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4R

It's OVER: Weeks 8-12(ish)

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It's OVER: Weeks 8-12(ish)

I am SO happy to announce that we had homemade pizza tonight!! With cheese! 

It's taken me awhile to get to this blog post, but have no fear, we made it through 12 full weeks on the 4R elimination diet and I am here to tell the story.  

Judah and her fancy curcumin drink.

Judah and her fancy curcumin drink.

Weeks 8-12 were pretty much the same as weeks before. For the most part uneventful, so I will try not to bore you with the same old. In a nutshell:

  • Pinterest is my best friend. Why didn't I think of using this meal planning tool before??
  • We started Judah on a DGL supplement --which is essentially a licorice powder supplement that helps with inflammation. She was supposed to take it 3x a day with meals. I was NOT good at remembering this. Also, the extra step of giving her something to eat 3x a day that it can be mixed into was quite a challenge. The other supplement we added in was Curcumin. Mucho thankful for the fizzy tabs that can be put into water with a citrus taste. Much easier than trying to get her to swallow a capsule. 
  • The forum response to Judah's itchy rash was a bit disappointing and the reason we ultimately decided to add in the rest of the supplements. Basically, her issue was a bit to complex to just give advice over a forum. It would require a consult with Dr. Aviva (or another doc, I suppose), and we just can't swing that right now. Plus, I figured we might as well give the last step to the 4R program a shot, first. 
  • By week 10, I found myself sneaking chocolate when the kids weren't looking. I know! So bad.  I have a problem. ;)
  • Before we started the elimination diet, Simon had this kind of bumpy, pimply skin all over his arms and was spreading to his torso. I had read that it could be a sign of gluten intolerance-- and by week 10 I realized it was completely gone.
  • I took the kids to visit some friends in New Hampshire for the day. ONE DAY and the food prep was overwhelming. I didn't want our friends to have to accommodate us, but I needed to make sure we had enough snacks and lunch and dinner so that the kids wouldn't be cranky pants all day long. It was difficult and I began (well, continued, probably) to become extremely SICK of the time commitment that goes along with super clean eating and food prep. Was definitely, definitely feeling DONE. 
  • There was one day that I was scrambling at home because food was completely gone from the previous week and the car broke so we couldn't food shop until dinnertime.  Exhausted, hungry and walking through Whole Foods, I picked up some turkey dogs for dinner. I mean, they were 1/2 legal... boy, oh, boy did my stomach pay for that choice!

Week TWELVE was an exciting one! Judah could see on the calendar that we were at the end so during the last week, we scrolled Pinterest, giddy, deciding which foods to add back in first. We decided to take it easy adding food back in by doing a sort of food challenge to see if we had any poor reactions to certain foods. Overall, we seemed to handle everything well. We did notice that nightshades made us feel bloated and gassy. 

Eggs are back. YUM.

Eggs are back. YUM.

We added eggs back in first, followed by nightshades, cocoa powder +honey or maple syrup, then beef and vinegar and yeast. We saved gluten and dairy for last. Once I started eating gluten again, I felt lots of brain fog and an overall "yuck" feeling-- it hasn't seemed to last but I do notice that processed food and refined carbs/sugar makes me feel  weird (which makes sense!). Unfortunately Simon's bumpy rash has come back slowly-- which tells me that it probably is gluten. He still eats it and I am trying to weigh just how important it is for him to stop eating it considering that, at this point, it's his only symptom. 

DAIRY was the big one. I waited and waited to add this back in. Not sure the best way to go about it, we eventually decided to start with a locally sourced, grass fed, organic, un-homogenized plain yogurt. Judah was in heaven. I only allowed a small bit a day, anything to her was such a treat. A week and a half in though, I noticed eczema on her hands.  We were all super bummed. It was the coldest week we had all winter and she was washing her hands a TON-- I wanted so badly to think it was from that. We cut out the yogurt and the rash went away :(  Next I decided to give her some cheddar cheese made from raw cow's milk-- NO PROBLEMS! We have continued to try cheese of different kinds either from raw cow's milk or cheese made from goat's milk and she has been doing great. It is SO nice to be able to garnish some meals with cheese!!

