Secret Weapon: Non-Dairy Milks, Again

Experiment: almond milk and vanilla...not quite there yet, but edible and dairy free!

First, a status update:  My recent GERD and gastroparesis flare up (belching, regurgitation, nausea, constipation, bloating) continues to subside, and I am feeling better!   I am being more mindful overall regarding portion sizes, eating slowly -- two factors that I think are the top reasons my GERD has subsided -- exercising more and differently (new strength training sets, and twice-weekly Tai Chi class), and choosing foods more wisely.

GOT (NUT) MILK?

I've further reduced my dairy milk intake over the past weeks:  I've avoided eating foods containing cow's milk at parties, and I am ignoring the usual stream of cupcakes and muffins at the workplace.   And, options for desserts (my usual lone source of dairy at home) have greatly expanded with the purchase of a Cuisinart Ice Cream Maker!   We have just started to play around with this new machine, and are having fun experimenting with all sorts of bases, including almond milk and hazelnut milk.  (I think cashew nut milk will be the secret weapon for quality vegan ice cream, given the extraordinary results by Lula's Sweet Apothecary -- a NYC phenomenon which unfortunately may be closed/closing.  Lulu's is the only vegan ice cream maker I've found that uses cashew milk instead of a coconut or soy or banana (see Gentle World's post on frozen bananas!) or almond base.

So, is it the addition of our ice cream maker (and, consequently, increased non-dairy desserts) that is making a difference, reducing my GERD symptoms?   Another possibility is my reduced carb intake, something I decided to informally monitor lately.  Less carbs = less breads = less wheat.  Another variable?   (But, elaborate tracking charts aside, it seems GERD can come/go without rhyme/reason/the stars align in mysterious ways.  Does anyone else ever feel this way?!)

Making a note and wondering if I need to go on another food elimination diet to see what's up with that.

From around the web, some dairy-free resources/recipes:

• YUM Universe's Dairy-Free Milk primer is a nice quick look at making and using dairy-free milks (including nuts but also sunflower, millet and rice!)

• Here's a thread from a celiac message board about people's experience going dairy-free -- and how it helps reduce/eliminate acid reflux

• I'm still exploring almond milk bases for our ice creams, and this West Coast blog has a few promising vegan ice cream recipes -- the photos are inspiring me to try these RIGHT AWAY

• And the My Whole Food Life blog spotlights a vegan strawberry ice cream and is a good resource, overall, to "clean" eating.

Secret Weapon: Pukka Tea

Stellar packaging by Pukka Teas.

I've been puzzled about a surge in my GERD symptoms.  Over the past month, I've had daily instances of reflux, the lump in throat feeling, heartburn, belching, and/or nausea, inspiring me to chew Tums on a daily basis.  So frustrating, since my symptoms have been subsiding!   The only cause I can point to is stress.  Since January, my life has been a whirlwind of deadlines, events, late nights, early mornings, galas, blizzards, even a concussion!  No wonder my guts are responding in kind.

To ease my digestive issues, I streamlined my diet this week, reducing caffeine and dairy, and I made a very deliberate effort to eat more slowly, eat smaller portions, and avoid constant "snacking" between meals to give my intestines time to catch up.   (I'm on the fence about whether snacking is good or bad, the "6 small meals a day" plan vs "give your digestive tract a break" plan.  And when I say "snacks" I mean bananas, nuts, homemade granola, oranges, applesauce -- not chips and candy bars.)

After a few days, I felt relief (though I did feel withdrawal from the caffeine).  Yesterday, I enjoyed two cups of dark oolong tea and a few squares of 70% dark chocolate for the first time in days, without problems.   This alternating between herbal tea and non-herbals continues to be a great strategy, allowing me to enjoy my beloved caffeinated teas and happy guts.  

Of note:  I am also filling my head with amusements to replace the stress -- long walks, comics, mindless television programs, music.  I do feel better, mentally and physically!

PUKKA TEA -- HERBAL TEA FOR THE HERBAL SKEPTIC!

Herbal tea is still a challenge for me.  I don't like the taste of many herbal teas that are out there, and many have ingredients I don't want to ingest (stevia, ginseng, acai, goji, etc.).   So I was thrilled to discover the array of herbal blends by Pukka Tea at their sample station at this year's NYC Vegetarian Festival.  They have their share of tulsis and ginsengs, but I was delighted to find various chamomiles and lemongrass teas, fennel and licorice blends -- a wealth of options for the troubled digestive tract! 

I bought Pukka's Chamomile Vanilla tea and the Rose, Lavender, Chamomile blend.  Both are wonderful, and I am not a chamomile fan.   (The chamomile tea that is still my favorite is the Chamomile with Lavender blend by Traditional Medicine.  Really good, and organic.)   I also picked up samples of the fennel blend and a rooibus variety.

And, the Pukka packaging alone is worth the purchase.  Visual meditation!

More Pukka packaging.  Aaaaahhhhh!

Linkage: Medical Students and GERD, Four Fixes for Acid Reflux,

Some interesting GERD-related items in the news:

• A survey of medical students in a Nigerian medical school revealed 26.3% were suffering from GERD.  Large amounts of cola and coffee are thought to be the cause, according to the GI specialist who discussed the survey.  I'm wondering if the pressure of medical school itself is a contributing trigger in this case -- med school is one of the most stressful training programs around.  

• The July issue of Spry includes "Four Fixes for Acid Reflux" by Dr. Jorge Rodriguez.  This quick list of tips are nothing new, but reminders are always welcome, especially since I am still not abiding by some of my own principles (tonight, I ate too quickly, too much, and finished a bottle of Diet Coke left behind by guests -- you can guess how miserable my esophagus feels right now).  

