Stool Transplant...Not Looking So Gross Anymore...

I've written about stool transplants before.  But even since then, my perspective has changed from something abstract to something that's a personal possibility.

It's been a week and a half since my first Simponi injections, nothing has changed, and I know I'm teetering on the edge of hospitalization.  After more than a year on high doses of prednisone, I want to avoid getting back on that roller coaster.  There aren't a lot of options.

This article about FMT (fecal microbiota transplant) was in the New York Times yesterday.  In short, taking a healthy person's stool and "transplanting" it into a sick person's colon can populate the sick colon with healthy microbes.  And it seems to really work when all else has failed.

Next time I see my doctor, I'll be asking about this. (Is that how you know you're at the end of your rope?)

Simponi: Not A Moment Too Soon

Just last month, Simponi became the newest biologic to be approved by the FDA for ulcerative colitis. 

And as I'm in a downward spiral of a flare, I'll be switching to it as soon as my insurance approves it.  (Or, I should say, IF my insurance approves it...please, please, please.) I've been injecting two Humira pens every week; Simponi will be one syringe every month. So that's nice. But the real question is, "Will it work?"

Let's hope so. I'll keep you posted. 

The other new development (or at least, new to me) is that there's a blood test to see if you've built up antibodies to Humira.  It's really expensive, so I'm skipping it since it's pretty obvious the Humira has stopped working, but it's nice to know that option exists.

And finally, for anyone else pregnant/breast feeding and on biologics, my doctor is telling me to continue to breast feed when I switch to Simponi.  He says that if the drug could have an effect orally, we could take it by mouth, but it's very fragile and will not pass to baby. Again, let's hope so!

SCD-safe Snacks, Part II

I love finding easy things that are SCD legal in the grocery store.  In this previous post, I told you about a couple stand-bys I love. Here are a few more snacks that almost fit SCD requirements, so they're my cheats lately:

Cliff's Kit's Organic Chocolate Almond Coconut Bar: These are a lot like LaraBar in the fact that they use dates to create their sticky, sweet base.  The cocoa in these bars makes them illegal for SCD, but everything else is okay. Plus they're addictively delicious; I buy them by the box.

 
 




Go Raw's Super Cookies: I buy these in Lemon and Ginger. They make other flavors too, some better than others (Pumpkin was not a fave for me). Don't expect cookies, but they have a nice crunch, a good flavor, and are SCD legal.

Wonderfully Raw's Cocoroons are delish, but they use maple syrup as a sweetener, so they're not SCD legal. I still eat them because they taste awesome and they don't feel as evil as some other options.  Vanilla Maple are my fave with Lemon Pie close behind. Cocoa Nibs...surprisingly not as good. And the Brownie are "meh"--I think I have higher standards for chocolate flavored snacks.

So those are my indulgences lately. Let me know if you've found some good, pain-free snacks!

Reboot!

Two months already??

 

I'm back! Baby is two months old, so it's about time I get back to it.

Here's what's been happening colitis-wise...

• Around delivery, I was flaring mildly (after tapering off oral prednisone and going off Humira to prevent infection while on bed rest after the water breaking).
• I restarted Humira when the babe was a few weeks old, 80mg every week.
• I restarted hydrocortisone enemas and Cortifoam (one in morning, one at night) when delivery mess healed (about 4-5 weeks postpartum).

Things are awful.  Tons of blood, frequency, pain, urgency.  I think it's exacerbated by the fact that the darling babe sleeps two hours at a time, so I'm not able to sleep at night.  Most of us have increased inflammation with lack of sleep, right? It sure feels like I do.

It's also been a lot harder for me to stay strict with Specific Carbohydrate Diet.  If any of you have tried it, the diet requires a lot of preparation and work, and I just don't have the energy right now.

The GI is making me take a C-DIFF test before we change anything. (Anyone else take a million of these per year? So annoying.)  It sounds like we'll be switching biologics if possible.  But I'm at the point where I'd really consider j-pouch surgery.

Any experience/advice with the surgery is welcome!

Welcoming...

Marcus Reid

March 18, 2013

5lbs 0oz, 17"

After 8 days on hospital bed rest (due to pPROM), Marcus was born at 33 weeks, 5 days.  Because my water was broken, we had a schedule induction at 34 weeks anyway. 

Because I had a solid week in the hospital before delivering, Marcus was able to benefit from two steroid shots (for lung development) and two courses of antibiotics (run at the same time).  When he was born, he didn't need any breathing support and, aside from being small, was healthy.  He did spend a week in the NICU to be sure that his weight was following an upward trend.

Some of you might also experience preterm labor, so here were my big take-aways:

On bed rest:

• Every hour extra that you can keep that baby inside, the better. We all know that, but when you're on bed rest, reminding yourself can be so helpful. 
• If you experience pPROM like me, take a probiotic during the antibiotic course.  My flare didn't get dramatically worse this time, and I attribute that to this probiotic capsule, Ultimate Flora.
• Ask your friends and family to bring in outside food for you.  Life on bed rest is dull enough without eating the hospital's roast turkey and string beans for every meal.  Treat yourself to little indulgences.
• Start a project.  I began a baby book and continued a knitting project.  Seeing the progress of both of those projects made me feel a little less useless.
• Don't watch TV.  This is my general rule when hospitalized anyway, but it's especially true when you can't leave the bed.  Daytime TV will make you feel brain-deadened and depressed.  (Ok, this is totally subjective!  If you love Billy Bush and Steve Harvey, never mind!)

On welcoming a preemie:

• Breastfeeding is a challenge with a little babe (so sleepy!), but be diligent about pumping, because as the baby grows, it will become easier and you'll want the supply to be there. (8 times a day for 20 minutes...it's a goal, not always possible.)
• Ask your hospital to speak with their lactation consultants if you're struggling.  The advice mine gave was truly invaluable.
• The day you are discharged and go home, leaving your baby in the NICU, will be the worst day of your life.  But the next day will start a new routine, and then it's just life.  My hospital had a support group, and it was very helpful for me--I imagine many other hospitals provide this support as well.  Seek it out.
• If your baby is anything like mine, don't expect more than 2 hours' sleep at a time.  They're just too small to have the energy stores to go very long between meals.  (This might be different if you supplement with formula, but I'm not doing that.)

