Happy Holidays!

I'm off to hang with the husband's family until the New Year!  Here's to health and happiness for all in 2013!

Portobella Pizza

 I swear, I don't always make so many cheesy tomato recipes...

...but we're leaving to visit my husband's family this week, and I've got a lot of tomatoes, fresh basil, and Parmesan to use up.

This is an easy, reheat-able SCD lunch.  And it's filling (I'm a big eater and was super full after one mushroom).

Here is the original recipe, which I actually recommend you checking out because their version is pretty.  Here's my straightforward (and slightly edited*) version:

Ingredients:

• 2 tablespoons olive oil for skillet
• 2 Portobella mushrooms
• 1/2 a carton of grape tomatoes, chopped
• 2 cloves of garlic, chopped
• 1/2 a lemon (for juice)
• 5 fresh basil leaves
• 1/2 a yellow onion chopped (I'd use less next time, but this is up to you.)
• Shredded Parmesan cheese to taste  (I probably used about a 1/4 cup.)
• salt and pepper to taste

Directions:

1. Preheat oven to 400.
2. Add oil to skillet and saute onion until it's brown.
3. Mix in tomatoes and garlic and saute until the tomatoes are soft.
4. Add salt and pepper to taste.
5. Squeeze lemon juice over the ingredients.
6. Stir in the basil leaves.
7. Place mushrooms on parchment paper-lined baking sheet.  (Bottoms down.)
8. Fill the mushrooms with the skillet ingredients.
9. Top with Parmesan.
10. Bake for 12 minutes at 400.

 Enjoy!

*If you compare this to the original recipe, you'll see I left out the leeks.  I felt like it was plenty onion-y without them.

Please, No Pneumonia!

 

Really hoping home remedies work this time! This is the least-gross one I've tried this week. 

Turmeric tea was a one time mistake...

 

What antibiotics can we take that are safe for baby AND for us?

Like all of you with suppressed immune systems from our myriad meds, winter colds are par for the course.  I get pneumonia pretty frequently, but I never minded in the past because a quick course of antibiotics could knock it out.  Now I'm knocking on the door of another bout with pneumonia, and struck with a pharma dilemma...

• When we're not pregnant, IBD docs can prescribe flare-safe antibiotics: Levaquin or Cipro.  (I have begun horrible flares by trying different antibiotics, but these two apparently don't kill off the flora in your gut the same way.)
• Those safe meds are NOT safe for baby, though.  The only antibiotics my OB says are safe for baby are the Z-pack and the Penicillin family.  However, I can hear my GI doc's words ringing in my ears: "The -illins are the villains!" And personally, I'm allergic to Erythromycin in the Z-pack, but I'm considering trying it with Benedryl since it seems like the only option.

Has anyone out there had a not-too-negative experience with a different antibiotic?  I'd love to hear suggestions/experience/opinions.

For right now, I'm just pounding honey/lemon concoctions like it's my job and hoping to avoid this choice altogether...

Pound Cake (or close enough...)

 Craving something sweet?

We got home from dinner at 9:45 last night, and I NEEDED dessert.  (This isn't a pregnancy thing...it's pretty typical.)

So I cared about two factors:
1) Ingredients I already had in my kitchen
2) Quick prep

This pound cake from the Paleo people fits those requirements pretty well (although it does bake for 45 minutes).

Ingredients:

• 6 eggs
• 1 cup coconut milk (Buy canned in the ethnic food aisle--the others have added ingredients)
• 1/3 cup honey
• 2 tsp. vanilla extract
• 1 tsp. orange extract
• 1 cup almond flour (The original recipe suggested coconut flour, but I didn't have it.)
• 1/4 tsp. baking soda
• 1/8 tsp. cinnamon
• 1/8 tsp. sea salt 
• Butter to grease the pan
• Frozen berries of your choice (I like organic wild blueberries; they're tiny and delicious)

Directions:

1. Preheat oven to 350.

2. Grease a loaf dish thoroughly.

3. Beat eggs until smooth.

4. Add remaining liquid ingredients and mix.

5. Add dry ingredients and mix until smooth.  My almond flour got clumpy, but just keep mixing.  It is a really liquid-y batter; don't worry, it will firm up.