• And maybe my favorite link of the day -- Certified Nutritional Consultant and alternative medicine practitioner Brenda Watson's recent blog entry, "Part 1 of the Poop Chronicles."  I can't emphasize enough my personal experience regarding the connection between GERD and healthy motility.  Simply, when things aren't moving, I'm a reflux mess!   So, hurray for Brenda, who isn't afraid to put it all out there. There's endless amounts of interesting information on her blog/website overall, presented in a highly readable style.  Sure, some of her site is trying to sell you stuff, but I always learn something here (or am inspired to read more about it).  

GERD and Stress: A Constant Juggle!

What to eat in a heatwave.

I've been experiencing increased GERD symptoms lately:  the lump/food in throat feeling, off and on nausea, belching, bloating, and some esophageal reflux.   I spent several days traveling during the Fourth of July holiday, and the next week in a very busy work schedule.  A heatwave complicated my cooking efforts -- who wants to do anything by the stove when it's 95 degrees three days in a row?   I missed a greenmarket, have been dealing with constipation, and neglecting to eat mindfully (slowly).  What a mess!  No wonder my system is responding as it is.

DON'T GRUMBLE.  GET GOING...

I am telling myself to just "go with the flow"-- maybe this just will not be the perfect week.   Maybe I will be eating out for lunch, eating quick frozen vegetables and veggie sausages.  Last night, J. and I resorted to pierogis from the supermarket (albeit "homemade" in our neighborhood) and frozen spinach.  Do the best I can to resume my GERD-friendly eating habits -- go slow!  Breathe.    The big greenmarket and cooking-ahead are in my weekend plans.

...BUT STOP AND BE IN THE MOMENT

I strive to find daily pockets in my busy days where I am outside -- crucial for my sanity, especially since I spend so many hours in an office.  Just being mindful and in the moment helps ease my stress.

Here are some mindful moments I try to incorporate each week:

Visiting a farm -- even in New York City -- or the next best thing -- the Greenmarket.  This is Eagle Street Rooftop Farm, which sells its crops to local restaurants and in its shop.  Visitors can stop by to buy produce and pop upstairs to view the farm itself (and the Manhattan skyline from a new angle).  I'm always more relaxed after stopping by!

Leafy things growing at the Eagle Street Rooftop Farm.

Green beans at Union Square.

My weekly ritual includes shopping at the greenmarket early Saturday morning.  I am always inspired  by the fresh foods, their smells and tastes grounding me.  I was delighted to spot these beans a few weeks ago at Union Square Greenmarket.

Connecting with animals.   My GERD symptoms began after the death of my cat a few years ago.  I am thinking about adopting another cat but this may be problematic due to my schedule (I'm gone all day) and my landlord (he's not keen on letting me have another one; I barely convinced him to accept my original cat).   Meanwhile, I volunteer once a week at the local no-kill shelter, where connecting with cats and dogs (and pigeons and chickens!) who need homes is immensely gratifying.  I know I am benefiting as much as the animals, probably more.  

One of the cats for adoption. 

Replacing the hassles of the commute.   Once a week at least, I hop the ferry instead of taking the subway lines.  This involves a 30-block walk to the pier, a reasonable wait for the next boat (which gives me time to catch my breath), and a lovely ride across the river.  It is a magical and rejuvenating experience every time, even under gray skies!

East River Ferry.  

Trigger Me This: The Challenge of GERD Trigger Foods

One of the challenges of managing GERD is knowing your triggers.  If only there was a fool-proof guide!  From my own experience, and from what I've read, triggers are different for everyone.  And, sometimes, what will be a trigger varies from day to day.  

For me, I can usually tolerate chocolate and caffeinated teas after eating other foods.  Lately, I've been drinking a high quality green tea (sencha) around 10:30 AM with no problem -- in fact, my whole body feels great afterwards!  A few months ago, any green tea would not work out.  I don't know what has changed to allow my body to tolerate green tea again.   Tomatoes and onions don't bother me at all, but processed sweets (packaged cookies, supermarket cupcakes) can instantly flare up my reflux.  Yet, the famous Berger cookie -- a processed "cult cookie" from Baltimore -- does not trigger anything.  Drinking water or any liquid too fast usually results in the "food in throat" feeling, like literally water is sloshing up to the middle of my esophagus.    

With all these possibilities and sometimes contradictions, I was interested to read a thread on CafeMom discussing GERD triggers.  I am interested to know what other people can eat or avoid -- and how variable this situation is for all of us.  

From the CafeMom thread, here are the items that trigger GERD -- and don't:

TRIGGER FOODS

Cilantro

Red pepper

Fatty foods

Really cold water

Chocolate

Banana

Carbs

High sodium foods during or after dinner

NON-TRIGGERS

Orange juice

Tomato

Raw vegetables 

Eating small portions

Vegan diet

Aloe

Baking soda (as a heartburn relief)

Putting on the GERD (Dinner at the St. Regis)

Last week, I was invited to a winter fundraiser dinner held at the swank St. Regis hotel.  Finding a dress to wear was a major concern (that I solved quickly -- thank you, Nordstrom Rack and Adrianna Papell!) but wondering how I'd survive the evening without pushing my GERD to its limit was an even bigger challenge.   

I decided to give myself a head start by avoiding caffeinated tea for a few days up to the dinner, and also being especially mindful to eat slow and small portions.   (I hate to admit it, but tea can be a trigger for me.  I've been experimenting with ways to still enjoy it and minimize any trigger backlash.  Avoiding caffeinated tea for a day or two really does seem to allow me to drink a cup without issues, as long as my gut is feeling comfortable to start.)  I also increased my apple intake (applesauce and raw apple) and again avoided caffeine.  When it was time to go to the St. Regis, I told myself to relax, to do what I can to minimize my triggers but not to obsess about what I was eating (I don't have an allergy), and to focus on the festivity of the evening -- not just the food.  (Being a "foodie" that's a tall order, but I think reshifting my mindset did help.  I did not feel deprived avoiding a truffle; there was a fabulous view to photograph!)