 Overall:

• Epidurals are amazing.

I need to thank those of you who offered words of support during this stressful but joyous time.  While I took forever to update you, I did see your comments and messages, and I was so touched by your thoughts.  Marcus's health at birth was far better than what the doctors had expected, and I can only think that part of that is due to all the thoughts and prayers supporting him.  Thank you.

 

Here We Go...

Well, I was warned from day one when my GI said, "You'll probably miscarry, so don't freak out." (Yes, he really said that.)  So I expected that my pregnancy wouldn't be typical.

And then when I was hospitalized, everyone told me I'd go into preterm labor since I had active UC.  They were right.

At 3am on Saturday morning, I woke up feeling like I might be peeing a little bit!  After going to the bathroom and feeling like things were still kind of leaky, I started Googling.  Lots of women talked about having little pee leaks later in pregnancy, so I tried to convince myself that's what was happening and got back in bed.  But every time I shifted weight, it felt like I was continuing to leak a little.  (I'm telling you these lovely details because I really had never heard of this happening before, and would have appreciated a detailed account!)  By 7am, I knew that I was either going to have a really annoying final 2 months of pregnancy (peeing my pants constantly) or my water was broken. 

I paged my OB's office, and they told me to go to triage at the hospital.  After a very quick internal exam, they confirmed immediately that my water was broken.  At 32 weeks and 3 days, the doctors decided to give me two shots of steroids to develop the baby's lungs and begin two courses of IV antibiotics.  My GI suggested Gentimicin and Ampicillin as the least dangerous for IBD.  The goal is to keep the baby inside and prevent contractions until 34 weeks. 

At 34 weeks, they will induce me, because at that point, with low fluids, the risks to the baby begin to outweigh the benefits of keeping him in.  (Risks include infection or him crushing the umbilical cord.)

So that's the latest.  Here are my conclusions/the lessons I learned about all this:

• Apparently active UC disease can really mean preterm labor, just like the docs and research say.  
• If your water breaks, the baby can stay inside (and the fluids actually replenish!), but there are risks of infection to the baby because the membranes are broken and bacteria can get in.
• If the water is broken and you're close to 34 weeks, my docs won't stop labor if it begins.
• But if you can make it to 34 weeks, the baby is in pretty decent developmental shape (though he will have to spend time in the NICU).

Just sitting in the hospital bed now, trying to stay relatively horizontal because, "Gravity is not my friend" when it comes to contractions.

Cinnamon Rolls...decent

These cinnamon rolls are only like normal cinnamon rolls because they have cinnamon and they're in a roll shape.  Those details aside, don't expect a real cinnamon roll. They're more like rugelach. Crunchy.

Which is why I would suggest adding raisins.  With raisins, this recipe would be a million times better.  Without raisins, I wouldn't make it again (although I have eaten every last one of these...)

(Note: I didn't make the icing because I'm not a huge fan of coconut oil.  That might make the rolls better, if you like the coconut flavor.)

Ingredients:

Roll:

• 1 3/4 cup almond flour
• 1/4 cup coconut flour
• 1/4 cup of raisins
• 4 tablespoons butter (room temperature)
• 1/4 teaspoon baking soda
• 1/4 teaspoon salt
• 2 large eggs
• 1 tablespoon honey
• 1 tablespoon cinnamon

Icing:

• 2-4 tablespoons honey
• 1/4 cup Coconut manna/butter (Melted)
• 1/2 teaspoon Vanilla
• 2 tablespoons Coconut oil (Melted)

Directions:

1. Preheat oven to 350.
2. Combine flour, baking soda, and salt in a bowl. Mix.
3. Add eggs and honey to the bowl. Mix.
4. Add butter and mix it well, until a ball of dough forms.
5. Using two Silpats (or two pieces of greased parchment paper) on either side of the dough, roll the ball into a 1/4-inch-thick rectangle.
6. Remove the top Silpat or parchment paper and sprinkle the dough liberally with cinnamon. 
7. Drizzle with honey.
8. Scatter raisins evenly over the dough.
9. Using the Silpat/parchment paper, roll the dough into a log.  Go slowly and repair any cracks along the way.  (Seriously, use the Silpat/paper! It's really helpful because it doesn't stick as much as fingers.)
10. Cut the log into 1.5-inch rolls and place each on a greased baking sheet.
11. Bake at 350 for about 15 minutes.
12. Melt the manna and coconut oil. Mix with honey and vanilla.  Allow it to cool a bit so that it hardens on the rolls.

Why Bad Bacteria Kills the Good Bacteria in IBD Patients' Guts

Photo from http://www.ucdmc.ucdavis.edu

Earlier this month, the UC Davis published research in an article linked here.  The bottomline is that nitrates in the gut allow bad bacteria to kill off the good bacteria in the gut, which causes inflammation (causing a vicious cycle we're all familiar with).

Here are some key bits and bites:

• "IBD begins when “good” bacteria are mistakenly killed by the immune system, while harmful bacteria multiply — resulting in inflammation and damage to the intestines"

• "The researchers found that potentially harmful bacteria in the intestine called Enterobacteriaceae use nitrate — a byproduct formed during the intestinal inflammation in IBD — to grow and thrive. Enterobacteriaceae strains include certain E. coli bacteria, which can worsen the intestinal damage of IBD. Eventually, the intestines of those with IBD become overrun by harmful bacteria, and the numbers of normal good bacteria in the gut decrease."

While this doesn't have immediate results for us (I guess we could avoid food with nitrates, but I doubt many of us indulge in those anyway), this does seem like promising progress for treatment.  And perhaps it's another argument for frequent use of probiotics.

"Ancient Chompers Were Healthier Than Ours"

I found this article on NPR interesting in its own right, but it's also interesting as it may connect to IBD.