6. Bake for 45 minutes, but you may need to add time (I added 5 minutes).  Start checking with a toothpick around 45 minutes every few minutes.  

7. Microwave your frozen berries just before serving/devouring.  

I like to use frozen berries because I'm cheap AND because they get extra gooey when you microwave them and the juices seep into the cake.  It's awesome.  The cake itself isn't totally pound cake-consistency (as I'm sure you'd predict with all those substitutions), but it really does taste good.  I promise.

An Unbiased Overview of SCD

I post so much about the Specific Carbohydrate Diet, I thought it was only responsible to offer the two opposing opinions on this controversial diet.

The fact is, throughout my 13 years with severe colitis, SCD has provided me with notable relief.  I notice a huge and immediate change in symptoms within hours of straying.  (Frankly, I wish it wasn't so dramatic, because it's really hard to stick to.)  Unfortunately, it restricts some very healthful foods (like whole grains) and can make it tough to retain weight, but for me, I lose a lot more weight when I'm flaring.

So it's really my only option to stay healthy--and I'm not even trying to get off medicine.  (Many people on SCD do it with the goal of getting off meds altogether.  That will never be my goal.)

But even though it works for me, it doesn't work for everyone.  Here is an article from the wonderful CCFA that responsibly explores the two sides.

Foundation of SCD:

• "The SCD is a grain-free, lactose-free, and sucrose-free meal plan that is several degrees more restrictive than the gluten-free diet. It is built on the premise that carbohydrates are the primary energy source for the intestinal microbes that contribute to the development of IBD. [The central idea is that] undigested carbohydrates in particular spur the formation of acids and toxins that can injure the small intestine, destroying the very enzymes that allow for carbohydrate digestion and absorption in a kind of vicious cycle."

The article goes on to explain:

• Some people are helped by it, some are not.  Very hit or miss. 
• There are no studies that prove its effectiveness, but that's because no one would profit from running that study, so who would pay for it? 
• And as we all know, everyone is so different.  You might do really well on Asacol, and the next IBD patient might see the opposite effect.  The same is true for various diets.

Bottomline: if you're looking for relief, and the strongest meds are doing nothing, I'd give it a shot.  If it doesn't make a difference in a few weeks, don't waste your time.  Or, take bits and pieces after you see what works and what doesn't for you.  For example, I know that wheat is horrible for me, but potatoes in moderation can be okay.  But I do urge you to try the homemade yogurt!  It's my lifesaver.

Gooey Tomatoes

I made a huge mess with these, but they're super delicious

Got a pizza craving?  Me too.  If bread isn't agreeing with you either, these cheesy tomatoes are a pretty decent substitution--and incredibly quick.  (The most time consuming part of this recipe is literally the oven preheating.)

Ingredients:

• 1 big tomato (Choose a relatively firm one.  It gets goopy.)
• 1/2 c. shredded Parmesan cheese
• Chopped fresh basil to taste
• Salt and pepper to taste
• Olive oil...if you dare*

1. Preheat oven to 450.
2. Slice tomato evenly.
3. Spread tomato slices on parchment paper-covered baking sheet.
4. Sprinkle tomato slices with cheese and then with seasonings.
5. *The original recipe recommended drizzling the tomatoes with olive oil.  I wouldn't do that again; it turned into a giant gooey mess.  Full disclosure: I set off my smoke detector as the oil poured onto my oven. Oops.  I still ate every slice in one sitting...so good.
6. Bake for 15 minutes. 

Halfway!

Finally! A legit bump arriving at 5 months.

Here's a bump pic at the five month mark.  I've been struggling to gain weight (yes, I can say that on an IBD blog because I know you all can sympathize) and feeling really down that I haven't been getting bumpier.  ("Is my flare impeding baby's growth?")  Looking online at other people's bump pics has made me really nervous about baby's size, especially between ultrasounds.  