Mike's bday treat-- vegan, gluten-free, paleo raspberry chocolate tart from  Bakerita

Mike's bday treat-- vegan, gluten-free, paleo raspberry chocolate tart from Bakerita

At this point, we are still unsure what her tolerance for dairy actually is, so we have decided to limit dairy to home only so that we can be sure of the source-- and even at home we eat it in small amounts. It has been working well so far. I am so pleased with our results: Judah's eczema is gone, we know where Simon's rash was coming from and I feel like life is SO much easier now that I can eat brie and get Chipotle take out! YUM!

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When Life Gets In the Way: Weeks 2-4

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When Life Gets In the Way: Weeks 2-4

After 4 weeks into this 4R-elimination diet-gut repair journey, I've come to realize a few things:

  1.  Most challenges would be quite simple if life didn't constantly get in the way.
  2.  Children are incredible beings filled with strength, determination and resilience. 
  3.  Moving sucks.
Judah preparing lunch for the family all by herself one day.

Judah preparing lunch for the family all by herself one day.

It is pretty unbelievable how my husband and I have whined and craved and exploded over the tiny things throughout these first four weeks. My children on the other hand continue to amaze me. Every single meal our four year old gushes over. She thanks us and tells us it's the best food she's every eaten, meanwhile, I am hoping someone will turn their back so I can stuff my face full of brownies or ice cream. 

Judah's creation! Brown rice with olive oil and salt, leftover seasoned chickpeas, carrots, celery, greens and some extra vitamin C for a sick dad.

Judah's creation! Brown rice with olive oil and salt, leftover seasoned chickpeas, carrots, celery, greens and some extra vitamin C for a sick dad.

I feel a sense of accomplishment each time i need to make another shopping list. Like I am checking off a to-do list. One less week to go. Delish. Meal planning, though, is still daunting. Creativity is lacking and falling into a food cycle makes us pretty cranky. We have found a few ways to mix it up though, and some life saving recipes that I am excited to share.  But, first-- what's new and weekly recaps. 

The high of moving back to PVD was soon shot by my husband throwing his back out. When I got the call that he was lying on rooftop unable to move (he had been power washing rooftop decks)  I wanted to cry. Not for him, ha. But for me! I'm sure that sounds pretty terrible and wildly selfish, but we were moving in ONE WEEK and the man of the house couldn't get out of bed. Not even to pee. I was left to care for the children, him, pack up our entire apartment and hope that we would have enough help on moving day. (Which we did! THANK YOU TO ALL OF OUR AMAZING FRIENDS!!!!!)

On top of that-- this f-ing diet. That's what it felt like in that moment. Such a waste of time and a constant pebble in my shoe. In general, it was getting easier, we were getting into a groove, we weren't constantly hungry anymore and we felt good. But when life throws curveballs, man, everything seems astronomical. 

Here's how it all broke down:

(Poorly presented) Berries and Cream!!

(Poorly presented) Berries and Cream!!

