Getting Back in Balance

It seems that Spring has finally arrived in the Pacific Northwest and I have been planting flowers and vegetables...and having fewer headaches. The tomatoes in the photo were from last year's crop. I am hoping to have more this year. 

While weather changes do seem to bring on headaches for me, the change to Spring has been surprisingly mild headache-wise. Each month since January I have had one less headache that I had to take a triptan drug to abort. April was the best month in a long while. Only 5 triptan-worthy headaches. As usual, I think the reason for the improvement is due to a mix of things. My doctor has me taking a preventative blood pressure med that I am now taking half a dose in the morning and half at night. I continue to watch my diet and blood sugar to avoid triggers and sugar crashes. And I exercise almost daily and get enough sleep. One other thing that has helped is to take Aleve with the triptan drug and then to continue taking Aleve on the third day after the headache to prevent any lingering inflammation from triggering it again. That seems to work pretty well, but is tricky. If I take too much Aleve it bothers my stomach. A lot. 

So balance seems to be the word of the day. If I keep myself in balance, mentally and physically, and if the weather isn't too changeable, I can keep the headaches at bay. I still struggle to remember to drink enough water for me. And I have been struggling to get my diet on track. My latest tactic is to really push the fruits and vegetables and try to keep things interesting.  Most days I make a big salad for lunch and I find that if I add some chopped apple or leftover roasted potato to it I don't have the cravings for sweets afterwards. Which is good. I make my own salad dressings to avoid gluten and preservatives that my head doesn't like. Recently a reader asked how I make dressings so I thought I would share my recipe, such as it is.

I keep track of how much oil I use pretty carefully so whether I make a small or large amount of dressing, I always measure the oil in teaspoons. This is because I am a lifetime member of Weight Watchers and I know that 1 tsp. of oil equals 1 WW point on their program. So if I know how many teaspoons of oil are in a serving of my dressing, I can figure out how to count my portion. So here it is. I just use 1 tsp. of good olive or walnut oil and add either 1 tsp. or 1 T of vinegar or lemon juice, salt and pepper to taste, maybe a bit of mustard or water. I use the 1/1 ratio if I want a less tart dressing, or I add some water. Sometimes I add some stevia (a natural zero calorie sweetener). Sometimes I add a little soft fresh goat's cheese (Chavrie) if I want creaminess.

The trick is to use high quality ingredients. I love the oils from O & Co. My favorite dressing is to use a 1/1 ratio of their citron olive oil and their balsamic vinegar. It is so sweet and delicious. I also like to mix their olive oils with champagne vinegar or red wine vinegar. When I use the latter, I use a larger amount of vinegar: 1 Tablespoon per 1 tsp. oil. 

Latest great gluten-free find: Glutino Fiber Bread. I got it at Whole Foods Market. It tastes like real bread and if you put a little butter on it toasted, you can forget it's gluten-free. It is made from corn and tapioca starch and has flax seed meal, sugar beet fiber, some sugar and egg white and is fortified. At 90 calories, 2 grams of fat, and 2 grams of fiber, it is 2 WW points per slice.

Reactive Hypoglycemia, Dehydration and Headache

It’s 2009 and I've been gluten-free for two years now. When I started this journey, I thought that discovering my gluten intolerance and other food allergies (or intolerances) would solve my headache problem. Unfortunately, they were only a piece of the puzzle, albeit an important piece. I am convinced that the undiscovered gluten intolerance lead to malabsorption of important nutrients, including the magnesium and B2 that my neurologist wanted me to take to prevent migraine. Now that I am gluten-free, my body seems to actually use the magnesium instead of flushing it through my system. Not to mention the fact that avoiding gluten can save me from osteoporosis, cancers and a number of other serious conditions.

But my headaches persist. Not as bad as before though. In the meantime I have discovered a couple other things that seem to contribute heavily to my propensity for getting headaches. Dehydration and low blood sugar episodes. I have always known that skipping meals or not drinking enough water were sure to bring on a headache, so I didn't skip meals and I thought I was drinking enough water. Here’s the thing: it seems I need more water than the average person to keep from getting a headache. The standard 8 glasses a day are not enough, especially on days when I practice Naginata. I seem to have to rediscover this every so often. When we were on vacation in Phoenix last Fall I needed 10-12 glasses of water a day because it was so dry there. Upon reflection, I think I need that much water no matter where I am. 