APPETIZERS: HARD TO AVOID, HARD TO SAY NO


The willpower needed to stay the GERD-friendly course is like that of anyone trying to stick to a diet, whether for a health issue or weight control.   I felt immediate pressure to indulge in the passed appetizers and while I could have nibbled on something "healthy" beforehand, I chose to enjoy food at the event -- it was a special occasion and I wanted to participate in this "foodie's paradise."  My first choice was not a good one -- the brie cheese with honey on a fancy cracker.  It was the first tidbit offered to me, and I gave in to the polite waiter's impressive gentle pressure.   I thought I was going to gag; the cheese was so rich, with my very minimal dairy intake these days, it was overbearing.


Some mingling, and then I had a few nuts from a bowl and some "crudites" from a silver chalice -- good choices!   Some sparking water with lime, and I felt fine.    I'm already easily avoid non-vegetarian choices, so the pancakes with caviar, smoked salmon, and pigs-in-a-blanket did not even vaguely tempt me.   But others I could not resist -- where else do I get to slurp high-end mac and cheese from a ceramic spoon handed to me by a waiter in black-tie?  I resisted for a minute but soon gave in to a spoonful.  And a second spoonful.  Did it affect my gut?   I'm not sure, but I did feel a little disappointed that I did not maintain my vegan aspirations.  (That casein addiction, again.)

FIRST COURSE: BREAD AND SALAD


Once we were seated, it was easier to manage what I ate, and to eat slowly.  I found the waitstaff extremely helpful -- a "secret weapon" for anyone with a dietary concern.  They assured me they would have something vegetarian for me (at this point, vegetarian was "good enough" -- vegan was going to be too complicated). 

Dinner began with rolls and a mixed greens salad featuring green and white asparagus.  Divine!

I decided I would try just a bit of the round butter ball, and ignore the scoop of goat cheese.

ENTREE:  ENVY OF THE TABLE


My first impression when the waiter brought out a "mushroom risotto" for the vegetarian entree was not good.  I am not fond of mushrooms but that's all you seem to get at a non-vegetarian restaurant -- slabs of portabello,  the ubiquitous mushroom risotto.  What's that about?  When did mushroom become synonymous with "non-meat?"  Say I don't like mushrooms (I don't) or am allergic to them.  Then what?  (Then you're given that other non-meat restaurant staple, "pasta primavera.")   Honestly, it is not that hard to make a creative veg dish.  Or, maybe it is, according to Stefanie Gans' City Paper blog post, "The Politics of the Vegetarian Entree."

So, I was relieved to find I was enjoying my risotto at the Regis -- while a hackneyed concept, the execution was lovely.  I could taste cheese in the rice, but this did not bother me, and at the end of dinner, my guts felt fine.  And, the risotto was the envy of the table, enticing the meat-eaters (whose turnip side enticed ME)!

DESSERT:  ONE MORE CALCULATED RISK


Finally, dessert!  I knew I would be risking taxing myself with whatever dessert was coming -- sure to be decadent and dairy-rich.   And here it was, a "composed" chocolate ganache slice with caramelized biscuit and chocolate embellishment, with a side of chocolate ice cream.  I slowly ate two-thirds of the slice before feeling like I should stop -- I was getting full -- but I went ahead and finished the whole thing.  (I'm not a "clean plate" advocate, but couldn't bear the thought of leaving any of this behind.)

Ten minutes later, I had a small chocolate from a silver tray that was passed around the table.   I was not sure if I should have the black tea, but I decided I was feeling okay despite all this food, and enjoyed every drop.  I could tell it was very high quality tea.  (Does this make a difference?  Probably not for GERD, but maybe for my willingness to risk triggering my GERD…)

Reflection:  While I clearly recognized opportunities for a GERD-friendly experience, I ignored some of these.  I was surprised I did not suffer heartburn or other GERD symptoms after all this.  I think my low-stress, small portions, and occasionally mindful choices helped.  GERD continues to baffle me -- why do some days churn my gut, and other days don't?    In any case, the St. Regis evening was a success on all fronts. 

Report from My Gut: Post-Holiday GERD Summary

Apples from the greenmarket.  For me, apples are a "secret weapon" to good gut health!

MY POST-HOLIDAY GERD SUMMARY

Like most people, my holiday (in my case, Christmas) festivities were full of round-the-clock activity and food.   Anyone on a "special diet" -- vegetarian/vegan, gluten-free, dairy-free, diabetic, anyone going "without" or avoiding categories of foods for whatever reason -- needs to be especially mindful, proactive, and in good humor to make it through the barrage of pot-lucks, dinners, gift chocolates, and other holiday food frenzies with one's health intact.

Now, a few days before the New Year, I am feeling the effects of a week of delicious food but over-indulgence.    Disclaimer:  I also got a cold last week, so my stomach and body overall is feeling overworked.   For the past week, I am now experiencing these off and on gut symptoms:

• heartburn (TUMS are helping)
• morning reflux (again, after being awake for 15 minutes or so -- it does not wake me up)
• irregular intestines
• stomach pain (near the belly button)
• "tired" stomach feeling
• sleep apnea (I had two cases of this in the past week)
• food in throat feeling

I took measures to prevent or minimize GERD symptoms during my holiday gatherings, including:

• Reducing and/or avoiding caffeinated tea/beverage intake
• Having my usual breakfast each day (whole-wheat cereal such as Wheetabix, 1/4 C. nuts, raisins, almond milk) 
• Increased consumption of apples/applesauce (secret weapon!)
• Choosing to skip a chocolate dessert one evening when I thought my system felt "overloaded" already
• Maintaining an exercise routine while traveling, though much curtailed
• Getting a full night of sleep most nights

Still, I abandoned my effort to eat "mostly plant-based" whole foods, eating a cheese omelet at a diner, a slab of buttercream vanilla cake at a tea house, cheese-based casseroles, and non-vegan cookies and doughnuts.   Why did I eat these things?   The "ambience" of the holidays, peer pressure, my own desire to just "eat like a normal person," the fact I like the taste of all of these foods.   Still, why suffer at all?  A week later, I am still "de-toxing" and taking 1-3 TUMS daily.  Next year, should I stick to whatever works to keep my gut in check? (I know my family and friends would understand.)

