Bread

     I spend a lot of time these days, figuring out what I can and cannot eat. The problem is, I love bread and products that contain flour but I cannot eat them; ever since my emergency surgery last year, they've all made me very sick.

     My gastroenterologist had suggested that I might have an issue with wheat. When I stopped eating it, lo and behold, my life got a lot better! To maintain my wheat-free diet, I've tried a number of breads made from other flours, for example, Trader Joe's sells tortillas made from brown rice flour. The problem is, all of these products taste terrible, with all of the rich and complex flavors of damp cardboard. Actually, damp cardboard might be preferable; it wouldn't shatter when I try to roll it around my sandwich fillings. A small loaf of gluten-free bread from Whole Foods costs almost $10 and weighs almost as much as a standard brick, with much the same consistency. Living without real bread is a real hardship!

     I've found a tolerable flat-bread recipe - I did NOT invent it. It isn't wheat but it isn't awful. It even makes a pretty good pizza crust.
     Mix
3 cups brown rice flour
3 cups corn starch
1 cup Maseca (white corn flour, often used to make real corn tortillas)
1 cup sorghum flour
1 cup garbanzo flour

I put all of the flours in a zipper bag with some air to mix it thoroughly. This makes a good all-purpose flour substitute. It yields about 9 cups, or enough to make 4 1/2 batches of flat bread.

Mix
2 cups of all-purpose flour substitute
1 1/2 teaspoons xanthum gum
2 teaspoons sugar
1 teaspoon salt
Add
1 cup warm water

Mix well. Divide dough into 8 pieces and roll into balls. Refrigerate if necessary. Use additional rice flour to keep the dough from sticking while you roll out each ball into a disk about 8 inches in diameter. Cook on medium heat on an ungreased no-stick frying pan until the disk puffs and browns, then flip with your fingers and repeat on the other side. The first side takes longer than the second. Eat immediately or allow to cool. I usually store bread in a plastic bag in the refrigerator, warming it up in the microwave for 10 seconds to make it more flexible. Or, you can refrigerate the dough balls for up to a week and cook it to order.

I use cooked flatbread as the base for quicky pizza, topping it with sauce, cheese, vegetables, and hamburger. I also use it for sandwiches and have toasted it to make bread crumbs.  It isn't wheat but it's a lot better than anything I've bought. Now, if only I could make a good bread for slicing!

I can buy Maseca and corn starch at Stop & Shop but the other flours and xanthum gum are Bob's Red Mill brand; the cheapest supplier in Western Mass is Ocean State Job Lot. You don't have to eat that awful (and awfully expensive) GF bread from the grocery store. Go wild! If you invent a recipe for a good sliced GF bread, PLEASE share it with me!

Having Jack - some more thoughts

Margaret had her stroke 11 months before Jack was born. I had helped her for a few days when she came home, installing various devices to help make it possible for her to live by herself. I specifically remember drilling a hole in her cutting board and hammering in a spike, so she could impale vegetables that she wanted to chop. Still, I worried about her and was reluctant to give her any shocking news.
So, a few weeks later, when I knew I was pregnant, I was afraid to tell her. We were chatting on the phone. I decided to get cute and asked her how she felt about being a grandmother. She let out a horrible shriek. I said, “Margaret? Margaret? Are you all right?” I was afraid I had killed her. It seemed like hours before she answered me. I almost hung up to call the rescue squad to check on her. When she was finally able to speak, she assured me that she was happy. Still, I decided to never give her any more surprising news over the phone!

                Sometime during the period when all I did was throw up and hurt, I started having nightmares about the baby. Repeatedly,  I dreamed that I wasn’t having a human child, I had an Alien fetus growing inside me, eating my innards and getting ready to tear its way out of my abdominal cavity, leaking my guts and goo, on its way to a pillaging frenzy and finally, to take over the planet for all Alien-kind. I was relieved when they did an ultrasound and I didn’t see a tail. I wasn’t sure about the safety of the world until Jack was finally born and he looked human. Still, you never know.