The second important discovery is about low blood sugar. For years I have noticed that I seem to get episodes of lightheadedness, shakiness, sweating, etc. midmorning. I noticed it got better when I stopped drinking regular coffee. Then I started getting them again. I noticed I got them after eating a breakfast that was high in refined flours or sugars. So I stopped eating waffles for breakfast. Then I stopped putting jam on my toast. Then I switched to whole grains and that seemed to take care of it. Going gluten-free kind of threw me for awhile. Most gluten-free grains are high on the glycemic index so the episodes came back when I ate things like gluten-free waffles, or toast for breakfast. So I switched to eating gluten-free oatmeal or buckwheat cereal. Everything was great for awhile. Then I started to have sugar crashes in the evening during Naginata practice. It seemed that the more I tried to avoid carbohydrates, the worse it got. Frustrated, I mentioned it to my doctor and she suggested I talk to a nutritionist. She said I might have reactive hypoglycemia. The nutritionist took one look at my food diary and said I wasn't eating enough, especially carbohydrates! I was very surprised by this, but thought it wouldn't hurt to follow her advice for a week and see what happened. She recommended that I eat 30-45 grams of carbohydrates per meal and 15-20 grams per snack. She gave me a diet plan that had me eating a mid-morning and mid-afternoon snack (which I was already doing). She also told me to forget about the glycemic index for now and concentrate on getting enough carbs each day, especially on days when I exercised a lot. She said I wasn't giving my body enough energy to work out and that was why I was crashing. Also, the Weight Watcher points level I was following was not enough calories for me. She recommended I add 200 calories a day to my diet.

At first I was afraid that I would gain weight. I had been trying to lose weight without success before. The amazing thing is that the new plan is actually helping me to lose weight again and I am not hungry all the time. The sugar crashes are gone as well. I got a blood sugar measuring kit to test my levels and as long as I eat protein with my carbs and fat and as long as I stay away from fruit juices and highly refined things (like GF waffles...at least in the morning) I seem to stay pretty level all day. 

The bonus was that my headaches went away as well. I had an entire week headache free the first week that was on the new eating plan. I think I may be on to something. These two issues are two important pieces in the puzzle. And I no longer have to feel guilty for eating corn or rice, both of which my body seems to like. Who knew?

Karen, herself

Carrot/Radiccio Slaw

Yesterday I decided to finally do something with the half head of cabbage that has been sitting in my vegetable crisper for a few weeks. I planned on using it to make a low-calorie vegetable soup. After making the soup, I found I had a couple of cups of diced cabbage left over. I wanted to make a more interesting salad so I looked around the crisper and found some radiccio and shredded about a half a head of that as well. Then I added some grated carrot, diced apple and about a half a cup of red seedless grapes and a few raw walnuts. I made a vinaigrette out of walnut oil and rice vinegar, drizzled in some agave nectar for sweetness and then added a teaspoon of mayonnaise. The dressing seemed to need more bulk but I didn't want to add any more mayo so I tossed in a couple tablespoons of plain, unflavored nonfat yogurt. The result was this dish, which was so good that even my husband, who is not a fan of radiccio, loved it. It is naturally gluten-free and lower in fat and calories than the usual slaw.

Carrot/Radiccio Slaw

2 cups diced green cabbage

1 large carrot grated

1/2 small head of radiccio, shredded

1 small apple (skin on) diced

1/2 red seedless grapes (sliced in half)

1 oz. or less raw walnut pieces

1 T walnut oil

1T rice vinegar

dash of agave nectar (or honey)

1 heaping teaspoon mayonnaise (I used Best Foods)

2 T plain unflavored nonfat yogurt

salt and pepper

Combine first 6 ingredients in large bowl. Whisk together walnut oil and rice vinegar in a small bowl. Whisk in agave nectar and mayonnaise. Pour over vegetables and toss. Add yogurt to salad and toss again. Salt and pepper to taste.

