Andrea's Blog

On Easter, this year, while everybody's eating their dark chocolate Paleo-friendly bunnies (I like to bite the ears off first), I'll be celebrating 15 years of being gluten-free. It's hard to believe. "Back in the day", things were a whole lot different than they are now. It seemed that few people had celiac (or were gluten-free) or knew anything about it--including the professionals. The testing was different--biopsy and IgG anti-gliadin or anti-endomysial blood tests. The pre-made food was a lot harder to find (and surprisingly less expensive) and the education of the medical community was nearly non-existent. My how things have changed! There are sensitive and specific blood tests now (tissue trans-glutaminase), everything seems to have a gluten-free label on it, and docs--especially those in our profession, seem to know more and more about the benefits of going gluten-free.

My household has been gluten-free--exclusively--for the last 5 years. It's so important that the whole house be in support of the diet. For me, it was a no-brainer. Both Grey and I are Celiac, and Forest has never purposely had gluten. All the support groups stress how important it is to avoid contamination (and NOT cheat!). In order for a product to be considered gluten-free, it has to have less than 200 ppm of gluten.

For Celiacs, even small/accidental exposures are dangerous. People might not have an overt reaction to contamination amounts, but they might still cause sub-clinical symptoms--flattened villi, malabsorption, deficiencies, and constant damage to the GALT--leading to lymphoma and GI cancers. Yikes, right?! These small amounts can remain in cooking utensils, porous cooking pans, and shared equipment. So, after a major move and shift within the family, we started over with new utensils, new pots and pans, and a completely clean house. Other than the occasional poison-carrying visitor and the cats (whose food smell reminds me of wheat bread toast), we don't even allow lickable envelopes (Did you know that glue contains wheat?).

I can't begin to say how much of a difference going gluten-free has made in my life. Besides feeling infinitely better, I've experienced a number of benefits--from clearer thinking to better skin and hair (and most importantly, a happier gut!). For Grey, the benefits were a lot more dramatic. He was born at the 95th percentile, and before being diagnosed, dropped to less than 5th percentile. Of course, that was a long time ago--and now he's bigger than I am! 

I've been asked if I'd endorse a gluten-free diet. I absolutely would. I'm not so sure that I'd endorse all the pre-packaged foods being sold on store shelves right now. Processing is pretty much always bad. But, with all the research that's coming out about lectins, gliadin, and grains, it's making more and more sense for pretty much everyone to be gluten-free. So, I'll leave all of you with this: Educate yourselves about what you CAN put into your body--and what effects it might have. If you're not doing it for yourselves, do so for your patients. Remember that not all cases are textbook (in fact most cases of Celiac aren't). If you need help, feel free to contact me. And for some other resources, check these out:

• http://www.glutenfreesociety.org 
• http://www.celiac.com

And one last thing: I'll leave you with some "crack" containing, non-Paleo, yet gluten-free yummies--just in case you're going gluten-free and missing something sweet. (Don't hate me, Dr. S.!) 

These are gluten-free, can be made egg-free and dairy-free, are vegetarian (but not vegan) and are most definitely NOT sugar-free. 

Gluten-Free Chocolate Chip Cookies 

Preparation

• Preheat oven to 350º F.

Ingredients

• 1/2 cup butter
• 1/2 cup cane sugar (not white - turbinado or dehydrated cane is best)
• 1/4 cup brown sugar
• 1 egg replacer (1 Tbsp. egg replacer powder with 3 Tbsp water - or sub 1 egg)
• 1/2 tsp. vanilla (I make LIBERAL use of vanilla - DO NOT use imitation vanilla)

Instructions

• Mix this stuff together with the mixer.
• Add in the following:
• • 1-1/2 cups gluten-free flour mix (6 parts rice flour : 2 parts potato starch : 1 part tapioca starch) (Keep some extra just in case you need to stiffen up the dough.)
  • 1/2 tsp. baking powder
  • 1 cup (or more) chocolate chips (I like Ghirardelli mini semi-sweets mixed with their 60% cacao)
• Bake for about 12 minutes per pan.

No baking adventure is complete without flour all over the kitchen LOL. Please do your part to continue the tradition.

Next Food Adventure: Converting gluten-free to Paleo. I accept this challenge.

Have a GREAT week everybody!

It's been unseasonably cold here for the last several days. I know; I know. For those of you that live in the "Great White North" (any place above Orlando, pretty much), you'd think this was a picnic. But for those of us that have been down here long enough to have "thin blood", it's freezing. 

