WHAT, WHY, and HOW: My Elimination Diet Experience for Eosinophilic Esophagitis

Maybe you or someone you know have experienced this too?

I chose to share this because when I started googling blogs/articles or anything related to this I didn’t find many others that were in the middle of the road severity and it’s nice to know you’re not the only one. Thanks to health insurance, I chose to seek out medical help and management tools, because after 5 years of symptoms and having scary choking episodes in foreign countries I wanted to know if I could manage it instead of making it my normal.

So, why were you eating weird meals and foods for most of 2018—insert -> The Elimination Diet

Why the heck would you go on a (medically monitored) Elimination Diet?

To uncover what the culprit may be that is causing inflammation in the esophagus and has slowly led to rings, furrows, and a stricture (narrowing) of the esophagus. Essentially, episodes of choking (food impaction or pill impaction)
What happens when FOOD IS STUCK? Think REALLY Uncomfortable stretching inside your throat. I like to think it’s a similar effect to gauging your ear, but in a couple minutes instead of months.

So, the food feels like it is mostly down your throat AND THEN, uh oh…nope, there’s a large amount of pressure and I usually can’t swallow my own saliva, but I am able to breathe. I’ll know it’s gone down when I’ve burped and whatever air was trapped is released.

Sometimes, I only need to relax for a few minutes and the food will go down. I try to laugh or engage more in the conversations to pass the time until it moves along. OTHER TIMES, I cough a lot, spit saliva into my napkin, or excuse myself to the bathroom and involuntarily vomit saliva and eventually dislodge a piece of food the size of your pinky fingernail (or smaller). Or, head to the emergency room because if it lasts longer than a couple hours it’s advised you receive medical attention.

Fast Facts: 1 out of every 2,000 people lives with Eosinosphilic Esophagitis (EOE) with varying levels of severity. EOE is more common in men than women and it’s often hereditary (It runs in our family!). Children and adults are equally as likely to have EOE, or adults may have been living with it for years and not realized it was abnormal. Those with EOE often have multiple allergies and are sometimes put on steroids to bring down the inflammation of the esophagus and/or a liquid diet (Elemental Formula) that will allow the individual to eat a normal diet after XX number of weeks. This is the spark notes version, but it gives you some background.

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How is it diagnosed?
Biopsies from your esophagus are taken during an outpatient endoscopy procedure.

A person can have severe acid reflux for years that will leave scar tissue in your esophagus that can cause narrowing and leave eosinophils in your esophagus (the tall-tale sign something is amiss). The average person has 0 eosinophils in their esophagus, any number over 15 is abnormal. If your swallowing returns to normal after taking an acid reducer (PPI) you’re one of the lucky ones.

So, back to the elimination diet. How does it work? In this case, my Gastroenterologist and Registered Dietitian worked as a team and we came up with a plan that would allow me to have the minimum number of endoscopies (which also minimized the amount of times I received anesthesia, because who wants to do that more than necessary??).IMG_20171010_224145.jpg

Over the course of 7 months I eliminated and reintroduced: Wheat, Dairy, Eggs, Nuts, and Soy. I personally refused to eliminate seafood and peanuts because, my symptom severity was moderate, seafood is a major source of my protein, and it’s also the lowest likely culprit.

I met with my dietitian twice and could e-mail any follow-up questions as needed, but I really only connected with my GI Doc pre-procedure and via emails.
It worked for us and I cancelled any office appointments that didn’t feel necessary because the information from my labs aligned with my changing symptoms.

My Outcome:

Aside from eating a LOT of potato chips during this time (because they are allergen safe, cheap, easy to transport, and worked as a filler food when I was still hungry between meals)

  • My eosinophil levels dropped to 0 with the first round of elimination.
  • My levels spiked again with reintroduction of dairy and wheat
  • My levels drastically reduced with the final elimination of wheat
  • My acid reflux totally disappeared when I removed the 5 major allergens
  • “Sticking” and minor food impaction episodes disappeared entirely
  • I was still drinking coffee and felt ok(usually a major acid reflux culprit)
  • I was still drinking cocktails 1-2 times a week and felt ok
  • I discovered almost all replacement cheeses are terrible (but, they work for pizza cravings) Not truly a finding, but a very strong opinion 😀

The second to last scope: We reintroduced wheat and dairy and my eosinophil levels SPIKED again. So, for the next 8 weeks I removed dairy (dairy is the most often culprit)

The final scope: We discovered WHEAT (not the just the gluten) spiked the eosinophils and inflammation in my throat.