I should add that even if I avoided any of my triggers while traveling, there is still the "return to New York City" syndrome.  This city escalates stress, and that stress does translate to GI issues.


BEANS AND POTATOES, SOUPS AND LEMONS

This week, to counteract the holiday diet, my meals and beverages were modest:  lentil soup, hot water with Meyer lemon, herbal teas, and a few potato and bean based meals.

A big hit was this combination of Cayuga Organics pinto beans, brown rice (Lundberg Farms brand), and turnips.   This was a simple, albeit monochromatic meal that tasted superb and was easy on the digestive tract!

Method: I pre-cook the pintos and freeze them into batches; to re-heat, either thaw in the refrigerator all day and then reheat in a pot with a small amount of water. Or, I've thawed/heated in one step in the oven.   The turnips are peeled, cubed, and boiled until their pungent qualities are reduced.)

Pinto beans, turnips and brown rice -- never mind the plain palette, this is wonderful!

The next night, I roasted a pan of carrots and turnips, and these fingerling potatoes and shallots, all courtesy of the greenmarket.

Method:  Mix with a few spoons of olive oil (use enough to coat; I "massage" the oil in with my fingers) and roast for 35-40 minutes in 400 degree oven.   Shake the pan a few times during the cooking to loosen vegetables; I also take them out near the end and turn with a spatula and cook a bit longer to evenly caramelize.  (This is not a perfect science; if I don't get all of them turned I don't worry about it -- I just make a small effort, and it gives me a chance to taste a few pieces, too!)    

I served this with leftover nut loaf and corn casserole.  

Roasted fingerling potatoes with shallots

I also made a batch of homemade applesauce.  I left the skins on, but my next batch will have to be peeled -- the skins provided an unpleasant mouthfeel in an otherwise lovely result.   This batch is made from four apples (one Fuji I had laying around, plus three heirlooms).  I also realized I need to add more water at the start.  

Method:  Take apples, peel and chop into small pieces.  Add to pot with water (amount varies; add modestly and see what is needed to keep the fruit from drying out).  Simmer until apples get mushy.  Mash with potato masher in pot.  Add cinnamon if desired.  (Don't add sugar!)  I've seen recipes online using apple cider (or Cognac!) as additions.  

Applesauce underway.

I am looking forward to Saturday's greenmarket trip and firing up my kitchen this weekend!  Happy and delicious (and reflux-managed) 2012!

Halloween and GERD -- Treats and Tricks

Each year, my office encourages costumes on Halloween -- we spend an hour giving non-edible treats to sick kids, so that justifies coming to work dressed as fairy tale characters, animals, and other eye-catching creatures.   It's fun, a good cause, and I love the fact I can go to work in something other than "work clothes."   I didn't have time to find costume parts to make myself into a giant pumpkin (my first idea), so last night, I cobbled together a pirate outfit from clothing I own: a red velvet shirt over a black and white striped turtleneck, old brown pants rolled up, old black shoes with buckles made out of cardboard and tinfoil.  Done!  (ARGH!)

Not done -- eating the candy.  For non-GERDy folks, over-indulging in Halloween treats is a potential problem.  For sensitive stomachs, even more so!  I have days when chocolate and other sweets do not affect me, and other days when one Oreo cookie is followed by acid reflux.   I'm still trying to figure out what triggers this response when it happens.


Meanwhile, I do intend to enjoy some chocolate treats today!    I tried to find some online tips about navigating Halloween with GERD and found this:

• Halloween candy without the heartburn (Health.com)

The rest of the Halloween/candy conversation out there focuses on how to get kids to NOT eat their candy.  Doesn't that miss the point of Halloween?    For instance:

• The Mayo Clinic's article about making Halloween a teachable moment
• Nutritionist summarizes the perils of too much Halloween candy

If you're going to do Halloween, then do it  -- and allow your kids to indulge (it's just one day or one week's worth of candy a year!), and don't forget to steal a few pieces for yourself!   p.s.  During our Halloween candy giveaway tonight, we offered chocolates to a few adult passers-by and they were delighted to snag a few bars!

Tuesday Dinner: Squash, Beans, Greens

My GERD has been more manageable the past week.  I have been drinking tea, eating chocolate, and went off my GERD Elimination diet on Saturday, apparently with good results.  I don't have an explanation, but I did notice by avoiding triggers for a few days, it allows me to then eat those triggers without penalty.  (Or, immediate penalty. Hmmm.)   Does anyone else notice this?

Here is our Tuesday night dinner -- roasted delicata squash (just slice, scoop out seeds, brush with olive oil, roast at 400 til soft), black beans (Cayuga organic beans that I soaked for 2 hours, boiled for 1 hour, sprinkle of salt towards the end of cooking -- these freeze very well), and frozen spinach (I was wanting greens and didn't have anything fresh left -- so this is just boiled in a tiny bit of water -- that's it).  That's a semolina bread hunk in the background, smeared with probably too much Earth Balance.  :)   I love these rolls -- they come from a NJ bakery that sells its goods at our local greenmarket.

