Shifting Gears

Earlier this week I had a meeting with my GI doc in preparation for surgery #7, which will happen on Wednesday of this week. Mostly I wanted to talk to him about managing my remicade infusions with all the surgeries, but I also had a couple of symptoms I had been noticing that I wanted to run by him. All in all he is happy with my progress and not making any changes to my treatment plan for now, except for one thing.

One of the things we talked about was diet and nutrition. I had been keeping a food journal for several weeks, and I was starting to notice some patterns. Some of my suspect foods (for example: dairy, even when properly fermented; tree nuts and peanuts in large quantities; fruit in large quantities) were some of the very same foods that are highly recommended on the SCD diet. Also, when I strayed from SCD, I noticed there were other foods that seemed to agree with me but that I wasn’t “supposed” to eat (for example: rice, sweet and white potatoes, oats). When I told him about some of the triggers I noticed, he told me he wanted me to try something called the low FODMAPs diet and gave me a brief explanation and some materials on how it works.

I have mixed feelings about this transition. On the one hand, I have spent so much time and energy doing my best to implement SCD. It also sort of fits in with my general view of what is good for our bodies (nothing processes, lots of fruit/veggies, nutrient-dense foods, and healthy fats). On the other hand, I wasn’t experiencing as much relief as I hoped while following it. To be fair, from the beginning I was told that to be effective you have to commit 100% to SCD, and I never was quite able to do this for more than a few weeks at a time. So I can’t say that the diet doesn’t work, I can only say that it doesn’t work for me. In my mind, if it is impossible to follow a diet and occasionally travel, go out to eat, or have a meal at someone else’s home, then it’s not a real option for me at this point in my life. Maybe it will be at some other time. Even  following the diet 90% of the time, I was starting to feel too deprived.

So, before I even talked to my doctor, I had thought about trying something else. He told me that the low FODMAPs diet is actually the diet with the most scientific evidence behind it for controlling symptoms of Crohn’s. I’m a scientist, too! I love scientific evidence!

I’m still learning about the low FODMAPs diet, but here is a quick summary of what I have learned so far. Like SCD, it works in part by altering the microbiome in the gut by restricting the type and amount of food available to gut bacteria. And, both diets limit foods that are thought to be difficult to digest. But, the specific foods that are identified as being hard to digest are different. SCD limits all simple sugars, grains, and starches, whereas low FODMAPs limits foods containing specific types of sugars that can lead to fermentation in the gut when too much of them is consumed (the acronym stands for “fermentable oligo- mono- di-saccharides and polyols). Also, whereas SCD requires the patient to completely eliminate these foods during a one-year introductory phase, low FODMAPs encourages patients to eliminate high FODMAPs foods completely for 2-6 weeks, then reintroduce them slowly to identify specific triggers. There are also quite a few foods that you can eat, even during this introductory phase, as long as you limit portion sizes. Best of all, the diet doesn’t depend on 100% adherence–just on reducing your overall FODMAPs load, because high FODMAPs foods are only considered problematic when you eat too much of them at once. In fact, except for the very short introductory period, 100% adherence is discouraged, mostly because many of the high FODMAPs foods are also important sources of prebiotics (compounds that encourage the growth and activity of beneficial gut bacteria).

I made a table comparing the types of foods that are allowed on the diet. This isn’t meant to be comprehensive, just a quick overview. As you can see, the main differences are that low FODMAPs allows gluten-free grains and a wider variety of sweeteners, but limits the type and quantity (usually to 1/2 cup per sitting) of fruits, vegetables, legumes, nuts, and seeds somewhat more than SCD.

Food Group Specific Carbohydrate Diet Low FODMAPs Diet
Grains None All except for wheat, barley, or rye
Meat, Fish, and Poultry All (unprocessed) All, unless processed with high FODMAPs foods
Dairy Hard cheeses and homemade yogurt Lactose-free dairy, low-lactose dairy, all in limited quantities
Fruit All fruit (except canned) Bananas, blueberries, melons (except watermelon), grapes, kiwi, citrus (orange, lemon, lime, pineapple, mandarin, tangerine), passion fruit, raspberries, strawberries, rhubarb, avocado, cherries, grapefruit, longon, lychee, pomegranate, rambutan, coconut, in limited quantities at a time. Also, no canned fruit permitted
Vegetables All except for starchy vegetables (white and sweet potatoes, yams, parsnips, yucca, taro, jicama, corn), seaweed and seaweed products, canned vegetables, artichokes, bean sprouts, okra, chicory, cucumber All types of leafy greens (kale, spinach, lettuce), red bell peppers, bok choy, cucumbers, eggplant, green beans, cabbage, parsnips, pumpkin, all types of potatoes, radishes, seaweed, winter and summer squash (butternut, zucchini, yellow squash, spaghetti squash, etc.), tomatoes, turnips, water chestnuts, carrots,  bamboo shoots, canned artichoke hearts, asparagus, beet, broccoli, brussels sprouts, celery, peas, snow peas, corn, all in limited quantities at a time
Legumes No legumes permitted, except for peanuts and properly soaked lentils, navy beans, adzuki beans, peas, and lima beans No legumes permitted, except for peanuts
Nuts and Seeds All, depending on form (flour, whole, milk) and stage of diet, in limited quantity All except for cashews and pistachios, in any form, in limited quantity
Nutritive Sweeteners Honey, aspartame, and saccharine (occasionally) Sugar (white, brown, cane, etc.), maple syrup, glucose, stevia, regular corn syrup (but NOT HFCS), brown rice syrup, all in limited quantity
Cooking Oils All except for soybean All
Herbs, Spices, and Seasonings All except for mucilaginous herbs and vegetables (aloe vera, marshmallow, slippery elm, etc.), spice blends, balsamic vinegar, and various additives All salsas, jams, chutneys, pickles, sauces, etc. made with permitted fruits and vegetables, mustard, mayonnaise, green onion (green part only), soy sauce, vinegar, most spices and herbs, homemade broth, butter
Beverages Most fruit and vegetable juices, weak coffee, weak tea made with permitted foods, dry wine, spirits, nut milks Juices and smoothies made with permitted fruits and vegetables, coffee, tea, beer, wine, nut milks, all in limited quantities