Having Jack

Being pregnant with Jack was not much fun. I wanted to have a baby but had difficulty getting (and staying) pregnant. Then, just as I was starting graduate school, I missed my period. I went to the doctor’s office during the first week of school and was sent to the lab for a pregnancy test. Afterwards, Dr. Smith had a kindly demeanor as she ushered me into her office.

“Now, do you know the results of the test?” she asked with a worried one.  

“Well,” I replied, “if I’m not pregnant, then there’s something terribly wrong with me!”

“Oh! You want the baby?” Dr. Smith was surprised. Since she practices at the University Health Services, most of her pregnant patients are young co-eds and unhappy with their state. She was pleased to have patient who wanted her news, for a change. Then, problems arose.

 I thought it was morning sickness, but it got much worse. Every day, I puked until I had nothing left in my stomach. I continued to wretch until I threw up bile. It was awful. I would try to force myself to stop vomiting and sometimes, it worked. I couldn’t keep anything in me. As soon as I got up, I threw up. As soon as I ate anything, I threw it up, but I also threw up without any provocation. My stomach started to really hurt. Some of it was the stress on my abdominal muscles from all of the vomiting but within days, the pain was terrible.
I went to the doctor. I got Dr. Rubin, a kindly fellow. He asked questions, poked and prodded, and sent me for an ultrasound, but didn't find any obvious source of my problem.

I continued to vomit, as many as fifty times a day. I vomited so often, I broke all of the blood vessels in my face and eyes. I looked like a drunk after a bender – my eyes and cheeks were so bloodshot, I hated to look in the mirror. Hydrostatic shock was the problem – the force of vomiting actually shattered the veins under my skin. I was lucky I didn’t stroke out. I had to drop out of graduate school; I couldn’t stay through a three hour seminar without repeatedly leaving to puke in the ladies’ room. My adviser was sympathetic and told me that I could come back the following year, without penalty.

Finally, I started to throw up blood. Even with this symptom, it took months to diagnose my problem. Since I was in the first trimester of pregnancy, there weren’t any tests that could be performed without compromising the safety of the baby. Dr. Lentz started me on Zantac, an anti-ulcer medication, but it didn't help, so she sent me to the gastroenterologist, Dr. Zucker.

Dr. Zucker’s office was in Northampton. He stopped the Zantac and scheduled a gastric endoscopy for as soon as the second trimester started, a few days later. The endoscopy was unpleasant. Since I was pregnant, I wasn’t given any of the normal drugs, such as Ativan, during the procedure. The advantage was, I was able to drive myself home afterwards; if I had been given any sedating drugs, the hospital would not have allowed me to leave without someone to drive and take care of me. John never came with me to any of my doctors’ appointments or procedures when I was pregnant.

For the endoscopy, Dr. Zucker sprayed the back of my throat with an anesthetic, to paralyze my gag reflex. That was the only medication he used. He told me that whatever else, I must not grab his hand or the instrument. I wrapped my hands around the rails of the procedure table. Then, he inserted a thing that looked and felt like a garden hose being jammed into the depths of my throat. I started to shudder; I couldn’t breathe and thought  that I would suffocate. Suddenly, I remembered that there was nothing wrong with my nose and inhaled deeply. I would survive. Dr. Zucker took a good look around inside my stomach and duodenum. After it was over, he told me that he found three large patches, the size of silver dollars, of irritated and inflamed tissue. A normal ulcer is no larger than the size of a dime so I was pretty sick.