It's easy to read all the advice for healthy moms and freak out.  I desperately tried to gain weight in the first trimester by eating all sorts of junk and avoiding exercise, which just pushed me into an unmitigated flare--totally counterproductive.  But my doctors have told me to not stress about the numbers on the scale; just live in a way that supports health and remission.  That gave me great peace of mind.

And after our 20 week ultrasound, baby is actually on the bigger end of normal.  Hopefully it all continues along that trajectory!   

In this pic, you can also see those leg warmers I was knitting a few months ago--finally finished!

Tapering Prednisone. Maybe.

 Here we go...

Well...my "quick taper" off oral prednisone is turning into a very, very slow taper.  While I'm still feeling a huge improvement, the actual progress isn't quite as impressive (blood loss, etc...you know the deal).  I bet many of you can relate.  My colon just isn't catching on: we're getting better, dammit.

I was supposed to drop from 40mg of prednisone to 30mg a couple days ago, but after still seeing blood daily, my doctor has decided to slow the taper.  I went down to 35mg yesterday and am still using the cortifoam and hydrocortisone enemas twice a day (as well as the Humira: 80mg injected per week). 

Tapering is always scary--I start to see little hints of the flare returning, and it's such a time of "wait and see what happens"; tomorrow could be a disaster or an exciting improvement.  One day can be such a huge turning point when on the cusp of a flare.

At first I really wanted to taper as quickly as possible; the less prednisone I expose the baby to, the happier I'd be.  But as time goes on, I dread a return to the hospital; stable medicine HAS to be better for baby than sporadic high doses right?  So I'm resigned to spending at least the entire second trimester on prednisone.  (That's what it's looking like with the rate of this taper.)  Break out the pill cutter...   

Julian Bakery's Paleo Bread

Almond Paleo Bread from Julian Bakery (comes in coconut too)

Can you tell I'm obsessed with eating again?  I swear I'll post about something other than food soon. 

Sandwiches: the saddest loss when sticking to SCD.  I've tried all sorts of homemade almond bread, and it totally sucks.  Gooey, un-slice-able, useless.

Recently, though, a brilliant friend told me about this online-accessible bread from Julian Bakery that has changed my life.  Full disclosure: the bread itself is not super delicious.  But it is SLICED.  And this allows me to make sandwiches, which is amazing.  Also, it takes a few weeks to process your order, but once it arrives, you can freeze it for months.

Ingredients: Purified Water, Blanched Almond Flour, Egg Whites, Psyllium*, Organic Apple Cider Vinegar, Baking Soda.

*SCD warning: Psyllium is not legal.  But I find that this bread actually does sit pretty well with me, so if you're feeling adventurous, I'd give it a shot.  Save it for those legit bread cravings!

Sweet "Oatmeal" Recipe

Bet you have no clue what this is.  Read on...

I'm literally writing this post while eating this recipe, because it's so good I need to share it immediately.

Pinterest has once again been kind.  (If you're following SCD, there are so many great recipes on there; it's a really helpful community.)  Don't judge the weird green-ness of this "oatmeal" before you try it; it's delicious.

Since it's SCD legal, there's no sugar or grain in this pretend oatmeal, but it still gives you that rib-sticking feeling that we're all looking for.

Ingredients:

• 1/4 c. blueberries (I used frozen and just microwaved/drained them. Worked fine!)
• 1 banana (I didn't use the whole thing, but it's up to you...how banana-y do you want it?)
• 3 eggs
• 1 tablespoon coconut oil
• 1/2 teaspoon gluten free vanilla extract
• cinnamon to taste
• salt to taste
• 1 tablespoon nut butter of your choice (I like to use the freshly ground peanut butter from Whole Foods: it's literally just peanuts.)

 Fastest prep ever:

1. Saute your fruit in the coconut oil (I used blueberries and bananas, but you can throw in whatever you want).
2. Scramble the eggs into the fruit (Yes, that's right...I didn't beat my eggs first.  Lazy, but who can wait for breakfast??)
3. Toss in vanilla, cinnamon, salt and continue to scramble.
4. After scooping the mixture into a bowl, top with your nut butter.