The hardest thing for me, for sure, will be cutting out garlic and onion (even for 2-6 weeks, assuming the reintroduction goes well!). If you’ve ever looked at any of my recipes, you can see they all start with cutting up lots of garlic and onion! On the other hand, it feels like such a huge relief to have permission to eat some gluten-free grains here and there that it might make up for it. Not that I plan on going nuts–I still fully believe that eating unprocessed foods and focusing on eating fruits, vegetables, and protein rather than filling up on grains is healthier for almost everybody–but it’s nice to have a little bit more flexibility. To me, this diet seems much more manageable in the long term. And, while I won’t go into any gory details, in the 6 days or so that have passed since my doctor’s appointment, as I’ve tried reducing my overall FODMAPs load without yet jumping in on the elimination part, I’ve experienced more symptomatic relief than I ever did on the SCD. 

So, yeah, I think I’m going to give this a shot. Before I try the elimination part, I think I have a bit more research to do. I’m also not going to try the elimination phase until after I’m (mostly) recovered from my next surgery, since it seems like a lot to ask others to manage when I am unable to help at all with cooking or shopping. In the meantime, I might take a bit of a break from writing as well while I scope out this new territory, but I will be back, hopefully armed with a whole new set of recipes!

Reflections on my 1-Year Crohn’s Diagnostiversary

I never expected that on my first Valentine’s Day as a married lady, I would be sitting in a gastroenterologist’s office being diagnosed with an incurable, lifelong autoimmune disorder. But, that’s what happened! So, on my second Valentine’s Day as a married lady, I thought I would take a little time to reflect on my first year as an official crohnie, to share some of the things Chris and I have learned and felt along the way.

  1. Crohn’s taught me it’s ok to ask for help. Before I got sick, Chris and I had both had some pretty minor struggles with anxiety. What I mean by that is we both worried, a little more than we thought was normal, but we could manage it and continue to function without outside help. My siblings and I all have a history of worrying excessively about our health (ironic, isn’t it?), and looking back I now know that I would have saved myself a lot of unnecessary suffering if I had talked to someone earlier about that, but I was too stoic to do so. When I got sick, the borderline anxiety that we both experienced spiraled completely out of control; I was so depressed and anxious that I struggled to even function normally. Eventually, Chris and I both realized we needed to see someone about what we were experiencing, and we did. We learned coping strategies individually, that helped us each feel better, and we also learned ways to avoid making each other feel worse. Sometimes it’s easy to get into a sadness spiral as a couple, where you share things that are upsetting you, and because your partner loves you, those things in turn stress him/her out more. I think it’s important to learn to be honest and open without overburdening your partner, and this is one of the most valuable things that came out of therapy for both of us. I read some books and blogs–the most helpful of which was probably How to be Sick by Toni Bernhard. I learned about meditation and breathing exercises and embraced yoga again. Oh and by the way, my psychiatrist prescribed a low dose of an SSRI medication and supplements for me (although Chris’s did not). I feel exactly zero shame in sharing that, especially knowing a little about how gut and psychological health are connected. After a few months of medication, I remember Chris telling me, “I felt like you were gone. For the first time in forever, I feel like I have you back.” I felt that way too. And we both agree that we are stronger individually and as a couple than we were before Crohn’s.
  2. Crohn’s has changed my interests. I used to run a lot–I ran two half marathons (very, very slowly) in the two years before I got really sick. I also used to ride my bicycle all over town, and stay out all night listening to live music and dancing and sipping on beer. I can’t do those things anymore–or at least, I can’t depend on doing them. Last summer, Chris took me to a Neko Case concert and I had a few glasses of wine and a burger on a gluten-free bun and I sang and danced my heart out and it was one of the best nights ever. And on days when I feel well enough, sometimes my greyhound and I jog instead of just walking. He usually even wimps out before me, too! But I kind of have to accept that I can’t drink wine and dance and eat burgers every weekend anymore, and I might need to consider specializing in 5Ks rather than half marathons. BUT! I’ve found new things to do. I know so much more about cooking and nutrition than I used to (just ask Chris about the shrimp quesadilla incident if you don’t believe me). I’ve learned to crochet. I have a whole shelf of novels that I’ve read–FOR FUN–in the last 18 months. I’ve fully joined my husband in his appreciation of TV and movies. What seemed before like wasted time at worst, or a guilty pleasure at best, is now an opportunity for us to relax and spend time together. Last but definitely not least, because I’m at home a lot more we finally adopted a dog, which is something we had talked about for a long time, and we are currently fostering another. I know it might sound silly, but having these sweet canine creatures has brought so much joy and love into our house. Now I can’t imagine life without a fur child, but before I got sick we never felt like we had time for one.

See, here is a recent project:

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Here I am cooking in the awesome apron my sister sent me!