• "Researchers found that as prehistoric humans transitioned from hunting and gathering to farming, certain types of disease-causing bacteria that were particularly efficient at using carbohydrates started to win out over other types of "friendly" bacteria in human mouths."

I can only think a similar process happened in our guts.  As we consume more sugar and processed carbs, the "friendly" bacteria in the gut is overrun by the new, disease-causing bacteria.

The article goes on to discuss the resulting oral problems:

• "...that's a problem, because the dominance of harmful bacteria means that our mouths are basically in a constant state of disease. [One researcher commented:] 'You're walking around with a permanent immune response, which is not a good thing.  It causes problems all over the place'. "

Sounds a lot like IBD to me.

The author of this article hints that this supports the Paleo Diet, and likewise, the way I see it, this also supports the use of the Specific Carbohydrate Diet to treat IBD.

A Prednisone Rant

 I would like to toss these out the window. 

But, realistically,  I'll probably need to take them again soon.

Over the course of the last four months, I've been tapering down oral prednisone.  I started at 40mg (on the IV at the hospital), and then transitioned to 40mg orally.  Over the course of many weeks, I tapered by 5mg (sometimes stalling to get blood under control).

I was on 5mg every other day for two weeks, and now I'm off completely.  (However, I still take Cortifoam and Hydrocortisone enemas, so prednisone is technically still getting in there.)  And I'm still on 80mg (two pens) of Humira every week.

Things aren't perfect.  I still see some blood and mucus daily.  But I'm hoping the enemas keep things under control (or maybe even alleviate the symptoms I'm seeing).

In the past year, I've been on high doses of prednisone for 8 out of the 12 months.  And it's taken its toll.  Here is my rant:

What I love about prednisone:

1. It lets me keep my colon inside my body.

What I hate about prednisone:

1. Fatface.  Sometimes it gets more dramatic than others, but I always get a voluptuous double chin and some truly lovely jowls.  Sexy.
2. Hairiness.  Holy fuzzy fatface!  And then when I taper (ie. right now), the hair on my head falls out in disturbingly chunky hand fulls.  You should see my shower walls, sinks, laundry lint filter, vacuum...
3. Insanity/complete lack of patience.  Looking back now, I regret the rage that almost everyone in my life (and some random strangers) were subjected to.  At the time, I was sure that they were the ones who were crazy.  Oops.
4. Insomnia. Who needs sleep when you can lie in bed thinking about all the things to be anxious about?
5. Total exhaustion when tapering.  Not sure how much of this is pregnancy related, but whooooooa...I'm tired. Maybe it's just that I'm not fueled by all that rage and anxiety anymore?

I'm sure I'll be back on oral prednisone sometime soon, but I'm crossing my fingers to get through delivery without a relapse. (Yes, I can hear the universe laughing.)

Baby Blanket Knitting Project

This isn't mine (it's from www.thecakeplate.blogspot.com).  

But let's hope mine eventually resembles this.

In case any of you are knitting for baby...

As our baby is arriving in, at most, 9.5 weeks, I decided to commit to a knitting project.

I like this cable blanket pattern: I have a penchant for cables and it's easy to memorize.  In other words, it's easy to knit while watching crappy tv.  This is a common theme, but due to my laziness, I used yarn that I already had at home (Blue Sky worsted weight organic cotton) and opted for larger needles (size 11).  This is giving my blanket a much looser gauge, but since he's basically a summer baby, this is okay with me.  Though, if I were to choose for aesthetic reasons, I'd probably opt to follow the pattern more closely.  I also don't love using cotton yarn for cables, but hopefully it comes out alright.

Anyhow, the pattern is very well written, and I highly recommend it for anyone looking for a very simple yet satisfying project.

UPDATE: I ripped out that stretchy, cotton yarn and bought a merino from Malabrigo (606 Frost Gray). What's the point of dedicating hours to a project that's going to turn out sub-par? Also using size 9 needles now. Much happier so far.

A Sweet Pastry: Hamantaschen

Hamantashen! With pregnancy on the mind, I can't help but think these could also be viewed as Uterus Cookies (sorry, sorry...gross, I know...)

This week is the Jewish festival of Purim.  There's a whole story behind this holiday, but basically it means children in costumes, rowdy adults, and delicious stuffed pastries called Hamantaschen.

I was hesitant to even try an SCD recipe for Hamantaschen because I grew up with my mom's insanely addictive creamcheese-based version.  But, alas, almond meal pastries are better than no pastries.

And, what a relief, these are actually very good.  Even if you're not Jewish, you'll appreciate this yummy cookie-like pastry.

This is also a good basis for any pastry recipe.  I'm super uptight about eating only well-done eggs and meat while pregnant, but I was so tempted by the amazing smell of this raw dough, I almost tasted it.  That doesn't happen often with SCD recipes.

Here's the original recipe.  I followed it fairly closely (just added cinnamon--which was actually pretty important to the final flavor. I also disregarded the egg wash instruction).

Ingredients:

• 2 1/2 cups of almond flour
• 1/2 teaspoon of salt
• 8 tablespoons of unsalted butter, cold and cut into pieces
• 1 egg
• 1 tablespoon of vanilla
• 2 tablespoons of honey
• about 1 cup of fruit preserves or other filling of your choice (I like Fiordifrutta because they don't add sugar.  It's surprisingly hard to find preserves without sugar added!  But there is pectin, which is illegal on SCD.  You could use fruit or berries if you're being strict.)
• 1/8 teaspoon of almond extract 
• cinnamon to taste (for sprinkling)

Directions:

1. Pulse all the ingredients in a food processor, until most of the butter is dispersed in well. Aim for all butter bits to be pea-sized or smaller.
2. Place the dough into a big piece of plastic wrap and roll it into a log. Freeze for about 15 minutes.
3. Preheat your oven to 350 degrees F. Take the dough out and slice a circle off the end of the dough roll.
4. Place the circle on parchment paper on top of a cookie sheet. Place about a teaspoon or so of filling in the middle and then fold the dough around the filling into a triangle. Repeat for each pastry.
5. Make sure to pinch each corner so that the pastries don’t open up when baking. This step is really important.
6. Optionally, you can wash the pastry edges with egg wash. I don't love egg wash on almond meal because I think it turns a little gummy, but it's your choice.  It will be prettier.
7. Sprinkle all pastries with cinnamon, for appearance and taste.
8. Bake the pastries for about 15 minutes, or until they start to brown around the edges.
9.  Cool well before removing from baking sheet.