Week 2: Recap

  • I struggled to keep it all together. Every night I prayed that no one would go into labor. Leaving to go to a birth on top of my already scheduled appointments, packing, cooking etc. would be stressful and stress is the last thing I want to carry with me to the arrival of a new baby. One day, a wonderful friend from church, who had heard about Mike's back asked to bring us a meal and I wanted to cry. How LOVELY that would be, except, no. How could we ask anyone to follow the strict guidelines we were on? I dreamt of that meal, though. Daydreamed about it and felt so much gratitude for the offer. I imagined how wonderful it would be to have food delivered to us. Goodness.
  • I realized that when food isn't convenient, I don't eat. I was taking nibbles of the kid's food, eating dinner with the family, but in the busyness of the day, if I couldn't throw some yogurt in a bowl, I really wasn't eating much at all.
  • We really, really, wanted something sweet and we found just the thing. Trader Joe's Coconut Cream stored in the refrigerator, scooped right out of the can with some frozen berries mixed in. HEAVENLY. Perfect after-dinner fix.  
  • My symptoms were lessening! Prior to this diet I had been having some tingling in my fingers. It was annoying but not really painful. More emotionally exhausting then anything. I hadn't realized that it had lessened until I went to prenatal appointment and cheated on the diet. Yup. I did it. My wonderful, incredible clients had WILDFLOUR waiting for me and so how could I resist!? That evening and the next day, I noticed the tingling was back, which made me realize it had been gone!
  • Judah, our four year old, had a strange flare up of eczema (which had been under control for quite some time).  It's gone now and hasn't come back so I'm not sure what that was all about. Also, her red yeast-like rash have improved! 

Week 3: Recap

  • Pinterest is my friend. I don't know what I was thinking but for the first two weeks I was trying to meal plan without Pinterest. Being able to put our diet restrictions in the search bar has been amazingly helpful. 
  • Will there ever be time to prep? Between packing, cleaning and working there hasn't been much time for anything else. It has been such a challenge to not just stop at Chipotle and grab takeout. 
  • Lunchtime has been redeemed by quesadillas! It seems like it is a struggle to make good quality (filling!) food until dinnertime. But this week we added in cheese-less quesadillas on Trader Joe's brown rice and quinoa tortillas. The tortilla wrap things are a bit more processed than I would like but they have minimal ingredients and are gluten free. They also crisp up SO nicely in the oven. YUM.
  • New on the menu this week: Creamy Lemon Chicken from Wholesomelicious This is seriously a delicious meal. If you aren't a mushroom lover, I would suggest cooking with them for the flavor and then taking them out at the end. This is what we do for my husband and kids and it works out just fine.

Week 4: Recap

  • Repetition continues to be hard. I have been trying to add in a new dinner meal each week, at least, but for everything else we pretty much rotate between 3 different breakfasts/snacks/lunches. I really wanted to branch out from the smoothies and banana boats for breakfast but was unsure if we could have oats and if we could, would my kids eat them without a sweetener. I ran to the Healthiest Kid's Universty forum and asked a few questions. Turns out oats are OK as long as they are definitely gluten free, as there is a risk of cross contamination.  Good for us that Trader Joe's (if you haven't already guessed with LOVE this place) has gluten free oats. So does Job Lot, for that matter.  I also asked some questions about sweeteners. Because my daughter has, what seems like, a yeast issue, I wanted to be sure that we could safely give her something without adding to the problem. Coconut Nectar was suggested-- and even though it's quite pricey, it is DIVINE.  We have officially started to have oatmeal once and awhile! 
  • We love cashews so much we ate an entire bag in one sitting. I'm pretty sure the goal here is variety, color and lots of vegetables but nuts make a great snack and perfect for on the go! With that being said, I've found that quality food takes planning right down to the snacks. When I actually map out our entire week (and stick to it!) things seem to go much smoother.
  • New on the menu this week: Sweet Potato Burritos and Chicken Pot Pie from Milk Free Mom with this Sweet As Honey's crust
  • We have officially moved and does it still make sense to go to Trader Joe's???!!  We aren't nearly as close to TJs as we used to be (insert panic). This week I was in a rush, per usual and quickly put together a shopping list and decided to check out Aldi's. AHHHHH!!! I will say that maybe I just went on a bad day or was in such a rush I couldn't spot the gems-- but after that trip, I just wanted to cry. Whole Foods is the next closest but we aren't millionaires, so I packed up and raced to Trader Joe's. Big sigh of relief. Where everybody knows my name. Not sure how we will make out without this place but I will choose to carry on and  worry about that next week ;)
@PVDdoula post of cheese-less quesadillas. Refried beans, hummus, sweet potatoes, artichoke hearts and Trader Joe's Power Greens.