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Chris with our dog (laying with his paws on daddy) and our foster (demanding attention):

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Yeah, the dog situation is pretty serious…here is our greyhound dressed up for a Christmas parade, along with my niece and me:

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  1. Crohn’s has changed my priorities. I used to be very career-oriented, and I’ve worked very hard to have a prestigious and lucrative career. Now I live every day knowing that I might not be able to have a career. Or, I might be able to have a career, but only if I give up…like…pretty much everything else. Even before I got sick, I was beginning to realize how much more important family, love, and relationships are to me than my job. My illness has only confirmed this. My mom flew out to be with me after surgeries, to help us cook and clean and keep me company. Eventually, my parents actually moved across several states to be closer to us. My in-laws have cleaned the house when I’ve been too sick to do it. My nieces have colored beautiful pictures to help me feel better. One of my best friends flew across the country to spend a weekend watching reality TV and getting massages with me. My boss and advisers have been really great, offering excellent advice and putting up with me when I’m flaky and distracted and crying and in general being less than a perfect professional, but this encouragement and understanding is not the same as the support of a loving family. I still don’t think I could stay at home full time, but I am at peace with working part-time, or working in a less prestigious (and less demanding) job than I am qualified for if that’s the way things have to be. I am open to all kinds of possibilities that I never would have considered before, and that ambiguity is actually kind of awesome.
  2. Crohn’s has changed the way I interact with people. I am not as much fun as I used to be. I go to bed early almost all the time. I hardly drink and I have weird dietary restrictions (that I follow…like…90% of the time). I can barely be convinced to drive more than 10 minutes at a time, especially if it’s after dark and I’m already wearing yoga pants. So, I don’t spend as much time with a lot of my friends, and I totally get why some of us have grown apart. It would be easy to feel bitter about this, but I really don’t. Friendships change over time even in perfect circumstances. While some of my friendships have faded, some of them have grown stronger. One of my best friends (the one who flew out to visit me) is also chronically ill, and I think, if anything, we’ve grown closer over time in spite of the geographical distance separating us, because we totally get what the other person is going through. I have another friend who actually has Crohn’s, and we might have eventually lost contact after she moved away from the desert, but because of our shared circumstances we are in frequent contact. I’m so grateful to have that support. In general, I’ve just become so much more compassionate than I used to be. Probably at least 80% of the people I interact with day-to-day have absolutely no idea what I am experiencing; they just see a girl wearing leggings as pants, breaking all the fashion rules, and walking way too slowly across the street. They don’t know I just had a surgery last week; they can’t see the gigantic scars and drains sticking out every direction like porcupine quills; they don’t know that I probably just used all the energy I have for the day making myself look not sick and getting out of the house. So now, whenever I come across someone who is annoying me or seems a little strange, I think of all the things that might be going on in their life that I don’t know about. The result is a kinder, gentler, less irritable version of me, and I think that’s definitely a good thing.
  3. I’ve learned the real meaning of carpe diem, and it doesn’t mean what I thought it did. One of the hardest things that has happened to us because of my illness–at least for me–was having to cancel our honeymoon. I have always had this absolutely insatiable wanderlust. I haven’t often had the time or finances to travel internationally, but I dream about it, all the time, and for as long as I can remember. So when my husband and I agreed that it was really time to cancel our flights and reservations in 4-star boutique hotels in Istanbul and Antalya, it really almost killed me. For real. It had been all I’d thought about for months. I cried for days. I felt really, really sorry for myself. I’ve finally had to accept that I can’t go to Turkey today or tomorrow. Today I have to find all the joy I can in watching 5 episodes of Friends with my husband, in squishing my greyhound, and in reading a really creepy book in the bathtub during my third bath of the day. Maybe next year we can go to Turkey. Or maybe we have to change our plans and go somewhere with fewer potential barriers to communication and reliable emergency healthcare. We’ll see. I’m getting better at recognizing that life doesn’t owe me anything, and being grateful for what I do have already. Life doesn’t owe me a two-week long honeymoon on the Mediterranean. But, in fact, in the scope of human existence, I’ve really lived a pretty extraordinary life already. I mean, I have air conditioning. I can afford to eat meat and fresh vegetables and chocolate every single day if I want to. I don’t have to worry about the Bubonic plague or cholera or anything. Do you know how lucky that makes me already?!

I don’t mean for this to sound preachy, or like I’ve got it all figured out. Some days I still totally feel sorry for myself and curl up in a ball and cry. Sometimes I have to save a difficult conversation for a day when I’m feeling especially optimistic. But the bottom line, to anyone who has just been diagnosed with Crohn’s or another chronic illness, is that it gets so much better. It takes a lot of work, time, and support, but having an autoimmune disorder does not mean your life is over–in fact, it can be even better than you hope.

Pizza Frittata

The Bachelor is one of my guiltiest pleasures. I literally cringe every time I admit to watching it, but I can’t help being sucked in. My mom and sister watch it, too, and for a long time we would have weekly phone conversations about what was happening in the show, dissecting every interaction and making predictions about what would happen. My parents recently moved to the desert also, though, so now we get to watch The Bachelor together, in real time!

Last Monday night, I had my parents over so we could watch the show, and I made this cauliflower crust pizza for us to eat as we watched. It turned out even better than I expected. I mean, I could actually pick up my pizza. It has been a long time since I’ve had pizza that was both good for me and pick-up-able. Chris is picky about his pizza, so I got him a flatbread instead for his crust, but he thought the cauliflower pizza was as good as his flatbread pizza. You better believe I’m going to make this again, and make extra to freeze for the next time we need a really quick meal.

After Monday’s meal, I had a bunch of leftover ingredients that were already cut up, but I was out of cauliflower. I experimented a little and came up with an insanely easy dinner that used up all my leftovers. More than a recipe to follow step-by-step, this is an idea you can use on those “OMG I am so exhausted and we have nothing in the fridge” days. You can easily adapt it to what you like and what you have on hand, or to keep scraps of this and that in the fridge from going to waste. This can be a quick one-dish meal, or it would be great alongside a green salad or veggies. It’s even fast enough that you could make it in the morning, and feel good about eating pizza for breakfast!

Here are my ingredients. You can see this is not an exact science, people. Literally just a bunch of random leftovers.P1000986

Saute the sausage and veggies.P1000987

Going into the oven, and coming out.