Check Your Fridge: Spinach Recall

Hello, fellow immuno-suppressed folks.  Look out for E.coli contamination with this spinach recall from Taylor Farms.

According to the Huffington Post article:

• The spinach that is being recalled is being sold in 5-oz and 16-oz trays under the following names: Central Market Organics, Full Circle Organics, Marketside Organics, Simple Truth Organics and Taylor Farms Organic. All the recalled spinach has a "best by" date of February 24, 2013.

If you have that spinach in your refrigerator, toss it.

Everything Crackers

 These crackers are delicious enough to eat alone, 

but they're also great vehicles for all sorts of dips.

I miss everything bagels.  Is there anything as satisfying as that salty, oniony mix?  With a small tweak to this cracker recipe, we can (sort of) replicate that taste.  Plus this is a good cracker recipe to accompany dips and soups.  (I'm making Amy's Split Pea soup tonight and wanted some crackers to go with it.)

Also, I doubled the recipe.  Why not have some extra crackers around the house?  Here's the original (undoubled) version:

Ingredients:

• 2 cups of blanched ground almond flour
• 1/2 teaspoon of sea salt
• 1 large egg
• 1 egg white in a bowl with a brush
• 1 tablespoon of olive oil
• 1 tablespoon of poppy seeds
• 1 tablespoon of sesame seeds
• 1 tablespoon minced, dried onion
• coarse salt to sprinkle on top of the crackers

Directions:

1. Preheat oven to 350.
2. Combine the flour and salt in a bowl and mix.
3. Add the egg, minced onion, and oil, and mix.
4. Shape the mixture into two balls of dough.
5. Place each dough ball on a non-stick baking mat (I used silpats), then place a piece
   of parchment paper (or other non-stick mat) over the ball and roll the
   dough into a thin layer.
6. Brush the top of the cracker sheets with egg white, and then sprinkle
   the seeds and coarse salt evenly over each sheet.
7. Score the crackers with a pizza cutter.
8. Bake for about 15 minutes, or until they start to lightly brown.
9. Cool for about 15 minutes and break apart into crackers. 
10. Store in a sealed container. (I actually might leave my tupperware unsealed to avoid the gumminess that seems to overwhelm everything almond flour-based.  But I'm planning on eating these pretty quickly.)

These are actually better than many of the store bought gluten-free options (and we can't eat those on SCD anyway).  

"Just Try Them!" Carrot Pancakes

This photo is from www.glutenfreehappytummy.blogspot.com because hers were much nicer looking than mine.  I didn't drizzle pureed strawberries; I nuked frozen berry medley and slopped them onto the pancakes. Still tasty.

This morning I asked my husband if he wanted pancakes, and he was initially intrigued.  But then he walked over, took a look at the batter, and said, "UGH! No!"

So they look really...healthy.  But start cooking them, and you'll see they're more like donuts.  My guy still won't try them, but if you give them a chance, I think they'll impress you.

Here's the original recipe which I didn't change much, but I did double it. Hey, I'm hungry.

Ingredients:

• 2/3 cup almond flour
• 6 carrots, grated (I bought pre-grated carrots, used 5oz.  Definitely worth the short cut!)
• 1/4 tsp salt
• 2 tsp cinnamon
• 1/8 tsp (more of a sprinkle) cloves
• Pinch of nutmeg
• 1/2 tsp baking soda
• 1 tsp pure vanilla extract
• 1 tsp honey
• 4 egg whites 
• Frozen berries of your choice

Directions:

1. If you're not as lazy as me, and you didn't buy pre-grated carrots, grate your carrots. Place them in a clean kitchen towel and wring out the excess liquid. 
2. In a medium-sized bowl (I used a standing mixer), whip your egg whites until they form nice peaks. 
3. In a separate bowl, combine your grated carrots, almond flour, spices, and baking soda. 
4. Fold your dry ingredients into the egg whites.
5. Add vanilla and honey.
6. On medium high, melt butter on a frying pan or griddle, spoon pancakes onto cooking surface. Cook for 2-3 minutes a side, until golden brown.  Watch out--they burn quickly!
7. Microwave your berries for about a minute and thirty seconds, til their warm.
8. Pour berries (I include some juice too) over pancakes.

Sugarless Fudge

 For the record, this recipe isn't SCD legal (we can't technically have cocoa).  But the third trimester is "first trimester"-ing my taste buds. 

Suddenly all I want are carbs and sugar again, and it's doing a number on my will power.

I've been trying to limit my sugar intake, but I have been cheating here and there (especially when my husband and I go out to dinner...the dessert menu is my Achilles' heel).  As a result, I am beginning to flare again, seeing blood daily.  (This should give you an indication of how crazy these sugar cravings are.  Even with the fear of a flare, I'm still cheating; I cannot control myself!)

So I tried out this less evil recipe today, and it's pretty good.

As I often say with recipes like this, if you don't expect real fudge, it's great.  Definitely not real fudge though.

Ingredients:

• 1/2 c. coconut oil (melted)
• 1/2 c. cocoa powder 
• 1/2 c. almond butter
• 1/4 c. honey
• 1/2 teaspoon vanilla extract (alcohol free)

 Directions:

1. Mix all ingredients together in a blender/Cuisinart
2. Spoon mixture into muffin tins with silicone muffin liners, filling each about 1/3 of the way.
3. Refrigerate for 30 minutes or freeze for 10 minutes.
4. Store in the fridge.

Ready-to-Eat SCD Lunches

Here are some of my go-to (almost) ready to eat SCD lunches.

• Avocado, filled with low mercury tuna (when not pregnant), or organic canned chicken breast (for these past 7 months), topped with ground pepper.

• Applegate Farms Organic Beef Hot Dogs.  I use mustard and dill pickle relish as condiments. Sadly, no bun.