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What now?

I’m back to a totally normal diet with the exception of gluten/wheat. I still have yet to try swallowing a normal sized Advil because my stricture has not been fully dilated to the average esophagus size (an 11mm instead of a 20mm). All in good time…
While having a bite or two of wheat occasionally won’t hurt me (as far as we know), it’s the prolonged effects that can lead to more narrowing and more dilations that I’m working to avoid.

Soapbox Moment: So, sorry, I will be asking for that GF bun or lettuce wrap because I’d prefer to pay a bit more in everyday food items than be put under anesthesia on a nearly annual basis.  Because, the every other year esophagus stretch protocol feels like TOO MANY when others have found 100% success in changing their diet. So, fingers crossed this adjustment is effective for the long-term and we can space out any dilations by many years by altering my diet.

TLDRIf you have more than occasional dysphagia problems or chronic acid reflux I’d encourage you to do some investigation because this is not as uncommon as you’d think! Or, if you happen to just have chronic acid reflux problems maybe figure out a way to minimize your symptoms because I wouldn’t wish a narrowed esophagus on anyone. EVERYONE SHOULD BE ABLE TO EAT ALL THE CAKE THEY WANT!

(Also, this is incomplete, it’s only a peek into my experience. Talk to a doc, do your own research, find medication/ management tools that work for you and your body.)

Other interesting bits:
EOE may be linked to a missing protein in cells lining the esophagus

Cheers!

 

She Says : He Says: Mornings

Mornings don’t always go this smoothly on my side, but this is what I shoot for 2-3 times a week. That extra hour or more before leaving home and heading to work is life giving. It also removes that nagging feeling that I should get some movement in my day after work. Are you more of a “He says” or  “She says” ?

Mornings

#Last90Days Ending the Year on a High Note

Have you heard of Rachel Hollis? Or, maybe, Have you heard the book title “Girl, Wash  your Face” ? Rachel is a lifestyle blogger, motivational speaker, coach, and author that I only recently stumbled upon. You can get a better grasp of what her empire is by clicking here and visiting her site. Why do I bring this up? Rachel is running a challenge for the last 90 days of the calendar year to inspire and motivate individuals to kick-off their goals NOW. There’s no need to wait until the new year, anytime is a great time to keep a commitment to yourself.

I’ve yet to read her book, but I can get on-board with her ideas to end the year strong; so I’m committing to my usual goals, but with more motivation than I can usually muster as we settle into late fall/early winter.

She provides ideas with her 5 to Thrive list that I’m using to loosely plan the next 90 days.

These are mine and  you can see her items below.

  1. Wake-up an hour earlier (or carve out an extra hour of focused time)
  2. Workout for at least 30 min. Walking, Barre3, and circuits will be my focus
  3. Drink half our body weight in ounces of water. Yup, done.
  4. Alternative: Throw in a serving of veggies at each meal. Done.
  5. Start a gratitude journal. 3-5 things each day.

 

Are you IN?

She Says : He Says: Reading

Yesterday I returned from the library with four books in tow, to add to the library book I’m fifty percent through completing on the coffee table. Also, I currently have one book club read sitting on my desk that is 75% complete, but on-hold until we have a club meeting date set.

Please, raise you hand if you are also  reading multiple books. I’d like to confirm that it’s not just me?!

 

Reading

She Says: He Says: How to Dress for a PNW Winter

We’ve just had the first major rain in Seattle. It’s reminded me that I need to start replacing my flip-flops for real shoes and cardigans for raincoats. It also reminded me of the infographic we started creating last year on the differences of the perpetually cold person dressing for winter and someone that runs on a much warmer body temperature.