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And the finished melty, saucy product. Like a deep-dish pizza with egg instead of a crust.P1000990P1000993

Pizza Frittata Ingredients

  • 8 eggs
  • 2-3 tablespoons cashew milk, or other “milk” of choice
  • 2 tablespoons nutritional yeast, optional
  • roughly 3 cups chopped veggies of choice (I used green bell pepper, purple onion, and cremini mushrooms)
  • 1/3 cup pre-cooked sausage*
  • 7 pepperoni slices*
  • 1/4 cup prepared pizza sauce*
  • handful of shredded cheese (I used a blend of mozzarella, parmesan, and fontina)
  • 2 tablespoons olive oil
  • salt and pepper

Pizza Frittata Method

  • Preheat oven to 400 degrees Fahrenheit
  • Heat 1 tablespoon of olive oil in a cast-iron, or other oven-safe, skillet over medium-high heat
  • Add chopped veggies and sausage to hot oil and saute about 3-5 minutes, until veggies are soft
  • Meanwhile, beat together eggs, milk, and nutritional yeast. Season mixture with salt and pepper, just as if you were making scrambled eggs.
  • Transfer the hot, cooked veggies to the egg mixture and whisk together. Then add the other 1 tablespoon olive oil to the hot pan and swirl to coat.
  • Pour the egg and veggie mixture back into the prepared pan and top with slices of pepperoni. Transfer to the oven for 15 minutes, until the eggs are set.
  • Remove the frittata from the oven and spread the prepared pizza sauce evenly over the eggs. Top with shredded cheese. Return to oven until the cheese is melted, about 3-4 minutes. Slice and serve!

*Check ingredients to make sure these are SCD compliant. You might have to shop around for brands that comply, but they are out there! I use Aidell’s chicken and apple sausage from Costco (it does list a rather vague “spices” on the ingredients, but I say it’s close enough). I can find nitrate-free, uncured pepperoni and pizza sauce that list only SCD-compliant ingredients at Sprout’s, and I feel comfortable using these, but of course if you feel otherwise you can omit, use homemade pizza sauce, or simply add fresh tomato with spices from your own pantry and olive oil to the top instead.

Baked Butternut Squash Pancake with Orange Blackberry Bourbon Compote

On New Year’s Day, I wanted to make a special breakfast for my honey but I wanted it to be good for me, too, after all the holiday indulgences. I hadn’t planned anything ahead of time so I had to scrounge in the fridge, and I saw that we had a bunch of leftover butternut squash from a risotto Chris had made for a dinner party. A quick Google search led me to this recipe, which I revised a little to make it SCD legal and, um, possible.

You see, I have a problem making paleo pancakes. No matter how many times I try, I can’t get it right. I try high heat, low heat, medium heat, cast iron, non-stick ceramic, lots of oil, a little oil, and I inevitably end up with an infuriating glop of pancake mush or burned little pucks. Even when the people who write the recipes swear that this is the best/easiest/simplest paleo pancake ever. I tried frying this batter and the first attempt had to be rinsed down the drain, so I improvised and decided to bake the rest of the batter instead. And, guess what!? It turned out to be delicious! It was also easier and less messy than frying individual pancakes, making this a perfect addition to a low-key weekend breakfast.

Here is what the pancake looks like coming out of the oven. You can kind of see how the edges are pulling away from the pan.

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And voila. Breakfast. I ate mine without maple syrup and it was still sweet and moist.

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Baked Butternut Squash Pancake Ingredients (serves 4-6)

  • 2 cups butternut squash, peeled and cubed
  • 3/4 cup almond flour
  • 3 tablespoons honey
  • 1/3 cup coconut butter
  • 3 large eggs
  • heaping 1/4 teaspoon sea salt
  • 1 teaspoon vanilla extract
  • 1 teaspoon pumpkin pie spice
  • 2 tablespoons butter

Orange Blackberry Bourbon Compote Ingredients

  • 1 small carton blackberries
  • 2 tablespoons honey
  • zest of 1/2 orange
  • 1 tablespoon bourbon (or feel free to replace with juice)

Baked Butternut Squash Pancake with Orange Blackberry Bourbon Compote Method

  • Place a cast iron pan on a middle rack in the oven and preheat to 400 degrees Fahrenheit.
  • Meanwhile, combine all compote ingredients in a small saucepan over high heat and bring to a boil. Reduce heat to medium and let cook for 30-45 minutes, until the fruit is broken down and the liquid somewhat reduced. Remove from heat to let thicken.
  • Place all pancake ingredients, except butter, in a food processor and blend until very smooth.
  • Once the oven is preheated, add the butter to the preheated pan and swirl to coat. Pour pancake batter into the pan. Bake 18-20 minutes, until the top is set and golden and the sides of the pancake are pulling away from the pan. Slice and serve with a generous spoonful of compote, and maple syrup (ok for paleo, not for SCD!).

Albondigas!

You know how on December 26th or so you start thinking that you never want to eat food or drink alcohol again, like ever?

I exercised a little more control than usual this year. It helped a lot that much of my family has adopted a paleo-ish style of eating. For example, for my sister’s college graduation dinner, which we also celebrated over the holidays, we had: lamb shanks braised in beef broth with fennel, carrots, and onions; julienned radishes cooked in butter; parsnip mash topped with the reduced braising juices and veggies; and kale with bacon, blackberry ginger balsamic vinegar, and pecans.

It was a delicious and special meal that still felt good to eat. But then we followed it with tiramisu and White Russians and, well, you get the idea.

On top of the holiday indulgences, I started getting infusions of a new treatment this week. I read that I should expect to feel very tired for a couple of days. I feel pretty good so far, but I already stocked the fridge with food for meals that Chris could prepare in case I couldn’t. First up was one of our all-time favorite meals, a super-flavorful, veggie-packed albondigas (meatball) soup.