Just the perfect mix of sweet and savory I want in my real oatmeal. This hits the spot!  I hope you enjoy too.

An SCD-friendly Breakfast: Egg Muffins

 Mine aren't as pretty as the ones from Pinterest, but they taste freaking great.

Thank you, Pinterest!  These egg muffins are delicious and easy; they were my first "home from the hospital" recipe and didn't disappoint.  (Though after nearly two weeks of hospital food, I guess I'm not the best judge...)

I altered the recipe a little bit from the original (linked above).

Ingredients:

• A dozen eggs were the perfect amount for my muffin tin.
• 1 c. chopped organic cremini mushrooms (or enough to cover the bottom of your muffin tins)
• one green onion
• 1 c. shredded cheese
• salt and pepper to taste
• butter/spray/something to keep the muffins from sticking

1. Preheat oven to 375.
2. Grease your muffin tin/liners.  (The original recipe called for a silicone muffin tray, and I would COMPLETELY agree. But I didn't have it.)
3. Fill each muffin tin with enough mushrooms to cover the bottom.
4. Cut several (I aimed for about 5) slices of green onion into each tin.  (I like to use scissors when cutting green onions. Lazy!)
5. Sprinkle shredded cheese into each tin.  I was pretty liberal because cheese is amazing.
6. Beat a dozen eggs in a separate bowl, stirring in salt and pepper to taste.
7. Pour egg mixture into each tin, filling about 2/3 of the way.
8. Bake for 25-30 minutes.
9. The original recipe says they keep for a week in the fridge.  We shall see!

Health.

 Me, in the world's cheesiest picture.  But it's how today feels!

This morning I woke up and felt it.  For the first time since last March.  Like many of you, I've gotten used to the physical, emotional, and psychological toll of the constant flare.  And then this morning I woke up and felt that almost tangible difference: health.

It's the feeling that today will bring happiness, not more pain and worry.  And the actual ability to feel that happiness.  It's so hard to really engage with the world and feel happy when your body is failing; no matter how much I try to muster the will power to enjoy the moment, month after month, the physical drain of illness makes it nearly impossible.

We go through the motions ("This disease won't get the best of me!") but the things that would normally bring satisfaction, feelings of achievement, or even joy are only a success because we were able to complete them.  I'm so happy to be able to get meaning from life again.

I am so grateful today.  Like anyone coming out of an 8 month flare, I have lots of progress and drugs ahead, but getting a glimpse of the health that is possible makes it such and exciting road.

A Really Big Study of Alternative Therapies During Pregnancy...

Photo from Shape.com...because I don't have fresh ginger in my hospital room

 
...and the conclusion: of all the herbal remedies pregnant women use, ginger is the only thing proven to work.

Here is the article from the New York Times.  Excerpts below.

• "The researchers found that ginger was the most thoroughly studied remedy, and the one found most consistently effective. It relieved morning sickness better than a placebo, and was as good as Dramamine at doing so."

• "But the evidence for other popular herbal options was lacking. Cranberry, often used against urinary tract infections, a common occurrence in pregnancy, was found ineffective. There was no evidence that garlic helps with preeclampsia, or that raspberry leaf shortened labor. And while castor oil appears to be free of side effects, it has no ability to induce labor." 

If you're anything like me, herbal remedies sound appealing from time to time because it seems like a way to skip additional pharmaceuticals.  Ah well...guess the take away is "Use with suspicion."

Returning to SCD: Mexican Casserole

 Photo and basis for recipe from www.scdforlife.com

Once I get home, I'll be focusing on maintaining the Specific Carbohydrate Diet again.  Over the course of the past week or so, I've been compiling lots of recipes, but I think I'm most excited to make an old favorite: Mexican Casserole.

Ingredients:

• 1 1/2 lbs ground turkey
• 1 can cooked black beans 
• 1 cup fresh pico de gallo (I just lazily buy the prepared kind from Whole Foods)
• 1 cup shredded sharp cheddar cheese 
• 1/2 cup homemade yogurt (if you don't have this, you can make it without)
• 1 avocado

Preheat oven to 350 degrees.