@PVDdoula post of cheese-less quesadillas. Refried beans, hummus, sweet potatoes, artichoke hearts and Trader Joe's Power Greens.

Our Cheese-less Quesadillas
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Serves one

Ingredients
(This is just one example, these quesadillas can be filled with anything)
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-(1) Tortilla that meets the standards for the 4R diet
(we used Trader Joe's Brown Rice and Quinoa Tortillas)
- 2 TBS Refried or smashed black beans (make sure these do not contain nightshades)
-2 TBS Hummus of choice or mashed avocado
-(1) Handful of greens 


Preheat oven to 350 degrees fahrenheit.  
Place a tortilla on a baking sheet. 
Spread beans and other toppings of choice on either side, topping it off with the greens. 
Place open-faced in the oven for about 7 minutes or until the edges of the tortilla are brown and to desired crispiness. 
Fold in half and enjoy! 

Sweet Potato Burritos
(adapted from the amazing Two Blue Lemon's Sweet Potato Tacos recipe).
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Ingredients
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2 large sweet potatoes
Olive oil
Salt
1 can of refried beans (that do not contain nightshades).
Greens
Yellow onion
1 Lime
1 Avocado
Tortillas that meet the 4R guidelines


Preheat oven to 425 degrees.
Chop sweet potatoes into small cubes.
Arrange in one layer on a baking sheet and toss with a bit of olive oil and a bit of salt. 
Bake in the oven for 30 minutes, tossing at the half way mark.
Meanwhile, chop the onion and greens. Slice the avocado and cut the lime into wedges.
Warm the refried beans on the stove top. 
Once the beans are warmed and the sweet potatoes are baked, warm the tortillas to soften over medium heat in a large enough skillet. 
Pile on the toppings, squeeze some lime, roll up and dig in.

 

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Week One: Learning a new normal + some of our favorite recipes

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Week One: Learning a new normal + some of our favorite recipes

I would say on a scale of one to ten, this week ranked as a five. It wasn't awesome, it definitely could have been better, but it wasn't terrible either. Maybe very typical of learning a new normal. As my body craved brie and crackers and dark chocolate, my mind kept thinking "Only X more days, no, shoot. 3 more months!" With that kind of thinking it was easy to feel discouraged. Early on I realized what a job food does on the mind. I couldn't think in terms of time, I had to think in terms of what was normal for our family right. now.

The first challenge was breakfast. We can't have eggs. We can't have toast. We can only have limited fruit: a choice of 1 cup of berries and 1 apple, 1 banana or 2 kiwis. So what do we do for breakfast?? This was the first question I asked on Dr. Aviva's Healthiest Kids forum. The answers I got were exactly what I was dreading. 

Dinner for breakfast. Leftovers for breakfast. Pumpkin pudding...sweet potatoes...

INSERT SOBS.

The first morning Simon woke up and immediately went to the fridge. He does this every morning, looking for an apple. He may do this because it's really the only snack he can get for himself while everyone else is still in bed-- but I like to think he eats an apple every morning because when I was pregnant with him, Mike would toss me an apple before he went to work. If I didn't eat before I got out of bed in the morning, I would pass out and an apple was the easiest fix.

Moving on... I had decided when I was prepping for the journey that we would have to eat smaller portions of fruit so that we didn't run out of snack choices before the days end. Limiting fruit is very challenging for us. I offered Simon a half of an apple (which miraculously, he seemed to be ok with) and then I proceeded to make the grossest smoothie ever. I don't even remember what I tried to put in it. I've blocked it out. Sorry. 

In hindsight, we should have stayed home this first day to get a handle on things. But alas, we went out for the morning. I packed what I thought would be enough snacks-- but I was dead wrong. Limited kiwi sent the kids into a maniac whirlwind. 

Lunch was next. I had planned Meghan Telpner's Heck No Mayo Salmon Salad with quinoa, over a bed of spinach. Hummus and a choice of carrots or cucumber. For me, I skipped the salmon but I had everything else. I am not a seafood person. At. All. 