This soup is very adaptable to different dietary restrictions. For example, if nightshades are a problem for you, simply omit the tomatoes. You can also substitute plain ground meat for the chorizo, if chorizo is too spicy or if you can’t find one with acceptable ingredients, or switch out the summer squash for a winter squash or sweet potatoes. We’ve made this soup dozens of times–usually without a recipe and with whatever we have on hand. But the recipe I’m sharing here is our fave.

Chris did the cooking, but I prepped for him. I got out all the pantry ingredients…

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And chopped up all the veggies. In the back left, I have the sliced squash. In the ugly orange bowl, I prepared all the veggies that will go into the meatballs. In the front left, you can see the mirepoix that will be cooked first. And in the last bowl, cilantro. You can do this ahead of time, too, to make dinner a breeze.

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Here is the final product. Buen provecho!

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Albondigas Ingredients

  • 1 pound ground meat (I used white meat turkey, but any ground meat will do)
  • 1 pound bulk chorizo (beef or pork is fine; just read the list of ingredients to make sure it is legal)
  • 26-28 ounces strained tomatoes (I use the Pomi cartons because they are BPA-free)
  • 3 large carrots, peeled and divided
  • 1 large yellow onion, peeled and divided
  • 3 stalks celery, thinly sliced
  • 2 summer squash, halved and sliced
  • 8 cups chicken or turkey broth (homemade is best, but this is a great substitute)
  • 1 bunch cilantro, finely chopped and divided
  • 2 avocados
  • 2 limes
  • Coconut oil
  • Cumin
  • Oregano
  • Salt
  • Pepper
  • Hot sauce, optional

Albondigas Method

  • Thinly slice 2 and 1/2 of the carrots and 2/3 of the onion. Set the rest of the carrot and onion aside for the meatballs.
  • Heat 1 spoonful coconut oil over medium-high heat in a heavy stockpot. Add carrots, celery, and onion and saute for 4-5 minutes. Sprinkle generously with cumin, oregano, salt, and pepper, and cook for another 1-2 minutes.
  • Add broth and tomatoes to stockpot and bring to a boil.
  • Meanwhile, make meatballs. Grate the leftover carrot and onion and combine in a bowl with half the finely chopped cilantro. Mix the vegetables with the ground meat and chorizo. Season lightly with salt and pepper (go very easy if you are using chorizo, since it is already seasoned). Roll into small meatballs, about 1 inch in diameter.
  • When the broth boils, carefully drop in the meatballs and gently stir so they don’t stick together.
  • Turn down the heat so it’s just barely boiling. Then let simmer for 20 minutes, until the meatballs are cooked.
  • Add sliced squash to the soup and cook about 8 more minutes, until the squash are soft. Taste and adjust seasoning of broth.
  • Serve in bowls topped with lime juice, diced avocado, fresh cilantro, and hot sauce to taste.

Christmas Treats and an Update

My husband is a web developing genius, so he moved my site here. He also suggested maybe it’s time to give an update on how I’m doing.

I’ve had kind of a rough six weeks or so. I mentioned in a previous post that back in August or September my GI doc had been very impressed overall with my progress, but wanted me back on antibiotics briefly before removing my final drain. When I went to my follow-up appointment (when my last drain was supposed to be removed) and reported that I still felt some swelling and occasional fever, he ordered an MRI. The results were a little disappointing. No new abscesses or fistula tracts were found (which is the good news), but the bad news was that the main fistula tract was still pretty giant. So, I had another surgery (#6!) and this time my surgeon opened the fistula all the way so that it could drain and hopefully close up with healthy tissue.

When I went into this last surgery, I thought it would be like my previous ones–three or four days down and then a slow return to normal. But the incision was much bigger than any of my previous ones. Poor Chris (who might as well be a nurse in addition to a web developer by now) had to pack the incision with clean gauze several times a day for a few weeks. It was not fun for either of us. After two weeks I was still very uncomfortable and unable to move around too much. Now it’s been almost three weeks and I’m finally starting to feel well enough (and painkiller free enough!) to get out of the house a little.

I’m going to start a new medication to see if it gives me better results and gets that last bit of healing under way. I also started some new supplements–a probiotic, vitamin D, and folic acid–at the suggestion of another doctor after she ran some blood tests and found that I was extremely deficient in some vitamins, in spite of all that I do to eat a really nutrient-dense diet that should provide plenty of these and other vitamins. Needless to say, all this news was not what I had been hoping for. But, my surgeon and GI doc both said that we are still moving in the right direction, just maybe not as quickly as we might hope. So I’m doing my best to focus on that.

Anyway, this has given me a good excuse to watch Every. Single. Christmas. Movie. Ever. I’ve also gotten to spend lots of time admiring our tree and cuddling our greyhound. And finally this weekend I felt well enough to do a little Christmas baking! This way I can bring my own desserts to share to Christmas festivities and that might help me keep my paws out of all the goodies I shouldn’t be eating right now. I thought I would share a couple of recipes so that you can treat yourself or a loved one with dietary restrictions as well.

The orange ginger spice cookies are fragrant, soft, and chewy, even after they cool down. The peanut butter cups are rich–just as they should be. Also pictured are the thumbprint cookies from Danielle Walker’s ebook Joyful, which you can get as a Kindle version for only $1.99. I made them just as instructed and they are both pretty and tasty! The ginger cookies and thumbprint cookies are both paleo and SCD legal. The peanut butter cups are all around a little illegal. But all three are grain-free (and by default gluten-free) as well as free of refined sugars. The peanut butter cups are egg free and dairy free. Both the peanut butter cups and the ginger cookies can be made nut-free if you substitute sunflower seed butter for the nut butters.

Here is the process for assembling the peanut butter cups: a little chocolate, a little peanut butter, a little more chocolate!

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Here is the finished product. Yummmm.