(And, I roasted an additional squash which I can re-purpose on top of pasta, or as another side dish.  I'm always thinking ahead, plotting and scheming how to eat local / fresh / home-cooked without killing myself!)

Food Diary: GERD Elimination Diet - October

I am recommitting myself to figuring out and better controlling my latest gut issues.  I think another GERD Elimination Diet week will benefit me.   So, here we go, another week without caffeine, chocolate, spice, oils.   I'm also interested in sharing a few improvements I've made -- more nuts throughout the day, for one thing.  Thank you for the advice!

At some point, I'd like to try a few weeks of a "Food Elimination Diet."  I am intrigued by a coworker who discovered her gluten reaction by a variation on the usual elimination diet -- she spent weeks eating one trigger food every day for a week and then avoiding that food, documenting if she felt different when she stopped eating it.   I'd like to try this approach, which seems more doable given my schedule, out of town guests, nutrition needs, etc.  (It can't hurt, right?)

FOOD DIARY

Breakfast

Mood: somewhat nervous about intestines/off and on constipation; going to doctor for follow up visit (non-GI related); otherwise fairly relaxed 

Symptoms: reflux/belching before eating; belching and some reflux after eating; bloated overal

1 Wheetabix square

1 C. Blue Diamond unsweetened vanilla almond milk

1 tsp bran

1/4 C. ground walnuts

handful of miniature grapes
1/2 C. apple cider (from the greenmarket)

1 C. lemon verbena tea

Snack
1 small oat-bran-apple muffin (from home)
1/2 C. mini-grapes

Lunch
Mood:  content, busy, hungry
Symptoms: belching, some reflux off and on

1 serving eggplant-chickpea-tomato casserole (from home)
1/2 whole wheat mini baguette from Au Bon Pain (I forgot my grain today!)

Snack
1 banana
1/2 whole wheat mini baguette (the rest of it from lunch)

Dinner
Mood: Irritated, fatigued
Symptoms: No reflux but very bloated

2/3 C. Bird's Eye mixed vegetables
1 C. baked beans
2 Morningstar Farm sausage links (veggie)
2 slices rye toast
1 T. Earth Balance whipped spread

Snack
1 C. Breyer's ice cream (three flavor)

I went to bed feeling exhausted from a rigamarole of a day but slept throughout the night.  No GERD to wake me up.    [Note: By  morning, I woke up refreshed but again, about 5 minutes after waking and rummaging around the kitchen, I experienced a heavy feeling in my chest/stomach area -- what I think of as "reflux."   It is as if there is something "wet" inside my stomach.]

FIT Me!

Have you seen those make-up ads with the woman challenging the brand to "Fit me?"  "Fit Me!"  "FIT ME!"   Well, I'm ready for my diet to FIT ME and not give me FIT -- my acronym for that "food in throat" feeling.  I'm tired of it!   I'm cranky!


WHERE I STAND NOW

• food in throat/lump in throat feeling (sometimes I wonder if I am imagining it…but there is always a subtle sensation of this)
• waking up and 5-10 minutes later experiencing acid reflux (rarely am I woken up by this; it happens shortly after waking)
• increased acid reflux throughout the day (it comes in the morning and stays, or goes away and returns; I am definitely seeing an increase in "reflux," something I haven't had in the past)
• constant belching
• the occasional heartburn
• feeling too full too soon
• feeling like everything I'm going to eat is going to be a trigger (let's not underestimate the psychological effects of dealing w/our chronic gastro issues!

WHAT IS WORKING?

I need to step back and assess the past few months, during which I've tried:

1) a GERD Elimination Diet for 7 days (really helpful and I felt empowered afterwards!  this felt like a "cleanse" to me -- to just jumpstart good habits overall)

2) slow mindful chewing (also helpful; I haven't been practicing this for a few weeks due to guests, busy schedule, forgetting to be mindful)

3) reducing/changing my tea consumption overall (some days I don't have any tea!  most days, I start with low-caffeine teas like twig tea or herbals and may have black or green tea later in the day -- this does help and many times I don't feel tea is a trigger when I stagger it like that)

4) small portions (breakfast and lunch are set but dinner remains problematic…how to divide into two meals?  I'm not sure…)

4) trying to de-stress with more exercise, more efforts at "relaxing," more tai-chi (yes, yes and yes)  

TRIGGERS FOR MY REFLUX?

• eating too much at a sitting
• tea (ugh!  I hate to admit it.   But I do see a difference in drinking tea after having eaten something, or later in the day.  It does not bother me as much, or at all.)
• sweets (sometimes they can trigger heartburn)
• constipation (this is a definite correlation and problem…when it happens, it's a major issue for me; one preventative is a cup of tea in the morning, but this is also a trigger!)

Note that I have NOT been experiencing much nausea lately...

NEXT STEPS?

Carry on but listen to my positive experiences?

Should I again try a GERD Elimination Diet, this time being even more rigid about certain foods?  (I "cheated" once or twice on the last one.)    In any case, this might make me feel better, even psychologically.    

Should I go on a Food Elimination Diet?   I recently spoke with a woman who tried this and discovered her gluten reaction; she ate some of one type of trigger food each day for a week, then gauged her body's response when she eliminated the food.  A different tactic than the "don't eat it for weeks and then introduce it."  Hmmm.

Should I blog/log another food diary for a week with a focus on this morning reflux?   I don't think I tracked my moods and activities as well as I should have in the past entries, and this is something that I would do this time with more precision.

Am I sure I am experiencing GERD and not something else?  (Gallbladder issues?  Hernia?)   What about slow motility issues?  Could this be a factor?   Do I need to swallow those radioactive eggs?!!