Makes about 8 servings if using as side dish

Karen, herself

Gluten-free Travel, the Good, the Bad and the Ugly

The hiatus in my blogging this Fall was the result of several trips: ones to San Francisco and Phoenix in October and the mother of them all— a 10-day Mediterranean Cruise in November. The photo above is yours truly at Santorini, a Greek Island. 

I thought since my last GF travel blog sparked some interest that I would update it with my more current experiences. Most of them were good—some not so much. My little weekend jog to San Francisco for a Naginata seminar was easy and good as I stayed with my sensei and she and I prepared gluten-free pasta salad to take with us to the seminar for lunch. It was such a hit that we shared it with several other people (also we made way too much!). Breakfasts were rice cakes with peanut butter as we stayed with yet another friend in San Jose where the seminar was and there wasn't much time for food prep. Dinners were at Chinese and Japanese restaurants in San Jose. I approached the Chinese one with trepidation, fearing all I would eat was a bowl of rice and steamed vegetables sans sauce. How wrong I was. This little hole-in-the-wall place (Bo Town) was wonderful. They didn't have wheat-free soy sauce, but they made several suggestions about things I could have which included a corn-egg soup, a whole steamed fish with vegetables, etc. There was one other person in our group who needed to eat gluten-free and we certainly did not starve. Similar situation at the Japanese restaurant in San Jose's Japantown (I think it was Minato). No wheat-free soy, but a friend ducked into a grocery store nearby and grabbed some bean sauce that was wheat free that we used as a substitute. Then I did sushi and rice for the rest.

Phoenix was even better. We were staying in a resort that had condos so I could have a kitchen and we discovered the Phoenix Whole Foods right away and stocked up on fruits and veggies, tofu, soy milk and a couple of things to make dinners. Breakfasts were tofu scrambles for the most part or cottage cheese fruit and brown rice bread. I also brought a little GF rolled oats with me to make oatmeal. We didn't eat in the whole time, though. I discovered a great restaurant in Scottsdale: Bloom. Fantastic food and service. The decor is very contemporary. Fusion cuisine. They went out of their way to make sure I had not only safe, but delicious food. Would definitely go back.

We were staying near a JW Marriott Hotel which has 5-6 restaurants and we tried 3 of them: Blue Sage Cafe where we had lunch a couple times and Meritage Steakhouse and Ristorante Tuscany. They were all good and all were happy to deal with my gluten and other food issues. The best of the three was definitely the Tuscany. We saved it for our last night and the chef, Brian Archibald came out to meet me and go over my food sensitivities with me. Everything there is made to order and they really took care of me. This was one of the best experiences I have ever had dining out gluten free. They even had warm GF bread for the bread basket (from a local GF bakery - Gluten Free Creations) they made GF pasta with a fresh tomato sauce for a pasta dish and I had shrimp scampi to die for. My entree had sauce too...no naked food that night. It was like being a normal person again and for that I thank them from the bottom of my foodie heart. For all the Marriott restaurants, I booked online and told them ahead of time about my gluten issues, so they were well prepared. I also used my restaurant card with my food allergies listed on it.

Ok., so that was the good, or most of it, anyway. Having had such wonderful experiences and after my previous good experience flying American Airlines and ordering a gluten-free meal, I was expecting a similar good trip to Europe, especially since we flew in Business Class this time. Unfortunately, my good luck did not extend to the trip on AA. Business Class is definitely nice and the seat, the leg room, all the pampering...no complaints there. Imagine my heartbreak while everyone else was dining on their choice of three entrees, starters, salad, etc. I am served an overcooked overseasoned (to the point where it was inedible) but gluten free meal. It was more like spicy mush, to tell the truth. If if weren't for the seasoning, I would pass it off on the flight attendants overcooking it, but even proper heating wouldn't have saved the slop I was served. Mush that was supposed to be quinoa, canned green beans (which I am allergic to) and overcooked chicken pieces that someone dropped a bottle of chili powder on). I took a couple bites and then pushed it away. I starved and then dug out my reserve rice cakes and peanut butter. It seemed to me that a couple of things on the regular menu would have been ok, so on the way back, I cancelled my GF meal and took my chances. It was a smart move. I had a fine meal and no problems. I know enough about how things are cooked and what to avoid that I can pretty much manage on my own. It must also be the case that a little cross-contamination does not cause symptoms in me.