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Santa could appreciate this plate, even if he has IBD or has gone paleo since last year!

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Orange Ginger Spice Cookies Ingredients (yield 1.5 dozen)

  • 2 tablespoons butter
  • 1/4 cup plain, smooth almond butter
  • 1/2 cup honey
  • 1 egg
  • 2 teaspoons vanilla extract
  • juice of 1 orange
  • 1/2 cup coconut flour
  • 1 teaspoon ground cinnamon
  • 1/2 teaspoon ground ginger
  • 1/2 teaspoon ground nutmeg
  • 1/4 teaspoon baking soda
  • 1/4 teaspoon orange zest

Orange Ginger Spice Cookies Method

  • Preheat oven to 350 degrees Fahrenheit and line a cookie sheet with parchment paper.
  • Combine butter, almond butter, honey, egg, vanilla extract, and orange zest in a large bowl. Use a hand or stand mixer and mix until smooth.
  • Add all remaining ingredients and mix well.
  • Drop batter by spoonfuls onto parchment paper. Bake 12-14 minutes. Cool on cooling rack.

Homemade Peanut Butter Cups Ingredients* (yield 10-12 cups, depending on chocolate to pb ratio)

  • 4 ounces 100% cacao chocolate (unsweetened; the only ingredient listed should be cacao)
  • 1/3 cup organic, smooth peanut butter (the only ingredient listed should be peanuts)
  • 1/8 cup coconut flour
  • 6 tablespoons honey, divided
  • 3 teaspoons palm or coconut oil
  • 3/4 teaspoons vanilla
  • 1/4 teaspoon sea salt, plus a dash more

Homemade Peanut Butter Cups Method

  • First make the peanut butter filling. Combine the peanut butter, 2 tablespoons honey, coconut flour, and sea salt. Use a hand mixer to stir until well combined. Divide into 10-12 balls by rolling between your palms, and then flatten a little into discs.
  • To make the chocolate, combine chocolate and oil in a heatproof bowl. Set on top of a saucepan with about 1 inch of simmering water in it. Stir until melted.
  • Remove from heat and add in remaining 4 tablespoons honey and vanilla. Stir until smooth.
  • Spoon a little chocolate in the bottom of a silicone cupcake liner and swirl to coat the bottom and up the sides just a bit. Then drop in one disc of peanut butter. Top with more chocolate to cover and a pinch of sea salt.
  • Refrigerate several hours, until set. Gently peel off the silicone liner. Store in the fridge.

*The cocoa makes these not 100% SCD legal but in my estimation these are still much better than most standard treats. To make them paleo compliant, just switch out the peanut butter with sunflower seed butter or your favorite nut butter.

Homemade Ginger Ale

You know how on airplanes, everyone around you orders ginger ale to drink? I know that people aren’t drinking that much ginger ale in their day-to-day life on the ground. But ginger ale is such a popular airplane drink because ginger is famous for settling upset tummies, and between the stress of getting to the airport on time, the greasy airport food, and the actual bumps in the air, flying can leave many people feeling a little off.

Ginger ale has always been one of my favorites–usually a treat reserved for traveling and the kid’s table at family holidays. As I mentioned previously, though, my husband recently got me a juicer and I decided to experiment with a homemade version. It’s really simple to make and it tastes like a spicier, more refreshing version of the real thing. Plus it’s full of real ginger–so much of it, that I can literally feel my tummy tingling (in a good way!) when I drink it sometimes. Try the recipe as is the first time, and then you can adjust to your taste. Use more ginger for more spice, more lime for a tarter drink, or more honey if you like it sweeter.

For reference, this is the piece of ginger I used.

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You’ll end up with a super-concentrated syrup that looks like this.

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And this is the final product. So refreshing!

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Homemade Ginger Ale Ingredients

  • 1 big piece of ginger. No need to be exact here; just choose the largest, freshest piece of ginger root you can find in your grocery store. That’s probably the right one for this project.
  • 1 large lime
  • 1 apple
  • 1/4 cup honey
  • sparkling water

Homemade Ginger Ale Method

  • Wash and roughly chop the lime, ginger, and apple so it will fit in the feeder tube of your juicer
  • Juice the lime, ginger, and apple according to manufacturer’s instructions
  • Pour the fresh juice into a small saucepan and add honey. Bring to a roiling boil and let boil for 2-3 minutes. Pour into a jar.
  • Stir syrup into sparkling water. Start with about 4 teaspoons of syrup per cup of sparkling water; add more until it is the right strength for your taste. Save the remaining syrup in the refrigerator and enjoy within a few days.

Sonoran Shrimp Cocktail

My husband and I recently celebrated our first wedding anniversary!

We had agreed not to do gifts, and to spend money instead on a great night out or a little trip, but the husband happened to see a juicer while he was out shopping and, knowing how much I’ve been wanting one, he couldn’t resist getting it for me. To be fair I also broke my end of the deal, but I got him something much less extravagant.

Having a juicer has made my life so much easier. I can make almond milk without having to strain by hand. I have been making syrups with fresh ginger and citrus that I boil on the stove with honey and then mix in with sparkling water for a healthier alternative to soda–kind of like a homemade ginger ale. And most importantly, having a juicer helps me make sure I’m getting enough veggies because, while I can’t large amounts of most eat raw veggies–especially greens–I can juice a huge amount and drink them just fine! I replace a meal or two each week with veggie juice–like a big salad in a cup–and sometimes make green juice to use in my morning smoothies, which helps to cut down on (naturally-occurring) sugars and boost nutrient content.

Chris loves tomato juice and a couple of weeks ago he asked me to make him something like a homemade V8 for a weekend lunch. I’m usually not a fan, but I tasted it and was surprised by how much I liked it. As we were sipping on it, the same thought occurred to both of us: SHRIMP COCKTAIL. 