This seemed to go over well except Judah was not pleased by the lack of mayo in the salmon salad. 

Dinner was, well, dinner was DELICIOUS. Here is what we made:

Roasted chicken and vegetables over brown rice! Sounds so simple doesn't it? It was easy to make, tasty, clean, filling, and made great leftovers. After a full day of hunger pangs we were all incredibly thankful for this meal.

Roasted chicken

Roasted chicken

Roasted Chicken and Vegetables
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Serves 4 (roughly)
Ingredients
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1 Whole Chicken
1 Lemon
1 Head of Garlic
Salt
Pepper
Dry Mustard
Garlic Powder
Olive Oil
3 Sweet Potatoes, chopped
4 Carrots, chopped
1 Head of Broccoli, chopped
1 Red Onion, cut into wedges

  1. Preheat oven to 450 degrees F
  2. While the oven is preheating, prepare the chicken and chop all vegetables. Taking into account how long the individual vegetable takes to cook through, the vegetables should be roughly the same size.
  3. To prepare the chicken start by taking out any giblets and filling the chicken with lemon wedges and garlic cloves. You may want to truss the chicken too, but I didn't. 
  4. In a small bowl mix together a few glugs of olive oil, some mustard, garlic powder, salt and pepper. The amount is different every time I make this. You will have to adjust to your liking-- but my advice is to go a bit heavier on the spices then you think you should.
  5. Once everything is mixed cover the chicken with the mixture. Make sure to cover the whole thing and even a bit inside the opening of the cave. Cave, yes. I don't like to use actual body part terms because well, I get too grossed out. 
  6. Place the chicken in a roasting pan along with all of the vegetables. Sprinkle a bit of seasoning on the vegetables and stick in the preheated oven.
  7. After 15 minutes turn the heat down to 350 degrees F and roast for 20 minutes per pound.
  8. Serve over brown rice. 

Despite the wonderful meal, the evening brought some irritable feelings effecting all of us, but by the next morning we were back at it. Mike was off to work and the kids and I discussed how the day before went for us. We openly expressed how hard it was and how we were sad and frustrated at times. I asked them if they wanted to continue on (mostly Judah) and they said yes. In that moment, I was so proud of their determination and I already felt better about Day #2-- we had learned so much the previous day. I decided on something different for breakfast, set specific snack times to avoid the constant asking for food (and the possibility of running out!) and I spent the morning making large batches of our new staples.

For breakfast we each had banana boats and a half of an apple. The kids LOVED the banana boats! Morning snack consisted of black olives, almonds and a choice of carrots or celery. For lunch we had leftovers of the salmon salad over quinoa with a side of black beans and sweet potato. Afternoon snack was a 1/2 cup of frozen berries and for dinner I served leftovers of the yummy chicken (with absolutely no complaints)!

Banana Boats with almond butter, hemp seed and coconut flakes.

Banana Boats with almond butter, hemp seed and coconut flakes.

Banana Boats
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Ingredients (Serves 1)
----------

Half of a banana
Almond butter; unsweetened (we used chunky)
Ground flax seed, hemp seed, chia seed --whatever you prefer
Unsweetened coconut flakes
Pecans

  1. Slice the banana lengthwise.
  2. Smooth on some almond butter, sprinkle some flax, coconut flakes and pecans.
  3. Eat!

Here is my FIRST WEEK RECAP!

  • Making a shopping list takes a massive amount of time. I need to plan ahead for this.
  • Pasta is my BEST FRIEND. We found a brown rice and quinoa pasta at Trader Joe's that is not only delicious but meets the criteria for our diet. Although processed foods are frowned upon, the pasta has saved my sanity for when I need to make something fast, or when we have nothing left and shopping is not an option. Hallelujah! 
  • Making large batches of things like quinoa, brown rice and sweet potatoes is a GAME CHANGER.
  • Setting snack times and sticking by them is super important for all of us. The kids are crazy if I don't do this and that makes ME crazy. It was interesting to see how much eating we all do out of boredom, having set snack times has pushed us past that into CREATIVITY.
  • Oh, and Mike and the kids are sick. Interestingly enough this is often a sign that the body is detoxing! Yahoo!
  • AND!! We got our apartment! Looks like PVD doula is moving back to PVD! 
  • Husband says that he's "not hungry, he's just not satisfied." Our addiction to flour and sugar is really coming out, eeek!  But, we survived the first week and we are mostly smiling. This is good.