We stayed in a Starhotel in Genoa, Italy for a couple days before departing on our cruise and the waiters in their restaurant were fantastic. They brought out GF crackers for me, made GF ravioli, and several wonderful dishes with sauces and everything! One dish was duck breast with pears and a wine reduction sauce. Another was sirloin steak with asparagus and cheese. No bad food, no reactions. The way it should be. I wish I could say the same for the food on the cruise. Unfortunately, Costa Cruises, while making sure no one gets sick, does not seem to care whether people with gluten or food allergies have the same level of food as the rest of their guests—which, by the way, also wasn't that great. They go as far as to reserve a section of the kitchen for dealing with food allergies, which is great, but they seem to be afraid to go any further. I had boiled potatoes and vegetables and naked meat and fish for 10 days. I was a very unhappy camper. I was also hungry most of the time because we tended to eat lunch early because of our schedule (we were on a MacMania cruise and had seminars all day) and then we had the second seating for dinner, which meant that I ate lunch at noon and dinner at 9 p.m. The only food in between was either the pizza buffet or high tea (gluten-laden cakes, etc.), which I couldn't eat, a side salad with no protein or ice cream. Guess which I chose. We were forbidden to bring any outside food onboard so things were bleak for me. Luckily I disobeyed that rule as I suspected they wouldn't have rice cakes on board and I brought a box of GF crackers and my handy individual serving sizes of foil wrapped natural peanut butter with me. I hid them in my lingerie drawer! 

Thanks to Costa Cruises and our weird schedule, I ate a whole lot of ice cream and gained 5 lbs despite the naked food and boiled potato fare. It was either that or get a headache from not eating for so long. I choose ice cream over a headache any day.

Breakfasts we ate at the buffet most days. Having just started eating eggs again, I really pushed it eating eggs every morning, but that or salty bacon were the only protein I could have. One morning we ventured into the dining room for breakfast. I had to sit at the GF table (the leper table, as I called it). I had high hopes of getting GF french toast or pancakes. No deal. They had GF bread, they had eggs, but taking that last step to put them together and make GF French Toast was impossible. So more eggs but at least I had toast. Sigh. 

So now I am home and cooking for myself again and dealing with the excess weight. After I lose the 5 extra lbs., I am making French Toast for sure...and writing a long ugly letter to American Airlines. Here's hoping your travels are all good ones. Comments appreciated.

Karen, herself

Gluten-free Holiday Fare

Happily, most of the recipes in my Thanksgiving repertoire are naturally gluten-free. The only exceptions are the stuffing for the turkey and the gravy, which are easily managed with gluten-free bread and rice flour, respectively. I like to make soups and usually feature one in my holiday meals. This year I made my favorite, the curried butternut squash soup from The Silver Palate Gourmet Cookbook (vintage 1980's). The first time I made this soup I followed the recipe faithfully and the soup was inedible because the recipe calls for 4 teaspoons of curry powder. I may have had fresh curry powder, but in any case, I had to throw the whole batch out. Since then, I have made some adaptations to the original recipe, mostly in the way that I prepare it, but most definitely in the amount of curry powder I use. I usually cut the recipe in half and then use a slightly larger squash than called for (— how do you determine whether a squash is medium sized anyway?). Then I add more stock than is called for because I like my soup on the thin and silky side, rather than heavy and chunky. I also cut down on the butter and I make my own curry powder minus the ginger, tumeric and mustard. Here it is. It is always a hit.