PNW Winter

 

How do you dress for the colder months of the year?

Scenes from the Weekend: Sunriver, Oregon

We spent the final week of August in Eastern Oregon. It was full of biking, hiking, and soaking up vitamin C. IMG_4148-EFFECTS

 

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This was part of our 18 mile biking day – Benham Falls.

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Group hike/walk around the Lava Lands park with Lava Butte in the background.

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Brian and I looking for our the log where we take our annual photo….

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Group mini golf outing!

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Trying allllllll the beers at Sunriver Brewing Co.

 

And now, back to reality. It’s September, summer is winding down, but i’m not quite ready to hang-up my paddle board for the season.

 

 

Personal Development and Business Books I’m Enjoying Right Now: GRIT

Here’s a fun metric. I’ve increased the total books read (this far) in 2018 by 500%.

Your next question is likely, “How can you increase you’re reading by so such a large percentage?”

Well…It’s easy to do when I’m unable to recall completing a single book that I started in 2017.

BAM

I know I’m not the only guilty person that picks up multiple books and puts them back down without reading the final page.

But, at a certain point in time the internet becomes boring, nothing new is on Netflix, my eyes glaze over upon opening Instagram, and the dust is piled so high on my bookshelf it’s now a hazard to my respiratory system. So, I blew off the first layer of dust and swiffered off the second layer, and finally reopened my books.

If you read my completed books list you’ll notice a theme – all of them are some form of personal development (aside from Gail Honeyman’s novel). Business skills, personal growth, leadership are on my mind now, and it doesn’t seem to be fading anytime soon.

Book Review:

I most recently finished Grit by Angela Duckworth (here the link to her TED talk.) She’s studying what exactly is grit, how some have grit, what does it take to grow grit, and how can we measure our personal grit.Image result for grit duckworth

When asked if hard work or talent is more important the average person will respond “hard work” but studies show that deep down we still believe it’s talent. When the going gets tough it’s easy to say, “I’m just not any good at (insert activity here)” and halt any further progress. Angela studied Olympian athletes, National Spelling Bee champions, and NFL teams (Seattle Seahawks) and found that, yes, some of them were naturals, but many had to learn grit along the way. Talent will only take you halfway across the finish line, it’s the deliberate practice that pushes the person to the finish.

You can have talent and effort that grows the skill. But! Talent x Effort X Effort = Achievement. The deliberate practice has a more impactful outcome than pure skill/talent.

One way to stay motivated to improve your goals is incremental goals that build upon each other to meet your long-term goal. DING DING  DING.
Commonsense, but how many of us aren’t working toward a single goal? You go to work, come home, occasionally enjoy a night with friends, rinse and repeat. It’s easy to roll through life on autopilot, complacent, when you’re not growing. Those goals become little magnets that help pull you through these ruts.

The other personal takeaway from Grit is choosing your Choosing Your Hard Thing. Grit is grown when you pick one personal “hard thing” and continue to pursue and grow a skill. It is one thing that is difficult that you must work on daily to improve. You can quit the hard thing, but not until the season, semester, membership, etc is over. It’s a nice reminder to try new things, fail at them, maybe a few times through the season, but see it through until the end. A small way to flex your grit muscle.

All in all, the book is a compelling and quick read. It provides what I see as tips you can use to improve your performance at work or skill at home. It shows us why we see some succeed and others stagnate.

What is your “hard thing” that your currently working on?

or

What would you like your “hard thing” to be?

 

In case you’re curious……

Completed Books:

  1. Man’s Search for Meaning – Viktor Frankl
  2. Eleanor Oliphant is Completely Fine : A Novel – Gail Honeyman
  3. Grit: The Power of Passion and Perseverance – Angela Duckworth
  4. High Performance Habits – Brendon Burchard
  5. The Subtle Art of Not Giving a F*ck

In – Progress Books:

  1. Smarter Faster Better
  2. How We Learn

Virtual Coffee Date [4]

If we were having coffee…

I’d tell you that  I’ve recently started drinking many more homemade Matcha Lattes.
I’ve followed the blogger trend and will blend my matcha to achieve optimal foam. One part water, one part oat milk, a dash of sweetener, and one teaspoon matcha powder. Blend it up for 30 seconds and pour into mug. It really does make the best foamy at-home matcha.