Thinking about all of this -- and already feeling more empowered.  :)

Managing GERD While Sick, Part 1

One of the many orange juice servings I've been sipping…

HOUSE GUESTS, MINIMAL GERD!

My GERD tolerated a whirlwind weekend with houseguests during which I managed to eat my usual foods, largely due to my friends' interest in vegetarian dining -- our dining out included Hale & Hearty, Whole Foods, and my favorite Thai restaurant, while lots and lots of walking around the city.  I noticed some FIT and belching, but overall felt ok.  I ate lighter than usual, due to all of our "racing around."   I was pleasantly surprised by how little effect this busy weekend had on my GERD -- I guess I managed to keep everything in check.

CITRUS, A SECRET WEAPON/DOUBLE-EDGED SWORD

I dropped off my guests at the train station and spent the afternoon doing some postponed shopping to freshen up the work wardrobe.  By the late afternoon, I felt cold symptoms creeping up:  stuffy nose, throbbing head, tell-tale body aches, an overall feverish feeling.  By Monday evening, it was clear I had picked up a bug.  I dislike medications when I am sick, reaching instead for the citrus foods, soups, hot tea.  One of my secret weapons is Odwalla's "C-Monster" line, which gives you 2000% of your daily Vitamin C in one bottle.  I know, I know, Vitamin C isn't stored and all, but this stuff gets me on the healthier side of sick in a flash, nearly every time.    Not this time, though…

I pushed on for the rest of the week, until Wednesday afternoon when I had to relent and "give in" to bed rest.   On the way home I picked up Amy's No-Chicken Noodle Soup.   It's one of the few Amy's products that is underwhelming; not as bad as some reviewers have noted, but still not something I'd go out of my way to buy again.

A dose of aspirin, lots of glasses of orange juice, and a small dinner (1 potato pierogi, small scoop of kasha) helped me feel better but I noticed more belching, queasiness, and some heartburn.  That lump in the throat feeling was pronounced.  I blame the citrus -- definitely harsh on my GERD belly.

What's a cranky gut to do?

Monday Stomach Issues

It's 10:40 AM and my work day is being interrupted by stomach pain!  It is a sharp pain that feels like it is just under my navel.  I am also feeling very full -- as if I've had a huge meal, though I have eaten modestly today.

For all my gut issues, I hardly get "stomach pain."  Pains are usually centered around my intestinal area or back.   I am feeling a little "gassy" today despite no issues in the motility area.  Perhaps that's it?  Here is what I've eaten so far:

Breakfast - 6:00 AM
1 Wheetabix square
1/4 C. raisins
1 C. almond milk
1/2 graham cracker square


Snack - 9:30 AM
2 water crackers
1 wheat cracker
(I thought about eating these with almond butter, but did not want to open a packet as I was going to eat just a bit of it.)

Snack - 10:15 AM
1/3 C. green sugar grapes

Water - 10:49 AM
Decide to have a bottle of Poland Springs water (part of our office supply).
Pain is subsiding.  A while later, had some leftover corn from the cob (from last night's dinner).

Lunch - 1:00 PM
Decided I did not want the tomato-based dish I brought, so I went to the cafeteria and bought a veggie burger.   Perfect.   Also had two pickle spears.

Snack - 4:00 PM
1 apple from greenmarket -- super delicious!
1 small hunk of semolina bread

Dinner - 8:00 PM
I had a late function after work, so my dinner was subsequently late, too:
2 small halves of delicata squash leftover from roasting last night
2/3 - 1C. pinto beans
small hunk of semolina bread
1/2 C. frozen mixed vegetables with Earth Balance

I had stomach pain around 10:30 PM and later in the evening.   There is definitely a gassy issue going on, too (I was not going to dwell on this, but it's becoming a factor).  I wonder if the sudden appearance of squash -- a high fiber food -- is triggering this.  I doubt it's the squash -- that's an easy to digest food.   I'll keep monitoring my gut issues…

Tuesday Morning: Woke up slightly nauseous, some stomach rumbling, food in throat feeling greater than usual.   This is demoralizing!

What Not To Do on a Friday

Yesterday was a gastronomic disaster.   My emotional state was grim* and I know this translated to stupid food choices.  Which translated to a cranky gut.  Here's what I did, and shouldn't do again:

1. Did not pack adequate snacks due to laziness and apathy.   Regretted this later.

2. Hungry around 11:30 AM so I snacked on an office platter of cheese cubes and crackers.  Dairy, I know, I know.  I actually enjoyed it very much.  I ate around 6-7 cubes of Swiss and cheddar, and the same number of assorted crackers.  I did make an effort to chew adequately.  

3. I decided to make the cheese and crackers my lunch.  To boost the nutrition value, I ate my apple, which tasted bad.   (A disappointment since I got it at the Farmer's Market.)

4. Between 10 AM and 1 PM, I ate two mini cupcakes (vanilla with chocolate frosting) from Magnolia Bakery.  Leftovers from Thursday's reception.  Yeah, this is all sounding pathetic.  I ate them with excitement, feeling I was breaking a "taboo" (non-vegan crappy baked goods!  sugar sugar sugar before noon!) and I did also enjoy these.

5. I left work early at 2 PM intending to go shopping.  Instead, I felt frozen by my grim thoughts.  And I was caught in a rainy deluge.   My shoes were soaked and my interest in doing anything was thin.     So I just wandered around, accomplishing nothing -- and not enjoying my lack of accomplishment.   I did buy squash at a greenmarket, though, and looked at new eyeglasses.

6. I was hungry at 4:30 PM but instead of eating something nourishing, I had a cup of Darjeeling tea.  With two packets of sugar.

7.  J. met me and I "had to eat" so we went to the local pizza joint and had slices for dinner.

8. By the time I went to bed, I was feeling all bloated, reflux-y, overall "not good."  

I'm not proud of this day's intake, but there it is. 