We can do this! 

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Group B What?: The Ins and Outs of Group B Strep (GBS) and a Three Month Adventure to Repair the Gut

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Group B What?: The Ins and Outs of Group B Strep (GBS) and a Three Month Adventure to Repair the Gut

Late pregnancy belly

Late pregnancy belly

Hello there.

You're getting close to your due month. How exciting! You're feeling pretty good. Maybe you are ready to have this baby, maybe you need a bit more time. Overall you are happy to have had such a healthy pregnancy. Then your care provider tells you, you've tested positive for Group B Strep.

Group B what?

Group B Streptococcus.

You may have some questions. Here are some answers.

Bacteria

Bacteria

Group B Streptococcus (Group B Strep) is a bacteria that lives in the intestines of many people. It can travel down to the vagina, urinary tract and rectum. Often, it is the culprit of urinary tract infections (UTI). But for the most part it lives in the intestine and doesn't seem to be much of a problem. Some women find out that they have a GBS infection which would show up during routine urine testing, but most women would only know they were Group B positive because of a swab test around 37 weeks pregnant.

So what's the deal with pregnancy, then?

Well, here's the deal. If the GBS moves its way into the vagina and/or rectum during the last weeks of pregnancy it can get passed on to the baby (in other words, baby can become colonized with GBS) during a vaginal birth. It is not alarming when a baby becomes colonized but developing an infection is. The chances they would develop an infection are small but if they do, they can develop meningitis, pneumonia and sepsis. This is why, in the US, we screen for GBS and the standard is to treat with antibiotics during labor and birth.

Pretty straight forward, right? Sort of.

When I was pregnant with my first baby I tested positive for Group B Strep. I didn't know much about gut health and the negative effects of antibiotics on our bodies.

In fact, I didn't know anything.

I was concerned about mobility. I wanted to move while I labored and I wanted to make sure that this Group B business wouldn't take that away from me. I was told that I would have to be hooked up to an IV periodically to administer antibiotics but it shouldn't restrict my movement. That's all I wanted to know.

But there's so much more.

How many babies actually develop a GBS infection? What are the short term and long term effects of antibiotic use for the mom and baby? Do the benefits outweigh the risks? and is there any way to avoid testing positive for GBS?

There is a wonderful resource on this grand Wide World Web called Evidence Based Birth. Here, they lay out the research and what it has to say regarding pregnancy and birth issues, including Group B Strep.  If you want answers to the above questions, this should be your first stop.

Second stop, right here: Dr. Aviva Romm has some truly wonderful information on Group B Strep for the thoughtful mom, including how to protect against an infection. She also has interesting research, over at Healthiest Kids University that connects antibiotic use in newborns with allergies, eczema, asthma in childhood, obesity and diabetes.

So begins our journey. My baby is four now. She has a dairy sensitivity, eczema and another recurring rash that we have yet to explain. It doesn't sound too complicated, but when I began to realize that eczema, skin issues, even allergies are our body's way of telling us there's something wrong, I needed to get to the root of the problem!

Hoyles at a PVD playground.

Hoyles at a PVD playground.

Our family is embarking on a 3- month (at least!) hunt for healthier guts :) We will be following Dr. Aviva Romm's 4R program and although I am excited to begin trying to help our daughter kick some of her symptoms (and maybe some of mine too!) I can't imagine it will be easy with a 4 year old, a 2 year old and a husband who loves ice cream and coffee milk.

Join us week by week for highs, lows, recipes and more!

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