Brown ground turkey on the stove until cooked through.

Place 1/3 cooked meat in the bottom of an 8 x 8 baking dish. Layer with half the beans, 1/2 the yogurt, 1/3 the pico de gallo, and 1/4 cup of the cheese. Repeat. Add the last third of the meat on top, cover with the remaining pico de gallo and cheese.

Bake for 30 minutes.

Garnish with avocado.

 This is my version--served in bowl for easy shoveling into mouth.

For your non-SCD friends and family, you can serve this with tortillas, but my husband eats it like I do--in a messy bowl.

11 is the Magic Number

Oral prednisone: My ticket home?

Finally a breakthrough after 11 days on IV steroids!  Everyone says that it should only take 3-5 days to see a difference from Solu-Medrol, but I guess when you let things get out of control for so long, it can take longer.  While I'm certainly not close to symptom-free, frequency and blood loss are finally lessening. 

So tonight I begin oral prednisone to see if I can get off the IV.  If all stays stable, they'll let me go home in a few days to continue recovering there.  And as my doctor says, I'll continue to stick "all that stuff up my butt."  Yes, the enemas may have been the big lifesavers this week. 

The going home plan is 40mg of oral prednisone, 80mg of Humira every week, and cortifoam/hydrocortisone enemas morning and night.  I'm basically a giant water balloon of steroids, but I'll take whatever works.

Quick and Easy Knitting Patterns!

Even when you're not stuck in the hospital, IBD peeps are often stuck at home or hooked up to a Remicade IV, so I thought you all might have fun with some of these knitting patterns too...

Bear Cub Hat

We conceived in Yellowstone National Park (TMI?), so I think it's hilarious to dress our baby as a bear.

 

I used Spud and Chloe worsted weight yarn and size 5 dpn's.  

Hat: CO 72 stitches, knit in 2x2 rib for an inch and then stockinette for 3.5 inches.  Begin decreases to close off top of hat. (Here's a good basic hat pattern if you're looking for more detail.)

Each ear (do this twice): CO 12 stitches (doubling the yarn) and knit in garter stitch for 8 rows.  
9th row: Decrease (k2tog, k8, ssk). 10th row: (k2tog, k6, ssk) 

Bind off and sew your ears on!

Fair Isle Hat

I've already done this hat in a few colors (for other people), and it is SUCH an easy, fun knit.

Mods: I always use dpn's throughout when knitting hats.   I also like to add a pompon and earflaps with tassles to this one. 

Blue Sky Alpaca Organic Cotton worsted weight yarn works really well for this sweet hat.  

Chevron Blanket

I love Blue Sky yarn, and I'm excited to start this relatively easy-looking pattern.  I'll use only blues, creams, and beiges though.  (Yes, we're having a boy!)

The fun continues!

After 4 days on 40mg Solu-Medrol (through IV), my doctor is having me use Cortifoam enemas in the morning and more expansive hydrocortisone enemas at night.  While I do have pancolitis, these enemas have offered a little relief (at least from frequency).

I also took a double dose of Humira this week. My doctor says sometimes this can "reclaim" patients who've built up antibodies.  Fingers crossed. 

Other than that, just hanging around waiting for something to happen so I can be discharged from the hospital!  Thank goodness for knitting projects.

Hanging in the Hospital

I began writing this blog because I was searching for others' experiences dealing with flares and autoimmune medications while pregnant.  I couldn't find a blog that followed a patient throughout her pregnancy (only forums where women would post concerns, but I'd never get to see the outcome.)  I wished there was a place where I could get a full picture of what pregnancy was really like with IBD, which is why I decided to start writing this blog.  That said, it's only right that when things get crappy, I actually share the honest experience...

Anyone who has experienced an autoimmune flare knows those things can come on fast and strong.  After months teetering on the edge, I'm battling a flare that really took hold when I began the second trimester.  

  

For those interested in the drug therapy I've been following based on my docs' advice from Northwestern and University of Chicago, here it is.  They assure me it's completely safe for baby (despite the terrifying things we read online). For my own sanity, I'm choosing to believe them.