Saturday morning --  I woke up determined to not repeat those mistakes!   Today's day-long art festival will not be conducive to eating the right foods in the right way -- it is a challenge to eat "in a crowd" and on the go, all day.   Where can I get vegetables?  Foods that are tasty but not overly seasoned?  Will people care that I am eating slow as molasses?

*My grim mood today is due to my realization that I can't have any pets right now for various good reasons.   There is a great cat up for adoption at the corner pet supply store and it's killing me that I can't take him home.

Taking Your GERD Out to Dinner: Macrobiotic Restaurants

Last night J. and I went back to a new favorite restaurant, Souen.  A longstanding "macrobiotic institution" in Manhattan, Souen is classic macrobiotics, with its blend of simple seasoning, complementary foods, easy to digest ingredients, and mostly vegan approach (macrobiotics does incorporate fish; still, for a vegan/vegetarian, macrobiotic restaurants can be very exciting places to dine).

Here is our dinner:  broccoli and shredded tofu with carrot sauce (front) and kombucha squash with tofu and vegetables with tahini sauce (rear).

Sublime!  What I love about macrobiotics is this is inherently very flavorful* food without the usual GERD triggers -- no spicy ingredients, no salt, and no fats.    Our food all settled quickly and neither J. nor I felt any negative after-feelings that can sometimes happen after a meal out.  NO regurgitation overnight for me, either!  :)

I feel especially good this morning -- just a slight food in throat feeling -- what IS that, anyhow?  why does this persist every day?  I am starting to wonder if I am imagining it, or if it is more related to "stress" than any food related triggers.  

RESOURCE: Meta list of macrobiotic websites



*Some people think macrobiotic cooking is too stark -- too bland compared with "regular" cooking.  Since we've cut salt way down and tend to cook simply ourselves, this approach is just perfect for me.  I think diners need to put aside their expectations and let the gentle flavors emerge.

9-11 and Acid Reflux Connection

Interesting!

A new study shows people who experienced the 9-11 tragedy have increased cases of acid reflux.   Researchers suggest both stress and the actual dust toxins seem to be triggers.

Acid Reflux, Again

Most of my GERD symptoms have been minimal -- that "lump in throat" feeling being the main concern for a long while.  Every now and then I'd get "heartburn" but this is rare -- months between episodes.   Regurgitation, or acid reflux, is not a regular symptom, either, but more prevalent than classic "heartburn."  None of my symptoms are "painful" but, rather, they are uncomfortable and the thought that I'm causing damage is the most troubling part of what I am going through.

Still -- when it happens, waking up to acid reflux is one of the worst sensations.    This is not common for me, but it happened this weekend.   And why not -- what a stressful bunch of days!

BUSY DAYS, NO BREAK, COLLAPSE = NIGHTTIME REFLUX

After a very busy work week -- many competing deadlines, my own self-inflicted pressure to "do it all" -- I had to continue the pace.  I worked on Saturday as well, staffing an information booth at a street fair.   By the evening, I was exhausted to my core, collapsing in bed far too soon after eating dinner -- and paid the price!   There was also a heightened alert for New York City due to possible terror threats.  

I had horrible acid reflux Saturday night.   I woke up around 1:00 AM and took two Tums, which may or may not have helped -- I fell immediately asleep.   I forgot to wear my nightguard -- I can definitely sense my jaw is clenched these past days, too.

Whenever I feel reflux, I engage myself in some "self talk," telling myself it will be okay, to relax, imagine the acids receding and a normal GI tract. 

My diet on Saturday was spotty -- no real lunch:

Breakfast -- 6:00 AM

1 C. Oaty Bites

1/4 C. raisins

1 C. almond milk

Snacks - 2:00 PM - 5:00 PM

Since I couldn't leave the booth for long, I stepped aside and snacked on:

1 banana

1 Odwalla Strawberry C-Monster

1/2 breakfast protein bar from Long Island City bakery (vegan!)

4 Oreo cookies 

Dinner -- 7:30 PM

1 corn on the cob

2/3 C. beans (heirloom yellow eyes)

1/2 C. frozen spinach

Earth Balance

1 semolina roll with olive oil for dipping

Dessert -- 8:30 PM

3/4 C. chocolate chip ice cream (Breyer's)

My reflux settled down by breakfast the next morning, Sunday (9-11).  I spent Sunday in a constantly fatigued state, barely willing to do anything but J. dragged me out for a long walk.    I decided to avoid all caffeine -- no tea! -- on Sunday, to see if this would help calm my gut.   Not sure if it did, but sometimes tea negatively affects me, so I'm learning to avoid it some days.   By this morning (Monday), I am still having the FIT (food in throat) feeling, but I hardly am aware of this -- I am still too tired to register any other sensations!

Heartburn Trigger: Cheese and Large Portions

I need to heed my own advice!  My diet on Wednesday was excellent:

Breakfast - 5:15 AM
1 Wheetabix square
2 tsp bran (to counter the constipative effects of my antibiotics.  grrrrr!)
1/2 C. orange juice
1/4 C. raisins

Lunch -- 1:00 PM
My own lunch concoction made of brown rice leftovers, half can of lentil soup poured over this, and a quarter cup of yellow eyed heirloom beans I had just cooked.   Filling and delicious and nutritious!

Snack -- 2:00 PM
 1/3 C. applesauce

Now it gets ugly.