Curried Butternut Squash and Apple Soup

1 medium butternut squash, peeled and chopped into 2" cubes

(use a vegetable peeler and if need be, microwave the squash for 1 minute first to soften)

1 large onion, chopped

1 Tablespoon unsalted butter

1-2 teaspoons curry powder

1 granny smith apple, peeled and chopped (plus a bit more julienned for garnish)

1/2 cup apple juice

4 cups chicken stock

salt and pepper to taste

toasted pumpkin seeds for garnish

Melt butter in heavy stock pot or dutch oven. Place onion in pan, sprinkle with curry powder, salt and pepper and sauté on medium-low heat until onions are transparent (about 10 minutes). Add squash and apple pieces and continue to sauté a bit, then add stock. Bring to a boil over high heat, then turn down to simmer for 20 minutes or so or until squash and apples are soft. Puree in batches in a food processor or use an immersion blender. (In my experience, the food processor gives a smoother texture).  Return soup to stockpot or dutch oven and heat, adding apple juice. Adjust seasoning if necessary. Serve hot with julienned apple and toasted pumpkin seeds. Sometimes I add a dollop of sour cream or creme fraiche too. 

Feeds 6 to 8, depending on serving bowl.

Low blood sugar and migraine

So I have once again fiddled with my diet. Now, on top of avoiding gluten, corn sugar, almonds, ginger and all the migraine causing things like: nitrates, msg, caffeine, aspartame, etc., I am also watching my sugar intake. Why, you may ask, would I want to eliminate or drastically curtail yet another food group? My reasons are threefold and all have to do with the high-glycemic value of most non-gluten containing grains.

1: I cannot get control of my weight since going gluten-free.

2: I have noticed a correspondence between low blood sugar episodes and my migraines.

3: I seem to get sugar “crashes” during exercise which makes problems No.1 and 2 worse.

I have known since high school that skipping meals, fasting, or waiting too long between meals is a sure recipe for a headache of any kind. So, for years I have made sure I eat something every 3-4 hours. The trouble is, as I have gotten older, I have noticed that this doesn't ensure I won't have a sugar “crash” which can and has brought on a headache. I even tried making sure I ate protein with my snacks, and it didn't seem to matter. 

Ten years ago, I gave up regular coffee at breakfast (which was a HUGE sacrifice for me) and noticed that the sugar crashes stopped. Great, I thought. Then a few years ago I noticed that if I had jam on my morning toast, I would have a sugar crash a couple hours later. After I gave up gluten, I started indulging in buckwheat frozen waffles for breakfast...with fruit and maple syrup (avoiding the corn syrup, of course). One day in May of 2007 I ate that for breakfast and had one of the worst sugar crashes of my life and as luck would have it, just as the weakness, lightheadedness and shaking started, I saw a bright light from the glare of sunlight reflecting off a window and — bam! Classic migraine (with aura). My day was shot. I took a triptan drug (Amerge) but it took 2 hours to work and I felt lousy the rest of the day.

Two weeks ago I had a ham sandwich on Tapioca Bread with lettuce, tomato and a few baby carrots and I grabbed a couple of potato chips off my husband's plate (!) and an hour and a half later in the middle of teaching our Naginata class, I had the mother of all sugar crashes. I had to stop practicing and since I hadn't thought to bring food with me, my only choice was to get orange juice out of the vending machine and chug it down while I sat on the bleachers waiting for the shaking to stop. Not good.

I had to find a way to eliminate refined carbs from my diet. Not easy when you have an egg allergy that you are not sure is a real allergy or just an intolerance and a moderate cow's milk allergy. I am a lifetime member of Weight Watchers and I had been struggling trying not to eat too many carbs. I looked on the WW forum under restricted diets and noticed that all the gluten intolerant and allergy sufferers were doing the “Core Program” which is based on real food, whole grains, etc. Sounds good, but I had avoided it because of the egg and milk problems I had. Same with South Beach Diet. Most breakfasts that are low carb seem to revolve around eggs.

I decided to try doing the Core program like the first phase of South Beach for 2 weeks and see if I could handle the eggs a little. At first it worked like a dream. I lost the sugar crashes and the sugar cravings and seemed to be ok with a little egg. Then on the third or fourth day I crashed big time. Could barely get out of bed I was so fatigued. I happened to be reading a book by Dr. Diana Schwarzbein about the importance of balancing carbs, protein and fat, especially if your adrenals are burned out...which I suspect mine are. Dr. Schwarzbein says that if you eliminate carbs altogether in that situation, you burn out your adrenals even more and will end up even more fatigued. So, I added some whole grains back in and things are going better now. I am not really missing the refined carbs now and they will taste even better when they are a rare treat instead of an everyday craving. Headaches have been fewer and really only resurfaced after I weakened and ate some chocolate the other day (!). Breakfasts are the most challenging, but I am rediscovering tofu as an egg substitute. Check out my lamb sausage tofu scramble. It's delicious and not too time consuming if you cut up the tofu ahead of time and refrigerate.