• Paleo Bread (coconut) sandwiches.  I recommend toasting the bread to mitigate the gumminess.  I usually make either...
• Toasted, with peanut butter and bananas or thinly sliced apples OR 
• Toasted, with one fried egg and a slice of cheddar cheese (toast the bread with the cheese on it before sliding the egg on).

There you go.  My super quick, "I don't have time for homemade sh**!" lunches.

Store Bought SCD Snacks

Following Specific Carbohydrate Diet makes me yearn for the days when I could just microwave a ready-made meal.  We have to make absolutely everything from scratch.

That's fine for dinner, but sometimes I just want something quick and easy--and portable.  Seems like every granola bar (even gluten free) has rice, sugar, or agave syrup in them.

These are a couple options I've found that don't have verboten ingredients:

• Larabars are made of just dried fruit and nuts.  Some flavors are better than others. My faves are Peanut Butter & Jelly and Cherry Pie.  They're the most filling granola-like bar I've found.  

  

• "That's It" bars are made of just dried fruit.  They're sweeter than Larabars, and pretty good.

• I wouldn't classify this next one as a granola bar, and they're not filling at all, but they satisfy my sweet cravings because they kind of taste like fruity gummy candy.  Stretch Island Fruit Co.'s fruit strips are about 80% as delicious as fruit roll-ups.  Which is pretty decent.

Crispy Kale

Always hearing that kale is so healthful but not sure how to make it appetizing?  Cover it in salt and oil!

Ingredients:

• One bunch of kale
• Olive oil to taste (about 2 T., but it depends on how much kale you're using)
• Kosher salt to taste (Use a little less than you think you'll want--it gets overly salty pretty quickly.  I'd say use no more than 1/4 teaspoon.)

 Directions:

1. Preheat oven to 400.
2. Rip the kale off its stems into bite-sized pieces.
3. Toss kale with olive oil and salt (like you're tossing a salad).
4. Lay kale on a baking sheet.  
5. Bake for 10 minutes, until the edges are looking crispy.

I serve this as an easy side dish, like a salad. 

If you lay the kale in a single layer on the baking sheet and bake it a few minutes longer, the pieces will bake into a chip-like consistency, which is also pretty good.   

Mmmm, salt.

Coat anything with egg wash and kosher salt, and I'll eat it.

The toughest time to follow SCD?  3pm.  Craving a snack, and who wants ANOTHER piece of fruit?  Here's a snack that is almost as good as its real world counterpart: almond flour pretzels.   

The link to the original recipe is here.  I followed it pretty closely, and it turned out well.  You won't trick anyone into thinking it's a real pretzel, but it's still a good substitute.

Ingredients:

• 3 eggs, divided use
• 1-1/2 cups almond Meal Flour
• 1/2 tsp. salt
• 1 T. butter 
• 2-3 T. coconut Flour
• 1 teaspoon water
• coarse salt (I used kosher salt since that's what I had.)

Directions:

1. Beat 2 eggs, and set them aside.  
2. In a separate bowl, add the almond flour, salt and butter together and mix well.  Into this mixture, pour and mix the beaten eggs.  
3. Add in one tablespoon of coconut flour and mix in well. Allow coconut flour time to absorb before adding any more.  You are looking for a dough that can be easily kneaded, yet will not stick to your hands.  Add a second tablespoon of coconut flour (and a third if necessary), aiming for a play-doh-like texture.  
4. Let the dough rest for five minutes.  Preheat oven to 350°F.   Line a cookie sheet with parchment paper, a silpat, or liberally grease it.
5. Take a ball of dough about half the size of a golf ball, and roll the dough on a flat surface into a long skinny rod about the length of a pencil.  Keep the dough uniform in thickness.
6. Carefully lift the long skinny piece of dough to the cookie sheet.  Twist it carefully into the shape of a pretzel (or whatever shape you'd like!)
7. Place the pretzels in the oven and bake for 10 minutes.  
8. Beat the remaining egg and add 1 teaspoon water.
9. Remove the pretzels from the oven. Turn the oven up to 400°F.
10. Turn all of the pretzels over and you will see the bottom is browned.  This is the top of your pretzel. Lightly brush with the beaten egg and sprinkle with coarse salt.
11. Return to the oven for 5 minutes.

Bio-K: Conveniently Packaged Probiotics

$5 worth of health in this little bottle?  I hope so!

The Crohn's/Colitis board on Babycenter is a wonderful community and its members offer a wealth of information and support.  One of those members recently mentioned a probiotic I'd never heard of: Bio-K.

Today I'm tapering off Prednisone. (Well, 5mg every other day for two weeks, then nothing: that feels like practically being "off".)  Nervous without my drug crutch, I ran to Whole Foods this morning for a probiotic fix.   

Since this was the first day I tried it, I don't know if it works yet.  But I really hope Bio-K prevents flare symptoms, because it's got two strikes against it:

1. It's very expensive.  $30 for a 6-pack.  Yikes!
2. I don't love the taste of plain yogurt.  And it's kind of...chunky.  

 But the word on the Babycenter board is that the probiotics in Bio-K are more powerful and effective than in the SCD yogurt, so I'm giving it a shot.  (Though the yogurt has worked for me, so I may just stick with that in the long run.)

Let me know if you've had any experience with Bio-K (or if you've found a cheaper source)!

We're on our babymoon! See you Feb. 5th!

Don't Buy That Maternity Maxi!

Cute dress! But $140 to wear it once? Ugh!

As I planned for our upcoming babymoon, I cringed at the idea of buying summer maternity clothes that I'd never wear again (baby's due May 1st).

On the other hand, who doesn't want to look cute on vacation?  Or for a special dinner?

Mine for Nine is the perfect solution.  Through this site, you can rent maternity clothing for weeks or months at varying prices.  I was suspicious of both the clothing quality and the whole rental system.  I'm not the lowest maintenance person...

I'm not going to lie. I called and emailed them no less than 4 times before and after placing my order to confirm dates of shipments, deliveries, etc.  They were really nice.  But they're probably used to dealing with crazy pregnancy hormones. 