He prescribed a different medication, Carafate, which he said would coat the patches and protect them from stomach acid; this was what caused all of the pain and bleeding. The Carafate coating would allow them to heal. Carafate wasn’t a drug that was absorbed into the bloodstream; it seemed the best thing for a pregnant woman with ulcers. I was to take the giant pink pills before every meal. Since I wasn’t eating normally, I was to take them three times per day. If I had any dizziness or lightheadedness before my next appointment, I was to call his office and immediately come to the emergency room. He was afraid that one of the inflamed patches might perforate  - that my stomach might spring a leak into my abdomen - and I could bleed to death internally without surgery.

I picked up the Carafate at the pharmacy and went home. I took one and threw up. I took another. This became my practice. Since Carafate wasn’t something that I could overdose on, I could keep taking it until I could keep it down. One morning, it took five tries. John never knew what my mornings were like.

After a week, I was starting to feel a little better. I could usually keep the second pill down and I was even able to eat half a slice of dry toast. I caught a mild cold but it didn’t dampen my rising spirits. Then, as I got up one morning, the world started to spin.

I was afraid. This was exactly what Dr. Zucker had warned me about. I was very dizzy but I had no lightheadedness. I didn’t think I was bleeding internally. This was just dizziness – everything was spinning. I called Health Services and staggered out to the car. I drove carefully; it wasn’t too hard because I didn’t have to stand up. Getting into the building was an adventure but the doctors quickly diagnosed me as having with vertigo from a viral infection, not internal bleeding. I went home and spent the next few days in bed. John complained that I didn’t cook him for him. I still wasn’t eating anything but lukewarm decaffeinated tea and dry toast, so I wasn’t interested in cooking, even if I had felt well enough to stand up.

The first meal that I was able to eat and keep down that entire autumn was Thanksgiving dinner at my father’s house.  Turkey with gravy, mashed potatoes, corn, stuffing, cucumbers with sour cream, rolls, and plenty of cranberry jelly - it was the best meal of my life. I had two plates, consumed very slowly, over the course of four hours. It was delicious. I’ve never been able to eat turkey again without remembering the feeling of complete gratitude that I enjoyed that day.It really was a day of thanksgiving for me.

I went back to Dr. Zucker. He was unhappy that I hadn’t called him for the episode of vertigo but was pleased with the improvement in my ulcer symptoms. He recommended that I try to discontinue the Carafate. If the ulcer symptoms came back, I should resume the Carafate. So, I stopped taking the Carafate. Within two days, I had started vomiting again and having abdominal pain. I restarted the Carafate and continued to take it for the rest of my pregnancy. It took over a week for the vomiting and stomach pain to subside but it was a worthwhile trial; Carafate interferes with the absorption of some nutrients and I worried about the consequences of taking it while pregnant but I had no other choice.

I was also following the directions of my OB/GYN team. I saw a group of nurse-midwives regularly to monitor the progress of the pregnancy. One of the tests early in my pregnancy had been an ultrasound, ordered my Dr. Rubin to determine the source of my abdominal pain. It showed that I had placenta previa. Placenta previa is when the site of the umbilical cord’s implantation within the uterus covers all or part of the cervix; during childbirth, it can be fatal for both the baby and the mother as the cord will detach long before the delivery, suffocating the baby and causing the mother to bleed to death. However, if it is diagnosed early in the pregnancy, it often resolves itself as the uterus stretches with the growth of the fetus. And that’s what happened with me. I still needed a second ultrasound, just to be sure all was well, a week before Jack was born.

As my pregnancy entered the third trimester, I started to have stomach problems again. I first met my friend, Amysue, when I had to run to the bathroom to puke just as Mike Moyle introduced us at Arisia, a science fiction convention that I had been working on for several years (the first one took place in 1990, when I was six months pregnant, but we had been planning it for about three years). I had a lot of responsibilities; Amysue was worried about me and followed me into the bathroom. She continued to check on me all weekend. I was the chief financial officer for the convention and I had to approve of expenditures and sign checks throughout the weekend; I kept a bottle of Maalox to drink between Carafate pills in the side pocket of my backpack, next to my laptop. I regularly swigged Maalox all weekend. Another fan, not knowing about my stomach problems, commented that running a convention must be stressful if committee members kept a flask of Maalox handy!