• I've been flaring since April (on 60mg of oral prednisone for most of the summer, and I was following the Specific Carbohydrate Diet).
• By August, I was able to taper down the prednisone, and my husband and I were excited by the surprising news that we were having a baby.  While I am over the moon about having this baby, the research and my doctors concur that getting pregnant while flaring is ill-advised. I would not have planned the timing this way, as your body typically stays in whatever state it is in when you conceive (flaring pre-conception=flaring throughout pregnancy).
• I happened to be tapering off prednisone the day after I got the positive pregnancy test, so I went the rest of the first trimester with no oral prednisone but stayed on Humira, injecting 40mg a week.
• Because of food aversions, the only thing I wanted to eat those first few months was bread, cheese and bread, and more bread.  In my totally unprofessional opinion, this seemed to worsen the flare up.
• By the second trimester, I was losing a lot of blood daily and was pretty much sick all the time (fluid loss was a concern too).  I went to my gastroenterologist at 17 weeks, and they said if I left the flare uncontrolled, I would lose the baby, even this late. This was shocking to me, since I had assumed that 12 week mark meant I was out of the woods.  Not so, if you've got active IBD.  I've seen women on lots of online IBD boards saying they're not reporting their symptoms to doctors because they are worried about prednisone's side effects on the baby, but this was a huge wake up call to me.
• I took one 5-day Medrol dose pack (always useless), and then a few days' worth of 40mg oral prednisone (so I could stay home for Thanksgiving) before being admitted to the hospital for IV steroids (Solu-Medrol, 40mg per day) and fluids.

So that's where I am now. Day 2.5 of steroids and fluids. No progress yet, but they say it typically takes 72 hours to see any difference.  And if this baby comes out with 10 fingers, and 10 toes, you can all feel relieved about prednisone during pregnancy since I've been your guinea pig. (Fingers crossed...)

Working Out Woes

Ran a 5k at 7 weeks. Super un-fun. How do these ladies do it?

I was never someone who "loved" working out to begin with.  So when struck with the one-two punch of nausea and exhaustion (yay, first trimester), I embraced total laziness.  Plus, while jogging on the treadmill had always been tedious, within weeks of finding out I was pregnant, I found myself getting really breathless.  (I don't think there's any medical basis for this.  Probably psychosomatic.  Or just psycho.)

The other issue I have--and this one actually concerns me in regards to the baby--is that working out often increases my IBD symptoms.  I'm not sure if working out leads to heightened immunity which then results in autoimmune issues, but I do notice a direct correlation between the working out and flares.

HOWEVER, my sedentary lifestyle (combined with a new-found obsession with all things carb) was starting to freak me out.  So with the second trimester, I'm back to the gym (very moderately).  I'm really enjoying yoga.  Spinning is okay too since it's up to you to determine the intensity.  Jogging still sucks, but the stepper is alright.

My flare has actually gotten worse, but I suspect that has more to do with my dependence on pizza (due to total food aversions to anything with protein or fiber), and less to do with yoga.  Here's to hoping the coming weeks bring that mythical "honeymoon stage" of pregnancy...

Ode to Dads

While I clearly write from the woman's perspective, the dads of the world are pretty awesome too.  I know my own dad could participate in this adorable video above...maybe one day my husband will be able to as well!

No More Tuna...

Trout from our recent fly-fishing trip. It's low mercury; who knew!

ABC News published this article today linking prenatal mercury exposure to ADHD.  Here's an explanation of the study:

"A new study highlights the difficulty pregnant women face while eating for two, finding that more mercury exposure leads to a higher incidence of ADHD symptoms, while more fish consumption -- the main source of mercury exposure -- leads to a decreased risk."

So should we eat fish or avoid it?

"Researchers...also learned that pregnant women who ate more than two 6-ounce servings of fish a week were less likely to have children with these [ADHD] symptoms. This is actually more than the Federal Food and Drug Administration recommends, which is only 12 ounces of fish a week." 