The dresses I received are beautiful.  They came in good, clean condition.  And the logistics of the rental are clear and easy.  Everything I could've hoped for. 

Baby's brain development: we only have to do a few things!

I'm a big fan of the show Modern Family.  In a recent episode, the hilarious (and pregnant) Gloria, uses headphones like these to talk to her growing baby.

But it begs the question: how much is baby really aware of?  I've been reading Brain Rules for Baby by John Medina, which I completely recommend.  The advice is generally logical and supported by reliable research.  Medina discusses how we can support baby's intellectual development through proactive decisions while pregnant (mostly regarding nutrition and stress management) and then throughout the child's early years (engaging with your child through a variety of modes).

And piping Mozart into your belly to raise baby's I.Q.?  Total B.S.

Additionally, NPR aired this segment today: Music, Multivitamins, And Other Modern Intelligence Myths.  I'd call it the blurb version of Medina's book.  With all the advice that we hear while pregnant, it's refreshing to get the boiled down basics of what really makes a difference based on solid research:

• Take Omega-3's while pregnant
• Engage with your child 
• NPR says to do this through interactive reading.  
• Medina discusses this too but also emphasizes the importance of just talking to your child, even when they're too young to converse.

That makes sense.

Weighing What We Eat While Pregnant

Nicholas Kristof compared two mice in his NYTimes column;

one was exposed at birth to a chemical that forever changed its DNA.

In the past few days, I've stumbled upon a recurring theme: what we eat (or expose ourselves to) while pregnant can have enormous and surprising consequences.

First, I read about the book Pottenger's Prophecy which deals with how prenatal nutrition affects baby's health.  (For the record, the book seems a little extreme for me, but I won't judge you if you want to check it out.  I just want to be clear that by mentioning it, I'm not necessarily endorsing it.)  It did make me look into the idea of epigenetics though. While looking at the book's website, I read this:

• "You are what you eat, the saying goes. And, according to two new genetic studies, you are what your mother, father, grandparents and great-grandparents ate, too.  Diet, be it poor or healthy, can so alter the nature of one's DNA that those changes can be passed on to the progeny." 

Here is an old article from Time Magazine that further discusses this field of study, if you're interested.  An excerpt is below: 

• "Epigenetics brings both good news and bad. Bad news first: there's evidence that lifestyle choices like smoking and eating too much can change the epigenetic marks atop your DNA in ways that cause the genes for obesity to express themselves too strongly and the genes for longevity to express themselves too weakly. We all know that you can truncate your own life if you smoke or overeat, but it's becoming clear that those same bad behaviors can also predispose your kids — before they are even conceived — to disease and early death." 

And then today, I read Nicholas Kristof's column, "Warnings From a Flabby Mouse" which pulled together the bits of information I'd been Googling.  While Kristof addresses some of the political issues surrounding this issue, here's the big take-away specifically for pregnant women, women looking to become pregnant, or anyone interested in the field of epigenetics (and how their environment may alter their DNA):

• If you're in the group mentioned above, be aware of several environmental toxins:
• BPA (avoid using plastic for food storage or preparation)
• Pesticides on food (eat organic whenever possible)
• Pthalates (avoid cosmetics or shampoos that contain these)

While this list of destructive chemicals isn't surprising, what I DID find notable is that steering clear of them is becoming more and more mainstream.  A few years ago, I felt a little psycho for carrying my water in a stainless steel container; now a respected journalist for the New York Times is calling out doctors for not warning their patients of BPA's risks.    

Kristof is also calling for legislation to regulate chemical use with the Safe Chemicals Act.  Perhaps the more of us who are aware--and supportive--of this act, the more powerful we can be against the lobbyists preventing its passage.

Very Flavorful Chicken Marbella

A Pyrex full of yum.

Non-perishable ingredients, easy, and delicious. All the components of my favorite recipes.  But do notice that you have to marinate it for a day beforehand...

Here is the original recipe.  Don't compare the photos!  Mine looks like a 3rd grader made it by comparison, but it still really tasted good.  (Also, I used drumsticks and a few boneless, skinless chicken breasts because that's what I had.) 

Ingredients:

• 3 drumsticks, 3 chicken breasts (or whatever chicken you have that fits into a 9 x13 dish)
• ¼ cup red wine vinegar
• ¼ cup olive oil
• 7 cloves of garlic
• 1 tablespoon oregano
• 2 teaspoons sea salt
• ⅓ cup halved or quartered prunes
• ¼ cup capers w/ juice
• 8 green olives – halved
• 2 bay leaves

 Directions:

1. Puree (I used the Cuisinart) red wine vinegar through the sea salt until the garlic is smooth.
2. Pour mixture into a large Ziploc bag (big enough to hold all your chicken pieces).
3. Add the remaining ingredients and mix to blend marinade ingredients.
4. Add your chicken pieces, and make sure all pieces are evenly coated.
5. Place in the fridge and marinate 24 HOURS.
6. When you are ready to cook, remove the pieces and place them in a 9 x 13 glass baking dish with all the marinade.
7. Preheat your oven to 350 degrees.
8. Bake the chicken for 50-60 minutes until well cooked.

Adjustment: When I make it again, I will reduce the sea salt to 1 teaspoon.  With all the capers and olives, it gets pretty salty.

Ew...hilarious...promising?

Desperation will drive us to extremes.  And here's a prime example of that...

This article was in the NYTimes today: When Pills Fail, This, er, Option Provides a Cure. 

It discusses the use of fecal transplants in C. Difficile infections.  The basic idea behind the procedure is that if you take a healthy person's poop--with all their good intestinal flora--and put it in a patient's infected digestive tract, the good flora will take hold and cure them. 

And the craziest part is...it works.

I've read about this for use in IBD, but it always seems way too gross to even think about.  But after reading this article, I looked it up again.  While I haven't found anything definitive, there are many small studies that show this seemingly far-fetched procedure working.  (Here's a clip from Huffington Post where they actually show how the procedure is done.)