                Finally, the end was in sight and I signed up for childbirth classes. John came to most of them; these were the only appointments that he attended with me. It was the rule for that OB/GYN practice that only partners who had taken the class could be present for the birth. We had our last class about a week before Jack was born.

                In the last month, my blood pressure started to rise. I got sent to the hospital for fetal monitoring twice, once in the last week, straight from my appointment with the nurse-midwife. I was told to stay in bed, lying only on my left side. It got very boring. John didn’t understand why I had to stay in bed when I didn’t feel bad, but he hadn’t been very nice when I had felt sick, either.

                Finally, on April 11, I woke up from my afternoon nap feeling crummy. John had told me that he had to go to Boston, to pick up some car parts. He left about 3 PM, just as I lay down to take my nap. I hadn’t thrown up for over a month but was feeling nauseous that day. I wasn’t sure if I was having contractions. I threw up twice, then, I had diarrhea. Eventually, my system was empty and I felt better. But my back really hurt. I took a shower. I paced around the house and took a few more showers as the evening wore on. I tried to call John on his cell phone repeatedly but there were a lot of “dead” spots in those days and I couldn’t get him. I talked to the midwife and to my sister (also a nurse). Karen told me to call our dad; if I couldn’t get a hold of John, I needed to have a back-up to get to the hospital. I was timing the contractions – I had decided that they were real about 6 PM. The nurse-midwife told me to call her and come to the hospital when they were five minutes apart.

                It was 10 PM and the contractions were five minutes apart. I called my dad and asked him to come and bring me to the hospital. I had my suitcase ready by the door. After half an hour, my dad had still not arrived. I was on the phone, seeing what was keeping him, when John finally got home.

                John had taken a nap by the side of the road and never went to Boston. I was pissed but there was no time for me to be annoyed. I needed to get to the hospital. Then, John decided that he had to start a load of laundry - the towels that I had used over the course of the evening, taking showers to help ease my severe back labor. John fussed around the house, picking up various things, for about 45 minutes. Finally, I grabbed the keys and hauled my suitcase outside. I was about to drive myself to the hospital when John finally came out. We got into the Jaguar and he drove across the river and up Route 5, along the Connecticut River, north from Holyoke to Northampton. The road was under construction; it was being repaved and was entirely dirt with traffic cones everywhere, to show where the lanes would be.

At first, John drove very slowly. As we approached Northampton, he complained that I wasn’t having any contractions and was the trip even necessary? I had been hanging onto the lip of the sunroof, lifting myself up to get through each contraction. I managed to squeal out, “I’m having one NOW!” When that contraction ended, I told John that the contraction were lasting about a minute and were coming every two minutes; I was timing them with the clock on the stereo. He sped up and bounced along the bumpy road so fast, I screamed in pain and begged him to slow down or he would bounce the baby out!

                We arrived at Cooley Dickinson Hospital at 11:45 PM. John drove up to the emergency entrance and I got out. I had to hang onto the side of the car to have another contraction. Then, I walked quickly into the hospital. I hung on to the admission desk to have another contraction. A nurse came down from the labor and deliver unit with a wheelchair. I sat down, then jumped out and hung on for another contraction. The wheelchair just didn’t work for me; I couldn’t sit during the contractions that were now almost continuous.

                We arrived at the labor and deliver unit. I was given a johnny; I undressed and put it on. I had to pee and was warned to not push while on the toilet; who wants to deliver their baby into a toilet? John finished signing me into the hospital and came up. It was time to have the baby. John pressed hard on the sorest spot of my back; it almost made up for his absence earlier in the evening. Jack was born at 12:14 AM on April 12, 1990. He weighed 6 pounds and ½ an ounce. At first, I thought he was so small because of the Carafate that I had to take while pregnant but later, I decided he was light because he was just a skinny kid. He has always been slim. Even now, at the age of 21, he is still long and lean.