This is my second variation on the Sonoran shrimp cocktail. As I explain in the first post, this is one of my husband’s favorite, but most recipes call for lots of processed foods including Clamato juice, ketchup, and even orange soda. This version replaces all that with a homemade, fresh-pressed juice made from tons of veggies. Chris claims that he likes it even more than the traditional stuff, and whether you have special dietary restrictions or not, this version is definitely much healthier!

Sonoran shrimp cocktail is usually more of a summer food since it is served at room temperature or chilled, but maybe you need a break from all the heavy holiday food. Rumor has it shrimp cocktails are also a miracle cure for hangovers–not that anyone would need to worry about that during the holiday season, of course. I think this could even be served up in small glasses as an alternative to the classic shrimp cocktail appetizer. Also, I’ve listed approximate amounts of everything below, but you know, feel free to mix it up if you like your juice more or less spicy, for example.

I mean, this is just what goes into the juice. This dish should be able to revive the dead, not just the hungover.P1000896__1416170084_61672__1416170084_63047

These are the veggies that should get chopped up to be eaten instead of drunk.P1000904__1416170000_56295__1416170000_14550

Chopped veggies waiting for a delicious juice bath.P1000905__1416170243_66839__1416170243_87530

Looking at this picture makes me want to be on the beach. With one of these to munch on.P1000909__1416170275_58108__1416170275_27179

Sonoran Shrimp Cocktail Ingredients

Juice Ingredients

  • 6-8 medium sized tomatoes
  • 3 carrots, chopped into 2-inch pieces
  • 2 sweet bell peppers (red, yellow, or orange), stemmed and seeded
  • 2 peeled oranges
  • 4-5 stalks celery, chopped into 2-inch pieces
  • 2-3 handfuls baby spinach (I know, my measurements are super precise here)
  • 15-20 small chives (about the equivalent to 1/4 cup roughly chopped)
  • the stems from a bunch of cilantro
  • 1-2 jalapenos, stemmed and seeded
  • 1 beet, chopped in half
  • the juice of two limes
  • 1/3 cup coconut aminos*
  • 2 tablespoons hot sauce of choice (we like Cholula!)
  • 1 tablespoon fish sauce
  • 1/2 teaspoon sea salt

*I always thought coconut aminos were SCD legal. I’ve recently found out this is controversial in the SCD community, but most people report no ill effects of including them in their diet. If you feel uncomfortable adding coconut aminos, simply omit and add sea salt to taste as a replacement.

Other Ingredients

  • 1 pound shrimp, peeled and deveined
  • 1 tablespoon olive oil
  • 1/4 teaspoon sea salt
  • 1/4 teaspoon black pepper
  • 2 cucumbers, peeled, seeded, and finely diced
  • 1/2 red onion, finely diced
  • 2 cloves garlic, finely minced
  • 1 jalapeno, stemmed, seeded, and finely diced
  • the tops of a bunch of cilantro, finely diced
  • 2 avocados, peeled and diced

Sonoran Shrimp Cocktail Method

  • First prepare your juice. Wash all of your veggies really well. Juice all of the vegetables and fruits, except for the lime, listed in the juice ingredients according to your juicer’s instructions.
    • Pour the juice into a saucepan and place over medium-high heat. Bring to a boil and let boil about 5 minutes, until it has reduced slightly. Remove from heat. NOTE: If you are going to eat all of your cocktail immediately, you can probably skip this step. However, for food safety reasons, any fresh pressed juices should be pasteurized or boiled if you do not expect to consume them in less than 24 hours.
    • Stir in the coconut aminos, hot sauce, fish sauce, and sea salt. Taste and adjust seasoning. Then place in the refrigerator to chill for at least one hour.
  • Meanwhile, prepare the shrimp. Toss with olive oil, salt, and pepper. Then grill over medium heat until pink and curled.
    • When the shrimp are cool enough to handle, remove tails and cut into bite-sized pieces. Set in refrigerator to chill.
  • Finally, prepare the rest of your ingredients. Combine the cucumbers, onion, garlic, jalapeno, and cilantro in a large bowl. NOTE: I use the food processor to chop these ingredients quickly, finely, and uniformly. Chill until ready to serve.
  • Add in the juice to the large bowl and stir to combine. Serve in bowls topped with shrimp and avocado, with extra lime and hot sauce on the side.

Marinated Pork Tenderloin with Orange Ginger Butternut Squash Puree

Last week I learned that you can spiralize butternut squash. I mean. This changes my life. Here is a video on that, completely unrelated to the rest of my post:

You can see that you end up with a lot of leftover squash that you can’t spiralize. So, I had the butts of two large butternut squash and some leftover cores that I needed to use. I’m a little tired of just plain old roasted veggies right now, so I decided to step it up a notch by making a puree. It was inspired by this recipe, which I’m sure is delicious as is, but I tweaked it so it would pair better with the pork tenderloin and marinade I planned to serve with it. The pork, by the way, is a variation on this recipe, which is probably my favorite pork tenderloin recipe of all time.

Let’s take a second to look at some of the nutritional highlights of this meal. Pork tenderloin has a similar nutrition profile to skinless chicken breast, which means it is a very lean source of quality protein. It also happens to be relatively inexpensive (I paid a little over $7.00 for a tenderloin that feeds my husband and I two meals each) and very easy to prepare. Butternut squash is also very healthy; it is a great source of vitamins A, C, and B6, and it is also high in potassium and folate, along with other vitamins and minerals. It also contains a lot of the antioxidant beta carotene and has anti-inflammatory and insulin regulating properties as well. This makes it a great grain-free and potato-free source of carbohydrates. Combine all that with a healthy dose of fresh ginger, which is famous for its soothing and anti-inflammatory effects on the GI tract, along with fresh orange zest and juice, and you can see that this meal is as healthy as it is delicious.