Is this the future of IBD therapy?  Many of us are trying to get off meds; could this be our answer?  (And what's worse, months and months on prednisone and years on biologics, or an enema using someone else's poop?)

Just keeping my ear to the ground on this one... 

 ***

And on a sidenote, I cannot hear about fecal transplants without recalling Miranda July's film, You, and Me, and Everyone We Know.  When I first saw this scene, I just thought it was a super weird idea.  I guess this kid was onto something...

(This clip isn't for everyone--it's strange! You've been warned.)

Glucose Test: If You're On Prednisone...

(Photo courtesy cardinal.com)

Yum! Who's excited??

Every doctor is different and will give different advice, but I thought I'd share my experience with the glucose test which we typically get between 24 and 28 weeks.

Bottomline: You know how everyone complains about that sugary orange stuff?  It might be pointless for you to drink it.

My doctor told me that when you're on high doses of prednisone, you often have problems metabolizing sugar anyway.  Instead of having me use the sugar drink, she had me just do a fasting blood test.  (We were both also concerned about how the high levels of sugar could affect my tenuous remission.)

I fasted for 8 hours before the test.  Then they tested my blood.  I ate my typical breakfast in the office, and then an hour later they tested my blood again.  The doctor was confident that this was enough, and I was happy to get out of dealing with the infamous orange drink. 

It's worth asking about if you're on prednisone or a sugar-free diet (like SCD)!

Growth Ultrasound: Phew!

Some peace of mind in case you're worried about meds and lack of weight gain affecting your baby:

Last week, I went in for my 24 week appointment, and the doctor actually was concerned that I haven't gained weight.  I thought I was in the clear after my meeting with the physician's assistant where she calmed me down about that issue.  (Of course, I'm still eating like a crazy fiend.  No kidding, people comment about it.)  But the doctor recommended an additional ultrasound to check baby's growth, so back we went to the office today.

Turns out he's been growing just fine, as the physician's assistant had assured.  Baby is measuring exactly the size he should be for the due date. 

I'm relieved, and I hope this offers others in similar circumstances relief too.  You know I've been on mega-doses of prednisone, which can cause low fetal weight, and I haven't been gaining weight the way I'd like.  But, as everyone says, the baby takes what he needs.  Thank goodness.

Best. Grapefruit. Ever.

I could eat 10 of these in one sitting.

Word of warning: check your meds before eating grapefruit.  (I couldn't eat it when I was on Cyclosporine for a vicious flare awhile back.)

But whoa.  This sweet grapefruit recipe is delicious and takes about 7 minutes total.  

Ingredients:

• 1/2 grapefruit (But, to be honest, you'll eat both halves.  Just double the recipe...) 
• 1 Tbsp honey  
• 1/2 tsp. vanilla extract 
• Pinch of cardamom 
• Pinch of cinnamon 
• Pinch of nutmeg

 Directions:

1. Position your top oven rack to 4" below the top of the oven.
2. Preheat your oven to high broil.
3. Cut your grapefruit in half, and also cut all segments (like a pie) for easy scooping/eating later.
4. Drizzle grapefruit with honey first--this holds all the spices nicely.
5. Drizzle vanilla extract over grapefruit.
6. Sprinkle all the spices over the grapefruit.
7. Set grapefruit in a baking dish (use one with edges because the honey mixture does run)
8. Broil for 5 minutes. 

Enjoy! It's impossible not to.

Grain-free meatfloaf, for cold winter days

Hmm...how to make a photo of meatloaf look good...?

I've never eaten meatloaf before.  I did not come from a meatloaf family.  My parents are both excellent cooks and never really made anything so...1950's.  But I was having a major comfort-food craving, so when I found a meatloaf recipe that was SCD friendly, I thought, "Why not?"

My first taste of this made me wonder what the real difference is between meatloaf and meatballs, besides the shape.  But I like meatballs, so whatever.

Here's the original recipe, which we really enjoyed, though I did modifiy it to remove some SCD-illegal stuff.

Ingredients:

• 2 lbs grass-fed ground beef
• 2 eggs
• 1 medium onion, diced
• 8 cloves of garlic, minced
• 1 tsp dried minced onion (from the spice aisle) 
• 2 tsp paprika
• 1 tsp sea salt 
• 1/4 tsp nutmeg 
• 1/2 tsp ground mustard

Directions:

1. Preheat oven to 375 degrees. 
2. Grease your loaf pan.
3. Dice onions and mince garlic. Saute the onions in butter until they are translucent and then add the garlic for a couple of minutes, careful not to burn it.
4. Combine all of the ingredients in a mixing bowl.  (I gave up and used my hands for this.)
5. Form into a loaf and place in the loaf pan.
6. Bake for 30-40 minutes 
7. Slice and serve. (Mine fell apart a bit, probably because I greedily dug into it the minute it emerged from the oven.)

If you like ketchup here is an SCD-friendly recipe.  I'm not a huge ketchup fan, so I can't say I've tried it.  I ate mine with pico de gallo, and it was pretty delicious.  My husband ate it with Siracha sauce, which made me a little jealous.  

The nursery is painted!

 Yes, I made them pose with a paint roller after they were done.  

I never said I'm not cheesy.

This was our week of feeling grateful for our parents.

My husband's parents drove up here to Chicago from Florida to paint our nursery.  We were incredibly grateful for several reasons: I was relieved to be able to avoid the fumes, and my husband and I are the worst painters in the world.  And most of all, painting is such a long and tedious process, and they were amazingly cheerful about it--and did the most perfect job.

We used Behr Premium Plus paint (Reflecting Pool) at Home Depot.  It's allegedly low-VOC, but I don't know how much I believe those claims.  I stayed at my parents' home all week while my in-laws painted, just in case.  So we owe both sets of parents big-time after this week.

The light fixture is the Adler Pendant from Restoration Hardware Baby & Child.

(No furniture til April.  I'm still superstitious about that.)

And yes, our poor child's view from his nursery is of a brick wall.  Oh, the joys of city living...

Lemon Shallot Chicken Paillard. Way better than it looks.