Lamb Sausage and Tofu Scramble

2 oz. loose lamb sausage (nitrite-free)

2 oz. firm tofu cut into small cubes

olive oil

1 green onion

1 T fresh mint, minced

1/4 cup or so cucumber, chopped

1/4 cup or so yellow squash, chopped

1 mushroom, chopped

1/4 cup tomato, chopped

salt and pepper to taste

pour a little olive oil in a non-stick skillet on medium heat

add lamb sausage and cook, breaking up with a wooden spoon

add tofu and cook until heated through

add squash, cucumber, mushroom and tomato and cook a minute or two

season with salt and pepper

add green onion and mint and cook another minute

makes one serving (5-6 WW points if you’re counting, depending on how much oil you use)

(note: lamb is pretty greasy, you won't need much oil, just enough for flavor)

Enjoy! You won't be hungry until lunch!

Karen, herself

Gluten-free Air Travel

Travel, particularly air travel, for those of us on a gluten-free diet is tricky. Adding migraine avoidance to the mix makes advance preparation absolutely essential for a pain-free travel day. With airlines no longer serving meals in coach and substituting boxes of junk food for purchase, bringing a healthy meal on board with you is key. You might be able to find something other than fresh fruit in the airport, but why chance it? Also, if you have a long day of cross country travel coming up, as I do tomorrow, a whole day eating nothing but fruit and water doesn't sound like much fun. The solution is to pack your own lunch and bring it with you. 

Whenever I travel I make sure I have gluten-free and migraine trigger free food with me. This time I am taking Real Foods Multigrain Corn Thins in a zip-loc bag, a few EnviroKidz Organic Crispy Rice Bars, some cut up celery and some apples for snacks. (You never know when you might get hungry, especially if your flight gets delayed. Better to bring extra things to tide you over). For breakfast I am taking gluten-free lemon poppyseed muffins I baked a couple weeks ago and froze and for lunch a smoked salmon and wild rice salad with blueberries. I made the salad this morning and have it cooling in the fridge. Tomorrow morning I will take it out and put it in a thermal lunch box with an ice pack so that it stays nice and cold until I am ready for it. I'll make sure I grab a plastic fork from a concession in the airport and buy a bottle of water and I'm set to go!

Smoked Salmon Wild Rice Salad with Blueberries

1 package (4 oz) smoked salmon (preservative-free)

1/2 cup or so fresh blueberries

1 cup sautéed vegetables (I used asparagus, yellow squash, zucchini and wax beans sautéed in 1 tsp. lemon-infused olive oil (O & Co) with a little minced garlic, salt and pepper)

1  1/2 cups cooked wild rice

2 tsp. basil vinaigrette (see recipe below)

salt and pepper to taste

(makes 2 servings) (6 Weight Watcher points per serving)

Slice salmon into slivers. In a medium bowl mix salmon, rice, vegetables and basil vinaigrette. Toss. Adjust seasoning. Add blueberries and gently mix. Divide into travel containers and refrigerate. Pack in a thermal lunch sack with a cold pack.

Basil Vinaigrette (from most recent AARP Magazine)

1/4 cup Dijon mustard

1/2 T finely minced shallots

1/4 tsp salt

1/4 cup champagne vinegar

juice of half a lemon

1/4 cup extra-virgin olive oil

1/4 cup fresh basil, chopped

In a medium bowl, combine the mustard, shallots and salt. Slowly whisk in the vinegar, lemon juice, and oil until the mixture is emulsified. Add the basil and chill for 30 minutes.

Note to Migraine sufferers: None of the above ingredients cause any problems for me. Even the mustard and vinegar are ok in small amounts. Your triggers may be different from mine. Substitute where necessary.

Try packing a gluten-free lunch on your next trip and see how much better you feel—physically and emotionally. Not to mention that those sitting around you will be jealous!

Bon voyage!

Karen, herself