After a lunch meeting ended, my coworkers and I snacked on the leftovers: baked ziti, salad, garlic bread.  (I bypassed the chicken.)    I was hungry for a snack -- but soon realized this was a mistake on many levels:

 - too rich
-  not vegan (my aspiration)
-  a banana or apple would have probably satisfied me; I did not need to eat all of that

Less than a half hour later, I felt not only disappointed at my lack of control, but heartburn as well.  This was a shearing, burning relentless heartburn that followed me all the way home and through dinner.  What a mess.  I think it was due to eating too much too fast more than the dairy (why don't I get heartburn when eating ice cream?).

Another trigger for your consideration:  deadlines!  I have several, all converging, all equally important.   I can feel myself getting clenched up over this, and no doubt my gut is also getting clenched from the stress…

Smaller Portions, Less GERD

Rainy days coinciding with a busy week ahead.  In the next seven days I will:

• attend Fashion's Night Out
• see Moby at a Barnes & Noble appearance
• coordinate a booth at a street fair
• coordinate a booth at a Mets game health fair
• volunteer at the animal shelter
• run "on all four cylinders" at work to meet deadlines and prep for the aforementioned fairs

I'm already pacing myself, getting nutritious foods ready, and planning for extra sleep.   (How is it that we don't take sleep seriously?  That it's the first thing to go when we're super-busy?  How did sleep deprivation become so glamorous and a mark of success?   I wonder if I got more sleep than my usual 6-7 hours if my GERD symptoms would decrease.)

SMALL PORTIONS -- ONE STEP TO HEALING

Progress!  I can definitely see a difference in my day when I have a "half breakfast" followed by a second half breakfast a few hours later.  

This usually involves a half portion of cereal (though I have a full serving of almond milk, since I like it for my calcium, Vitamin D, and other nutrients) around 5:30 AM - 6:00 AM and a homemade oat-flax-raisin-apple muffin (these are tiny, made in a vintage tin!  not your usual bowling ball sized muffins!) around 9:30 AM.   Or I'll have a hard boiled egg (from my pastured eggs at home), or a quarter sesame bagel, plain.   I have been experimenting with nut butters for a second breakfast, as well.   I usually have some fruit as well -- berries, applesauce, or a stone fruit.  

For lunch, I have a regular portion, which is already reasonable, and for dinner, I've reduced my intake altogether by about one-fourth of my usual portion.   I allow a couple of snacks throughout the day as well (granola bars, fruit, nut butters on crackers or half slice bread).  

Immediately, I feel better, and really feel the positive effect during the morning into the afternoon.  No bloating.  There may be some "food in throat" feeling after breakfast, but I suspect this may coincide with my caffeine intake, if I'm drinking black or green tea that day.  I will have to log this!   I'm still playing around with alternating days of tea in finding a way to still consume it, even if it is a trigger.   

A PUZZLE...

One thing puzzling me -- why do I have GERD symptoms (slight heartburn, FIT) after a few moments of waking up in the morning?  I don't wake up from symptoms, and don't have them right upon waking -- they kick in 5-10 minutes afterward.  Hmmm.  

BONUS LINK: To help pace myself and generally de-stress, I'm trying to incorporate more mindfulness in my days.  Here is a useful piece on mindful breathing.

Detective Work -- Did the Red Grapes Do It?

Am I trying to prove to myself that it is stress and not food that is my GERD trigger?  Well, maybe.  That would be a lot less complicated, right? 

In this spirit, I was pleased to find a link to a 2006 study linking GERD symptoms to stress.   The study's caveat is that stress does not predict GERD's impact on the esophagus.  (The study is flawed in a few ways, but I was interested to see the distinction made between GERD symptoms and endoscopic results.)
 
While I'm getting back to my regular diet, I am experiencing a lot of GERD symptoms today.   Here's my intake so far:


First Breakfast - 6:30 AM:
1 Wheetabix square
1/4 C. raisins
1 prune
1 C. almond milk

Second Breakfast - 10:00 AM:
1 package Irish instant oatmeal with my own cinnamon
1/2 C. orange juice
I managed to have an expanded brisk walk this morning, as well.

Snack - 10:30 AM:
5 red grapes
2-3 cherries

This is where the problem exacerbated.  I have been belchy (and gassy) for the past days, and experienced definite heartburn pain yesterday and the day before, to the point of reaching for Tums.  (Which did not help.)
I was feeling a little better this morning with less symptoms overall. 

Around 10:30 AM I decided to have some fruit, but after a few grapes, I immediately felt that "food in throat feeling" more severely than in recent weeks.  It was as through the grape skins were stuck to my esophagus.  The skins were especially thick and bitter -- does this mean anything?   Usually, I don't have problems with grapes.

Lunch - 12:45 PM:
1 serving chickpea-eggplant-tomato dish (homemade by me)
My accompanying rye bread was moldy.    Darn!

Snack - 2:45 PM:
1 white roll from Le Pain Quotidien
1 packet maple almond nut butter (3/4 finished; interrupted by meeting)

At 4:21 PM, I feel ok.  FIT but heartburn.  Some belching, more gassy.   This, despite a super busy day.  I don't feel "stressed" but rather excited and even a little manic, with all the projects swirling around me. 

Dinner - 6:30 PM
Bean curd with basil and brown rice at local Thai restaurant.  I had an unpleasant sensation while eating the green peppers and eggplant that were part of this vegetable-loaded dish.  I felt unsettled in my stomach afterwards, and took a Tums to see if this would help (it did).   In this case, the veggies may have been bad; I don't think this was GERD-related.  I felt very full after this modestly sized dinner despite having been "starving" at the start.

During dinner, I learned that J. also had trouble with the red grapes.  Earlier, he had a few and said he did not feel right afterwards -- they made him feel "funny" in the stomach and head.

Dessert - 8:00 PM
1 C. Breyer's ice cream (Vanilla Fudge)
By this time, I felt fine.

I am looking forward to the greenmarket on Saturday, and resuming my normal diet full of fresh produce, grains and beans!