Looks pretty bland in the photo, but it's surprisingly lemony and savory

Because you pound this chicken to smithereens before cooking it, this is a super fast poultry recipe.  And, despite the overwhelming beige-ness of it, the chicken really is very flavorful.

HERE is the original recipe, from Martha Stewart, but I changed it a bit.

Ingredients:

• 4 chicken breasts, pounded thin
• 3 tablespoons olive oil
• 1-2 tablespoons unsalted butter, cut into small pieces
• 1 cup chicken stock*
• 2 shallots, sliced
• 2 lemons
• salt and pepper to taste

Directions:

1. Preheat oven to broil (high)
2. Heat one tablespoon olive oil with one tablespoon butter  in skillet
3. Season front and back of your first pounded chicken breast with salt and pepper
4. Fry chicken in skillet, cooking each side so the chicken is cooked through, about 2 minutes.  Each side should be golden-brown.
5. Transfer chicken to Pyrex-style baking dish and repeat process to cook all meat. (If you can fit more chicken in the skillet, go for it.  Once mine was pounded, it was way too big to fit multiple pieces.)
6. Add oil and butter as needed to the skillet.
7. Once all meat is cooked and removed, saute shallots until golden in the oil and butter.
8. Add chicken stock, remaining butter, and the juice and fruit of both lemons (I scraped the entire insides out of the fruit--more lemon is better!)
9. Simmer for about 3 minutes
10. Pour the skillet mixture over the chicken in your baking dish and broil for about 5 minutes.

I decided to broil it because I don't feel like the meat is getting the seasoning from the sauce unless I see it actually simmering...probably doesn't make a huge difference!  

*I have never found SCD-legal chicken stock in the store, so I do use illegal chicken stock.  I haven't noticed that it causes me any problems; I suspect the sugar in it is pretty negligible.

Flu Shot...it's not too late.

This MSNBC article highlights the risks of this year's flu season, and as part of the immuno-suppressed population, I can't help but have a position on this sometimes controversial issue. 

I've seen a lot of information online about how the flu shot isn't effective (or that it can cause the flu), and I'm not a medical expert, so I'm not even going to get into that.  But I do feel pretty strongly that we should follow the advice of our medical experts (when it's logical), and my doctors at University of Chicago and Northwestern insisted on the importance of the flu shot. 

I am sometimes suspicious of advice from pharmaceutical companies, and I often doubt my doctors and do my own research or seek second opinions.  I am a supporter of questioning things that seem like facts.  But given the information out there from the CDC--and the unverified research that counters it--this one seems like a no-brainer.

Banana "Ice Cream"

Looks like ice cream, but it's JUST bananas! (...and, in this pic, peanut butter)

This recipe is all over the place, but if you haven't tried it, I really recommend it.  Couldn't be easier, and even if you're not on a restricted diet, it's delicious.

All you do is slice a couple bananas, freeze them (at least for a few hours, but I'd suggest overnight), and then blend them in a Cuisinart/blender.  Something magical happens, and it turns into the consistency of ice cream.

If you eat chocolate, you could add chocolate before blending.  I like to top mine with peanut butter (as you can see in the picture).

And it can stay in your freezer for months...but with how tasty it is, it probably won't.

"Make this once a week"

You know a recipe is pretty decent when your husband says this while eating it.

Sorry, no pics of this recipe because we ate it up like crazy animals.  I'll edit it in next time I make the recipe...

Since you have no image, here's what this one is: chicken drumsticks with a great spice rub.

Got this recipe from a Paleo site, and she made hers with turkey drumsticks--which sounds awesome--but were tough to find.  (My Whole Foods is still claiming that turkeys are in short supply after the holidays.  C'mon...)  So I made mine with the chicken drumsticks.  Still awesome, though not quite as Medieval Times-y.  Also, if you compare the original, I added cinnamon and took out coriander.  Just preference.

Ingredients:

• 10 chicken drumsticks
• 1/2 cup of olive oil
• 1/2 tsp cinnamon
• 1/2 tsp paprika
• 1/2 tsp cumin
• 1/2 tsp chili powder
• 1/4 tsp sea salt
• 1/4 tsp ground mustard
• 1/8 tsp white pepper
• black pepper to taste

Directions:

1. Preheat oven to 350.
2. Mix all spices in shallow bowl.
3. Pour olive oil into a different shallow bowl.  One by one, cover drumsticks in oil and then spice rub.  
4. Rub the spice rub in under the skin, and then return the skin to cover the drumstick.  It'll get deliciously crispy, so don't remove it.
5. Place drumsticks on a lined baking sheet (I use a silpat).
6. Bake for 50 minutes.
7. Turn the oven to broil for 5 minutes to make them crispy. Flip and broil for 5 more minutes.  Done.

Seriously, yum.  And so easy.

Today I spazzed.

Happy New Year, by the way!

Yesterday we announced the pregnancy on Facebook (with the photo above).

Then today I experienced a perfect storm of anxiety:

• A 3 lb drop when I weighed myself (despite my obsessive quest for calories)
• Multiple people (in real life, not Facebook) commenting on the small size of my baby bump
• A really busy day where I didn't feel baby kick as much as normal

So...yes.  I had a meltdown.  Self-diagnosed myself with IUGR.  (IUGR does affect IBD pregnancies, so it is important to be aware of it as a possibility.) Called the OB.

They were kind enough to see me.  Here's what they said, in case anyone else has a similar freak-out: 

1. "Big movements and small movements 'count' the same.  Just because you feel really big kicks one day and then light flutters the next does not mean you're feeling decreased movement.  Count and make sure you're feeling a total of 10 movements (big or small) per day."
2. "The baby takes the nutrients he needs.  Maternal weight doesn't measure fetus size.  Your uterus height, however, does indicate fetal size." (Which they checked in the exam.)
3. I was really worried about this ongoing cough I've had.  Don't make fun of me, but I asked if the baby could catch a virus from me.  The answer is no.  

So that's my embarrassing moment of the day.  I share so you can avoid your own (maybe...)  After all, there's nothing as comforting as hearing the sound of that heartbeat on the doppler!