Monday, April 13, 2009
Food Allergies and Me: an asthma odessy (part 2: gluten)
During my second quarter of graduate school we learned about food allergies and sensitivities, and how to do an elimination diet. On an elimination diet, you eliminate a food, or number of foods (the usual list is dairy, gluten, soy, eggs, corn, citrus, and possibly nightshades which are the most common allergens) for two or three weeks and then add them back slowly, one at a time to test for reactions. It was February, I had spent the Christmas holiday in a haze of overeating wheat products. I had discovered an unbelievable pear-walnut bread made my a local bakery and I think I was probably eating 4 or 5 slices a day, on top of other wheat containing products and I felt lousy. I actually thought I might be coming down with bronchitis. Two years before I’d had the flu which turned in to bronchitis and I was sicker than I’ve ever been in my life and coughed all night every night for two months. I was terrified that I was about to repeat that hell. I felt not only some wheezing, but pressure on my chest, as if a very large cat was sitting on my breastbone (I used to have a 20# cat named Socks whose favorite place to sit was right there, so I can assure you I know how this feels). In the back of my mind I had a suspicion that wheat was an issue for me, as I had gone without it for awhile in Eat to Live which is a low grain vegan diet, and noticed a reaction reintroducing wheat, but I have to admit I was in denial. If you thought dairy and I had a love affair, that is nothing compared to the passionate relationship I had with wheat.
I love bread—I really do. I grew up spoiled with wonderful bread from Great Harvest Bakery, a local Seattle institution that makes whole grain delicious breads fresh every day. My best friend and I would walk there from her house because they give free samples—and not just a taste, but huge, warm slabs of bread with plenty of butter to smear into it. My mom also makes amazing bread and around the time of my gluten discovery was going through a phase of bread experimentation—all of which were delicious and wonderful. This does not even begin to cover my love of baking, especially cookies, which I have done almost weekly since I was about 2 years old at my mother’s knee. Gluten was an essential part of who I was. However, when I decided to do an elimination challenge, I did not really comprehend the implications of what a diagnosis would mean.
I decided at this point only to eliminate gluten—we were in the middle of the hardest quarter of our academic careers and a full-elimination diet requires more cooking and preparation than I was prepared to do. If it hadn’t been for the constant near-bronchitis feeling I probably wouldn’t have even done this much.
** I should note here, that what wish I had done at this point was get a blood test for Celiac Disease, prior to eliminating gluten. The test only measures whether you have anti-gluten antibodies in your blood stream. You have to be eating gluten for it to work. To get this test now I would have to start eating gluten again and it could be awhile for those anti-bodies to rebuild if I did have Celiac. Thus, I probably will never know if it is just an allergy or Celiac disease.***
For two weeks I avoided all wheat, rye, barley and spelt. I ate more quinoa and rice, potatoes and squash and said no to bread, cookies, cake and their friends. And my lungs began to clear. By the end of two weeks my congestion had resolved and I was no longer terrified I was about to plunge into serious illness. The time came to test, and I chose 100% Rye bread, so that I could test whether it was gluten or simply wheat causing my symptoms. I sat down and slowly ate one slice of rye toast. Within 10 minutes I was coughing and wheezing. It was rapid, dramatic and unquestionable—I had not just a sensitivity to gluten, but a serious allergy that impacts my ability to breathe.
What I was not prepared for after this discovery was the grief that followed. Wheat was part of my identity—it was present in very important parts of my life. I could no longer just spontaneously go to any restaurant without fear of contamination. I could no longer eat a piece of wedding cake or a cookie from a bake sale unless it was labeled “gluten-free.” Bread became no longer enjoyable, as gluten is an essential part of the rising process and anyone who has had gluten-free bread will tell you it just is not the same. The devastation came in little chunks—small realizations every day of things I could no longer eat, places I could no longer go because of this allergy. I am incredibly lucky to have been a graduate student at Bastyr, with a cafeteria that often has gluten-free options, wonderful friends who understand food allergies and who always make me (and other gluten-free friends along the way) allergen free options whenever we eat together, and who never make me feel like I’m the odd man out.
It has been just over a year since my discovery of my gluten allergy. I have come to terms with it and I have discovered some wonderful products and recipes that have filled that hole in my life. I even went on a gluten-free, dairy-free road trip with my friend Laura. What helped most of all was having a number of patients in the Bastyr clinic whom I was able to help with their food allergies—I became known amongst my friends on my shift as the go-to food allergy expert, which helped me form a new gluten-free identity of sorts. I had no idea that my entire life would change just by giving up bread for two weeks, but it did and I am a healthier happier person because I went through that experience, and a much better nutritionist as well.
Part three will explore my recent attempt at a full-elimination diet, and my discoveries about sugar.