Did I mention that this is also a perfect fall dinner? Last night marked a very important seasonal shift in the lives of desert dwellers: the First Open Window Night. My husband and I took our greyhound on a walk around 8:00 last night and I almost wished I had a sweater. So when we got home we opened all the windows, made a cup of cinnamon spice tea, and luxuriated in the first delicious hint of fall in the air. It was a happy coincidence that we had also eaten a fragrant fall classic for dinner. When we were finishing, Chris looked at me and did his best Gordon Ramsay impression, “What a shame. I wish there was a little more.” I have a feeling there will be plenty more of this meal in the future.

Here are all your marinade ingredients, and what it looks like when you are marinading your pork tenderloin.p1000861p1000862

You can see here the butternut squash going into the oven and coming out, when they are glistening and soft and just beginning to brown.

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And here is the final product:p1000868 p1000867

Marinated Pork Tenderloin Ingredients

  • 1 Pork Tenderloin (whatever size works for the crowd you need to feed)
  • 1/2 cup coconut aminos
  • 1/2 cup marsala cooking wine (or any dry red wine plus an extra tablespoon of honey to be completely SCD compliant)
  • 1/2 cup honey
  • 1/4 cup rice vinegar
  • 1/4 cup olive oil
  • juice of 1/2 an orange
  • 3 tablespoons finely minced sweet onion or shallot
  • 1 tablespoon dried herbes de provence (no salt added)
  • 1 tablespoon fresh grated ginger

Orange Ginger Butternut Squash Puree Ingredients

  • 1 large butternut squash, peeled, seeded, and cut into 1-inch cubes
  • zest of 1 orange
  • juice of 1/2 an orange
  • 2 tablespoons olive oil
  • 2 tablespoons butter
  • 1 tablespoon honey
  • 1/2 teaspoon fresh grated ginger
  • dash of cinnamon
  • salt to taste

Marinated Pork Tenderloin Method

  • Combine all marinade ingredients.*
  • Place the tenderloin in a small casserole dish or large bowl, and add just enough marinade to cover it half way. Marinate 1-2 hours, turning over halfway through.
  • Meanwhile, place reserved marinade in a small saucepan. Bring to a boil. Boil for 15 minutes, then reduce heat and let simmer until significantly reduced, about 1 hour.
  • Grill pork tenderloin over medium-high heat for 20-30 minutes, until a thermometer inserted in the thickest part reads at least 145 degrees Fahrenheit. Let rest at least 3 minutes to continue cooking; then, slice into medallions. Top with a generous spoonful of reduced marinade to serve.

Orange Ginger Butternut Squash Puree Method

  • Preheat oven to 400 degrees Fahrenheit
  • Toss cubed squash with olive oil and a generous dash of salt. Spread out in a thin layer on a parchment paper covered cookie sheet.
  • Roast about 40 minutes, depending on size of cube, until the squash is very soft and just starting to brown in some places.
  • Place squash in food processor along with all other remaining ingredients. Process until very smooth. Taste and adjust seasoning as desired.

*Note: This marinade is the bomb.com so I purposefully make extra to use later on in the week. It is great on grilled seafood, pork, and chicken. You can even use it as a quick stir fry sauce. Tonight we’ll be using the leftovers to jazz up chicken, pepper, onion, and pineapple kabobs. But, if you don’t foresee another use for it, you can always halve the recipe to prevent waste.

Apple Spice Probiotic Smoothie

I haven’t blogged in a while primarily because I recently got both of Danielle Walker’s fabulous cookbooks and I’ve been cooking everything in them. I’ve been eating lots of good food, but none of it has really been original. If you are paleo or SCD, I can’t recommend her cookbooks enough. Her recipes have never failed us!

However, all of our feasting came to an abrupt halt when my GI doctor put me on a round of hefty antibiotics because he was worried I was forming a new abscess. While he was encouraged by my progress over all, ramping up medication always feels like a bit of a failure on my part. It’s easy for me to start thinking, “did this happen because I let myself get too stressed,” or, “if I hadn’t eaten out that one time a couple weeks ago, would I be feeling better today?” I’ve been learning about meditation and mindfulness, because it is one of the things that people with chronic illness report as being most helpful to them, and I’ve been reading about just how self-destructive these kinds of thoughts are. It is better to react to setbacks with self-compassion and equanimity since we can never know for sure if there was anything we could have done to alter the outcome, and allowing negative and stressful thoughts to control us only further exacerbates both physical symptoms and mental suffering. So I’ve been working on that during this round of treatment.

Anyway, the antibiotics make me so nauseous I can’t even stand to look at most food–much less cook it and eat it. Plus, my GI doc stressed the importance of probiotics while I was on the antibiotics, so I started drinking most of my meals instead. I’ve been making all kinds of smoothies, often times with some hidden veggies or a raw pasteurized egg blended in so it makes a better meal replacement, but the following recipe is my absolute favorite–light and easy on the tummy, and it even helps those of us who are still dealing with summer weather get into the fall spirit. It tastes way better than a pumpkin spice latte when the AC is still running!

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Apple Spice Probiotic Smoothie Ingredients

  • 1/2 cup SCD legal yogurt
  • 1/2 cup unfiltered apple juice
  • about 8 ice cubes
  • 1 cup frozen banana chunks
  • 1 tablespoon plain almond butter (optional; it makes the smoothie richer and adds some good fats and a little protein)
  • 1 teaspoon honey
  • 1/2 teaspoon pure vanilla extract
  • 1/4 teaspoon pumpkin pie spice

Apple Spice Probiotic Smoothie Ingredients

  • Place all ingredients in a blender and blend! If it’s too thin, add a few more chunks of banana or ice cubes. If it’s too thick, add apple juice until it blends easily. This makes one large meal-sized serving, or two generous snack-sized portions.