The take-away is to eat more low mercury fish while avoiding high mercury fish. Not surprising:

"Fish high in mercury include shark, swordfish and fresh tuna, Korrick said. Fish with lower mercury levels, which are also rich in healthy fats, include salmon, rainbow trout and herring. A third group, which has different health benefits but still is low in mercury, includes cod, shrimp and haddock." 

Here's the question that I kept wondering: do lox on my bagel count?  Many online sources warn about listeriosis associated with smoked fish and deli meat.  I guess I'll aim to get that weekly fish quota through salmon fillets (which could not sound more barf-tastic right now)...

Maternal Diet and Baby's Health

The Huffington Post published this article citing research that what we eat during pregnancy affects our babies' health long after delivery.  Excerpt below:

"Studies have already shown that if a mother eats large amounts of fish oil during pregnancy, it may exacerbate her child's colitis — an inflammation of the colon.
The effects of a mother's diet on her unborn children seem to be linked to the microflora — the microorganisms that live in people's guts — that are passed on from mother to child, Gibson [one of the lead researchers] said. There is evidence microflora can affect not only susceptibility to infection but also may have links to metabolic disease, diabetes and even autism, she added."

Frankly, the info is so vague, there's not much we can do but freak out.  I plan to switch my DHA supplement to one from algal oil rather than fish oil.  Aside from that, what can a constantly nauseated, carb-craving girl do? 

First Trimester=Knitting

Making it to the gym has become an internal battle that I don't have the will power for lately.  Seems like everything is exhausting recently!  So I've spent more time than normal knitting.  I'm still in the first trimester, so I'm superstitious about knitting baby things, but as the weather cools, all those winter patterns become more and more appealing.

I'm currently working on leg warmers I found on Pinterest (click to see what they'll look like completed).  The lace pattern is surprisingly easy to memorize, so it's a satisfying project.  The link to the free Ravelry pattern is here.

"It might get better, it might get worse...

Pain scale from the excellent blog Hyperbole and a Half

...or it might not change at all."  Those were my gastroenterologist's words to me when I asked him what to expect with my colitis now that I was pregnant.  It's looking like I'm in the last group.  A few friends with colitis have conveyed that their conditions actually improved during pregnancy, but I haven't had that experience.  I would be curious to know the stats on that (how many people improve/decline) and how quickly those who improve see that change.

After a few dietary dalliances this week (a bagel one day, sukiyaki with rice the next), I definitely paid the price.  Back to fruits and veggies...(boo! hiss!)

Spazzy About Stretch Marks

Yes, it's probably super neurotic to buy organic lotion.  But when so many things can go wrong, why not make choices that you won't regret?  I'm an "err on the side of caution" person when it comes to pregnancy.  And beyond the organic status of Spoiled Mama products, the tummy butter is so thick and creamy; I can still feel it in the evening.  The fragrance isn't anything to write home about, but that's because there's nothing artificial in it, and that makes me happy.

(Shockingly Good) SCD Carrot Muffin

Pregnant women want bread (at least this one does).  I've tried Specific Carbohydrate "breads" before (almond paste mashed into a bread pan).  Not good. 

But thank goodness for those Paleo Diet peeps; they've come up with some delicious recipes, and they're generally SCD friendly. 

This carrot muffin recipe (made with almond flour and chopped pecans but not nearly as dry as typical almond muffins) is delicious.  You can see I was pretty liberal with the cinnamon, and I'll add raisins next time.

CLICK HERE to link to the recipe.

Drugs, drugs, drugs...

For a typical mom-to-be, the idea of taking Tylenol would make her squeamish.  But for those of us with chronic illnesses, powerful drugs are a necessary evil.  When researching IBD drugs online, "the experts" reassure us that all is fine, but I kept asking myself, "Are real women following this advice or am I the only sucker?"  I couldn't find anyone legit online (besides anonymous forums) that discussed using biologics or immunosuppressants while preg.  

I currently inject 80mg of Humira once every two weeks.  It's not ideal, but I need it.  Both my OB-GYN and gastroenterologist insist that it is safe during pregnancy and even while breastfeeding (although baby cannot have live vaccines).  I was also on prednisone when I discovered I was pregnant and quickly tapered off that same week.  