                I stopped taking Carafate a week after Jack was born. I never had another ulcer symptom.

Guts

      I have not posted for the last two months because life..... sucked.
       I feel bad about complaining. Compared to how I felt after my surgery, I am SOOOO much better! But I haven't felt well. I haven't been well since before I got sick last March, and that's a long time to feel crummy. There's no polite way to say it; I've had diarrhea. No one wants to hear about the Hershey Squirts and I really don't like to talk about it. No one wants to hear about how you constantly feel like you need to find a toilet, even if you're still sitting on the pot from the last bout! So, I did what I thought I was supposed to do and ate more fiber - fiber will thicken you up if you have the runs, just as it will provide moisture if you are constipated. It's an all-purpose cure for digestive distress. I eat at least 25 grams of fiber every day, in the form of either Cheerios or oatmeal at least once a day, every day. The fiber helped with the worst of the symptoms but it didn't do anything for the constant urge to go. I tried my best to stretch out the time between trips to the potty, but all I could ever think about was how badly I needed to go, all of the time. It has been very distracting.
     I had a colonoscopy in January (oh, no! the dreaded poop-shute periscope!). My surgeon, Dr. Holly, drove the device. I had this exam to check up on the state of healing of her lovely internal embroidery without having to rip out all of the outer seams - so messy. All things considered, I rather have the poop-shute periscope than to be gutted, again. Things looked good but she took a biopsy, just in case (I have some inflammation at the surgical site, which was not unexpected). I told her about my need to "go" up to fifteen times a day. She recommended a visit to the gastroenterologist.
      It only took five months to get an appointment with the gut doctor. I finally saw him in May. He was nice enough. He sent me for more tests - blood tests and a barium upper GI series. I had a barium lower GI series done when I had the colostomy (which was dreadful - they filled up my colon with liquid barium through a nozzle placed in the hole in my side. When it was done and they took the plug out, I spurted barium goo three feet in the air, like a very nasty fountain!). For this test, I had to drink the barium - first really thick stuff, then a lot of thinner stuff. All of it was nasty. Then, I had to hang around long enough for the crud to percolate through my small intestines. It took a couple of hours. I walked around, to have gravity help the process. Finally, I was done and could go home. I was warned to drink lots, so the barium would be flushed and not turn to shellac on the inside of my guts. I drank a whole liter of water before I even left the hospital! I was thirsty; they had given me nothing but barium all morning. I drank constantly all night and had the constipating effect of the barium was a pleasant change from the runs!
      The barium studies were normal - my doctor says that almost everyone has a hiatal hernia and I'm normal in that respect. It doesn't bother me, so no big deal. I'm relieved that they didn't find anything extra, or any holes. my best friend from college has stage four colon cancer, so I count my blessings.
      I'm left with the last tests, which have still not come back. The gastroenterologist drew blood because he thinks I'm allergic to wheat. Apparently, the diarrhea and constant urge to go is symptomatic of this allergy. The assumption is, no matter what the tests say, I'm probably allergic. I have so many other allergies. I'm SOOOOO pissed! I like bread! I like to bake! Can't I be allergic to Brussels sprouts, instead?
      For the last two weeks, I've gone on a gluten-free diet. I've had one error (didn't check a label before eating) and only one bout of the trots (need I say when this happened?). I don't have the constant urge since going wheat-free. But maybe it's just a cruel coincidence. Whine! Whimper! Snivel! And more whining!
      Cheerios have wheat in them - I read the label. Rice and Corn Chex do not. I guess I'm going to change my breakfast cereal.
      Jack says he gets the runs from wheat, too, so he has also gone gluten-free. Can you catch allergies from your kids?
      Life is cruel. I guess I'm going to have to learn how to bake without wheat. Or barley. Or rye. This sucks. But it's better than a constant Code Brown looming over my life.