years.  I've been trying to find new recipes to use this amazing cooking tool about twice a week.  When I come home with the kids it's like someone has already cooked for me!

If I sound neurotically optimistic, I probably am.  It's a mix of the nervous anxiety of starting this blog (will anyone read it?  More importantly will they come back to read it again?) and the fact that I have more energy than I have since before the Boy was born.  Being gluten free for just 2 weeks gave me back something I didn't know was missing - me!