Should the ever-lurking flare recur, I will be going back on prednisone.  The Docs say the risk to the baby is far greater if mom is flaring than the risk of prednisone's side effects; I'll keep telling myself that.  

Homemade Yogurt: Probiotics Without the Sugar

One of the cornerstones of SCD is homemade yogurt, and it's healthful for everyone--even those with unrestricted diets--especially pregnant women.  Those of us with IBD or IBS often avoid diary, and this is a great way to get calcium that you need now more than ever.
Additional benefits of homemade yogurt are:

• It has very little lactose (even less if you use goat milk). 
• It has probiotics that can help with digestive upset that all women suffer from when pregnant.
• You can control the ingredients.  Conventional yogurt has a ton of sugar, but homemade yogurt is literally just milk and probiotics.

My sweet mom makes me a batch every few weeks.  (I've done it myself too but failed because I didn't mix the probiotics well enough.)  She uses the Yogourmet yogurt maker and GI ProHealth probiotics.

Here are the steps:

1. Heat 2% organic milk for 2 minutes, keeping it between 185 and 190 degrees to kill bacteria.
2. Refrigerate milk until it returns to 70-80 degrees.
3. Slowly add probiotics (heaping 1/4 teaspoon for a gallon), mixing VERY well.
4. Allow the yogurt maker to heat the milk for 24 hours.
5. Remove internal container from yogurt maker (but don't open!) and refrigerate for 8 hours.
6. Enjoy!  I always top with honey and bananas or berries.  (Not tough enough for plain yogurt...)

Not Your Grandma's Peas...

One awesome pregnancy symptom I've had recently is instant hunger accompanied by nausea.  And when you're following the Specific Carbohydrate Diet, you can't just pick up a muffin at Sbux.  Whenever I find an SCD legal food that's nonperishable (ie. I can carry it around in my purse), it makes my day.  Today that food is freeze dried peas from Target (They have a whole line of freeze dried produce from Archer Farms).  Literally, the only ingredient is green peas, and they're actually pretty addictive.  Plus we can enjoy them without worrying that we're harming baby or ourselves.  Win-win.

(Mostly) Chemical Free Nail Polish

With chronic illness, there are so many things we can't control.  So whenever I can choose the most healthful, natural (read: risk-free) routes, I do.  However, I'm not ready to wear natural deodorant or forgo nail polish if I don't have to.  And I'm so grateful to Priti NYC for creating beautiful nail polish that doesn't have all those chemicals we're warned against: toluene, dibutyl phthalate (DHB) and formaldehyde.  It's as nice as Essie (yes, seriously), so I'll continue using it even after baby arrives.  You can also buy polish remover from Priti NYC, but it's a tiny amount for a not-so-tiny price.

If you're bothered by the smell of normal polishes, unfortunately these still have fumes.

Specific Carbohydrate Diet: It Can't Hurt!

While taking prescribed medication is essential to remission, I'm always trying to keep control using natural means.  I find the Specific Carbohydrate Diet offers some relief from symptoms and can keep moderate flares at bay.  It is extremely strict, but when I follow it obediently, it makes a difference.  The key rules are:

• No grains (wheat, barley, oats, rice, quinoa)
• No refined sugar OR sugar substitutes (replace all sugar with honey)
• No soy
• No potatoes (including sweet potatoes)
• Limited dairy

So what can you eat?  Lots of lean protein, veggies, fruits, and nuts.  There are some fantastic recipe books out there, and I'll post some of my favorite recipes as well.  Frankly, this is a very rich and healthful diet for your growing baby, and if it helps keep your symptoms in remission, it's worth it.  My OB-GYN and gastroenterologist both suggested that I continue the diet throughout pregnancy.

If you're new to SCD, check out the bible: Breaking the Vicious Cycle: Intestinal Health Through Diet by Elaine Gottschall B.A., M.Sc.

My favorite recipe book: Eat Well, Feel Well: Meals to help manage Crohn's disease, ulcerative colitis, celiac disease, diverticulitis, IBS, and other digestive conditions by Kendall Conrad, M.Sc.