When I think back to when I was a kid--we'd go outside in 3+ feet of snow barefoot. I can't even imagine doing anything like that now. Now it becomes parka weather when it's below 60. I take solace in knowing what the weather will be like next weekend (at least the predictions) and also that I've had to be inside studying for midterms--so it's not like I've missed anything. Next weekend will be a different story--a welcome break in between sets of exams. Ahhh. Yes. Thank You. 

I've admittedly been having a tough week. Trials and tribulations with my own issues as well as issues "back home". We all hope and work for the best, but sometimes it doesn't happen that way. We do what we can and try to remind ourselves that it's all going to be OK. I was writing that on the chalkboards in some of the classrooms. It's not just midterms and finals that stress us out. I don't know how many pep talks I've given over the last 2 weeks, but I'm extremely grateful for the ones I've received. A special thanks to Super Vito. I'm gonna make you a cape, my friend. 

It's a rarity that any of us come through this unscathed. Whether it's a health issue, a break up, a family member, a new relationship, a child, or any number of other reasons--there are more than enough things to distract us from what we're trying to do. Sometimes it's hard to keep those priorities straight. Sometimes all of those other things take priority over school. Above all, it comes down to taking care of ourselves. It's a new thing for me to stop and take a step back when I'm reaching my breaking point. I'm still working on that. 

The most important thing to remember, when I'm NOT coming through unscathed, is to be a little gentle with myself. Forgive myself. Take care of myself. It really does make all the difference. 

Our pictures today are of the St. Pete Pier--from either direction. The pier building itself is set to be demolished sometime soon. It's been an icon of the town for decades. I've seen the designs for its replacement. It's interesting--somewhere between the Jetsons, the Sydney Opera house and tinker toys--but I'm going to reserve final judgment for when it's all done. We shall see. If you're around town for the 4th of July, they usually do an AMAZING fireworks show over the pier and on either side of it. Of course, I know the best spots to watch it--without being stuck in all the traffic. But those are pics and stories for a different day. 

Study hard, folks. But most importantly, remember what's important. Only you can decide that.

There are pockets and spaces here in St. Petersburg that I'm convinced no one knows about. In fact, there are quite a few of them--essentially abandoned and breathtakingly beautiful. The strangest thing about this, is not only are they off the beaten path, but finding that path is virtually impossible. One road in; one road out. They're tucked into areas where it looks like there are just houses or the coastline and that the land just drops off into oblivion. These are my favorite places. 

Every once in a while I find myself in one of these places--usually in awe and almost definitely alone. There might be the occasional dog walker or runner, or a dolphin fin in the water--but for the most part it's just the space, my thoughts and me.

Not all our paths lead to out-of-the-way places, but all of our paths have led to here. Each of us came here--to National (and to my blog) from somewhere else--whether it was from a different school, from a different career, or from a different Life. There's so much diversity, experience, and wisdom. Each of us brings something (many things) very special to the table. Some have had more struggles in their lives than others. We always carry this with us and it comes out through our daily lives. 

Plato said, "Be Kind, for Everyone you meet is fighting a hard battle." 

I was really reminded of this quote this week. I've been dealing with a lot of people obviously going through a lot of trials. We are all taking midterms--and that's taking its toll on many of us. And outside of school, many are struggling with financial issues, searching for work, and seeking solutions for their own health and well-being. In some cases, it's truly easy to approach these people with compassion, but in others, when people are angry, frustrated and upset--and I don't know why--it's not so easy. The last thing anyone wants to do with a person that's screaming, insistent, or downright rude, is to listen with an open heart and mind. Perspective is a beautiful thing. I have to remind myself not to get caught up in frustration, and keep seeking solutions (and helping them seek solutions as well). 

When I'm out in practice, I'll be dealing with the same things. People from all different paths will converge into one place--my practice. I won't know what brings them here, how they got here, or maybe even the true nature of their illness. All that I can do is approach each and every person with that same compassion, listen to everything they're telling me, and work towards and help them work towards solutions. 

Study hard Everyone. Learn. Listen. There's far more to know, than what's in our books. Remember.

What do you do when you haven't seen daylight for the last several days and have to take lovely pictures for the blog? You take them of your back "yard." If I look out my patio door, this is what I see. Of course, I never look out my patio door. I never even go out my patio door. But today, I did--so I could take some lovely pictures for all of you. 

It's time for midterms. It's REALLY time for midterms. Now is the time, not only for studying, but also for making sure we take care of ourselves. Different tris have different schedules. I know I've mentioned some of our heinous exam schedules before. This midterm schedule isn't too bad, but that doesn't mean it won't be difficult. 