Allergies in Seattle this year are insane. I once swore I did not suffer from seasonal allergies, but there’s no escaping the pollen, grass, tree, and EVERYTHING that is floating in the breeze.  I’m not feeling so “Claritin Clear” this year.

Jumpsuits. I’m really digging the return of the jumpsuits for similar reasons that I adore wearing dresses; you don’t have to take time to match an outfit and you appear as though you spent great time putting yourself together. Do I look like Audrey?

 

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We just returned from a wedding in Davis, CA. A long weekend with all of my favorite people from college under one roof was a treat. Five years later and we’ve all changed, but have largely stayed the same.

 

I’d tell you that Mamma Mia 2: Here We Go Again is a much higher quality movie than Mamma Mia 1. This movie is most enjoyed in theaters while wearing a jumpsuit to really immerse yourself in the era. We sang and danced and had a really, really, really, good time (name that song!)

 

Cheers!

 

Iceland in Three Days

How to plan a trip to Iceland – Our Way:

  1. “Can you get time off work for a long weekend to Iceland?”
  2. “Well…only three days…sure, let’s go!”
  3. Book tickets
  4. GO

And that’s how we took an extended weekend to the Nordic Island where, in the summer, the sun never sets.

Four friends, one digital guidebook, a rental car, and a hunger for adventure we set out on three packed days our touring.

Our itinerary went something like this:

Day 1: Reykjavik

  • Take a 3 hour nap to off-set the zero sleep
  • Walk around Reykjavik downtown and pop into any museums we find of interest
  • Drink espresso, eat lamb hotdogs, try local beer, and hit the hay early to prepare for our driving tour

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Day 2: The Golden Circle

  • Drive the scenic route, through the “mountains” (foothills compared to the PNW)
  • Stop at Gullfoss, Thingvellir National Park, Geysir Geothermal Area,  Secret Lagoon
  • Stay out until 4am at the bar singing-a-long to American songs

 

 

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Day 3: South Coast

  • Wake-up at 1pm and begin our day
  •  More Waterfalls: Seljalandsfoss and Gljúfrabúi, Skogafoss
  • An Iceberg you can walk on and around
  • Vik’s Black Sand Beach
  • Drive until we are too tired to do anymore and then head home. Arrive home at 12:30AM (and it’s still bright as day outside)

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Day 4: Blue Lagoon and Fly Home

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Highly recommend. Would travel to Iceland again. 14/10

Zagreb,Croatia and Plitvike Lakes [3]

We left off the last Croatia post as we boarded the plane from Munich to return to Croatia, this time landing in Zagreb. Zagreb is the polar opposite of Dubrovnik, it’s a fast paced metropolis that slows down in the evening only to continue business meetings over dinner and drinks. I enjoyed the hustle of the scene, but was ready to head back to the slow old city feel of Dubrovnik.

We stopped over in Zagreb for two nights and after four nights sharing a room with four strangers in a hostel we decided to splurge for a 4 star hotel. Chocolates on our pillows and beer in the fridge was the ultimate warm welcome.

We walked around and enjoyed the city views, breakfast off the square with the freshest eggs I’ve ever tasted, and many prosciutto platters.IMG_20171013_080300-PANO.jpg

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We rested up and after two days rest began our drive out to the Plitvike Lakes National Park. After taking an electric boat off the main entrance visitors choose to take one of five routes. We opted for a shorter hike, approximately 5 miles due to starting later in the day and still having a long drive to go. You can expect to see dozens of waterfalls, birds, and beautiful lakes that are essentially untouched.

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This hike was the highlight of my trip. If we’d known to plan for more time around the park we would easily have spent an entire day and gone for a longer hike. If you visit Croatia, this national park should be a must see on your list.