For the last, I don't know how many days, I've been studying and working on E&M: Cervical notes. I'm already on my third pass of them, and I still don't feel like I know anything. This is how it goes when there's a HUGE amount of information on one exam. It's easy to get discouraged. It's easy to get overwhelmed when it comes to exam times. It's REALLY easy to neglect the Self and the Body. 

So, with that in mind, I offer this bit of advice for midterms (and finals).

• Rest.
  Only once has staying up all night worked to my benefit. I don't recommend it. At some point, the fatigue and brain fog overtakes anything that might have been learned. And while there's some debate as to whether the brain needs to sleep in order to process information, or whether the brain forgets things as we sleep - either way it doesn't work out. Don't do it.
• Be careful of what enters the body.
  Admittedly, I drank a TON of coke during finals last tri. By the last final, I don't think I could fill in the bubbles on the scantron I was so wired. Caffeine is a stimulant that does help with some mental clarity, but once a certain blood level is achieved, it doesn't work anymore. Plus, all that corn syrup, phosphoric acid, and caramel coloring is definitely not good for the body. Just say no.
• Keep your regular routines.
  For this first exam, I have eschewed the gym for studying. I wish I hadn't. Exercise improves brain function. It's proven. Besides feeling sluggish (or like a slug - not sure which one), I'm going to have to work THAT much harder to dig myself out of the hole I've dug over the last week. The 5 or so additional hours that I would've spent at the gym over the last week, would probably have helped me focus a whole lot better. Keep moving; it helps.
• The important thing to remember about exams is that they're temporary.
  They are hurdles that we all have to cross to get from point A to point B, and in the grand scheme of Everything, they don't mean a whole lot. We do what we have to do. If you haven't heard this analogy a million times already, let me remind everyone out there in blog-land. This is a marathon - not a sprint, kids. We're in this for the long haul. I have faith in all of you. 

Another week gone by, where does the time go?!?!? Monday starts Week 6. That's only 9 weeks left in the tri. This tri definitely is going faster than every other tri thus far. I'm not complaining! One of my illustrious classmates has a countdown to graduation going. If I asked her, she'd probably tell me it was something like 2 years, 2 months, 1 week, 5 days, 6 hours, 32 minutes, and 52 seconds--or something like that. I think we're all happy to learn, but will also be VERY glad when we're done. Last week we were all asked what our goal is. Instead of "bring about world peace" or "cure cancer," every single person said, "Finish the program!" That may be telling. 

The first exam of the tri is over. Everyone lived through it--no matter how many of us thought we might die. We have one week "off" and then 2 exams each week for the next 3 weeks. I MUCH prefer this to what I've had in most of my previous tris--8+ exams in one week, right on top of each other. I always felt like I was cramming non-stop because I couldn't do the studying justice.

Hats off to my classmates in Diet and Nutrition. Every single one of the presentations that I've heard, thus far, has been absolutely amazing. I can't wait to hear the remaining talks. There's been SO much information presented. I had the pleasure of giving my talk on Thursday. I never could get my slides down to 30. I think it was somewhere around 64. Oh well, I honestly could've taught a seminar or an entire tri's worth of classes on this one topic. There's still so much to learn. Special thanks to Dr. S for answering some of my own questions (and not grilling me too much--although I was ready).

In anticipation of the next three weeks, I took a little bit of time out to tackle other responsibilities, projects, and decompress this week (end). I can't (or won't) tell you where the pictures are from. If I did, I'd lose my favorite "hidden" spot. Truth be told, if you can see in the distance the Sunshine Skyway, you'll know it's somewhere within sight of there. I've gone to this spot many times to clear my head, watch the water and the rays swim below, or the herons catch fish on the shore. It's a quiet and magical place.

I also found the time to run by the Wagon Wheel Flea Market on Saturday (it's right down from school). They have a HUGE farmer's market presence, and their produce is ridiculously cheap. They also have infinite amounts of junk to look at - from knock-off Pokemon cards to plants and flowers. I'm sure I laughed more than a few times at some of the things I saw there this weekend. If ever you want to have high trans-fat, breaded and fried candy bars, and you're not near the fair (which just happens to be in town right now), do check out the flea market. Or check out the produce--you'll probably fare just a bit better there - your body will thank you. The thing that surprised me was how unique some of the produce was. They had these HUGE spiked fruits--I think they were Durians. I should've taken a picture of those! They were about the size of watermelons (and slightly scary!). 

Last, but definitely not least, Happy Valentine's Day!!!! Whether you support Hallmark, are on your own (by choice or not), or are happily involved, please share your Love with others this week. Happy Valentine's Day to my Beloved!!! Happy Valentine's Day to my boys, AND Happy Valentine's Day to all of you! Thank you for sharing your time, with me.