Wednesday 30 April 2014

The GERD Diet & Lifestyle (Part 2)


Bad Foods For Reflux

1. Deep Fried Food

2. Fatty Food (Trans Fats & High Fats Food)
High fat foods, particularly those that contain trans fats, can cause reflux because of the large amounts of acid required to digest them. Foods with a high fat content have been linked to a decrease in LES pressure and a delay in stomach emptying which can also lead to acid reflux.

Trans fats have been connected to esophageal disease, and since GERD can also contribute to complications with the esophagus, it is best to eliminate them from the GERD diet.

3. Tomatoes
This is on my salicylate and GERD list of foods to avoid! *SOB SOB!!!!!!*

4. Spicy Food

5. Butter
What?!! Why butter??? WHY??????  *Sob sob sob!!!*

6. Mint

7. Oily Food
And that includes baked chicken skin. I learned that the hard way!

8. Alcohol. 
Alcohol irritates the lining of the stomach. I have not had alcohol since I had the anaphylactic shock which almost killed me. 

9. Chocolate
Both peppermint and chocolate contain chemicals that can stimulate the release of stomach acids while also relaxing the smooth muscle sphincter between the stomach and esophagus, often resulting in acid reflux and heartburn.

10. Onions & Garlic

11. Very hot food and liquid
It can intensify the symptoms of acid reflux.

12. Your Own Trigger Foods. 
Given the complex nature of GERD one man's meat is another man's poison. Thus, certain foods can trigger severe reactions in some but just irritates another person's stomach.  Make a list of these foods and avoid them in the future.

Tuesday 29 April 2014

The GERD Diet & Lifestyle (Part 1)


In order for my esophagus to heal, I have to keep the reflux at bay. Even though I'm on acid blockers, I have to make sure that episodes of reflux attacks are not triggered.

So here are some foods which are good for people with reflux:

Food Good For Reflux

1. Oats
This low-fat, high fibre meal can apparently sooth the stomach.

2. Bananas
Bananas apparently soothe the stomach but for a small group of people it causes the reflux to throw a hissy fit! So experiment in minute amounts.

3. Grains
Millet, quinoa, buckwheat are some powerful super foods which are packed with nutrition.

4. Beans
An excellent source of protein and fiber.

5. Aloe Vera
I have not had aloe vera for 5 years. I read that it's high in salicylates. Apparently aloe vera is soothing for the stomach. 

6. Ginger
What?! Ginger for the salicylate-sensitive me???!!!! I have to strike this out. 

7. Pasta
Without the red, red sauce that is.

Saturday 26 April 2014

An Appointment with Dr. Rockstar


I have been having very, very bad reflux of late. Actually the reflux came back with vengeance after the surgery due to the painkiller, Tramadol. But I've been taking my acid blockers here and there and ignoring it at times too. 

I wake up in the morning with bile in my mouth. Of late I taste blood in my mouth whenever I burp up bile. I regurgitate my food after every meal. And even 2 hours after a meal, I can still regurgitate chunks of whatever I ate.

I have a reflux cough, and occasional hoarseness when the reflux throws a hissy fit tantrum.

And then the pain started waking me up in the middle of the night. And I would wake in the morning with sharp pain in the upper part of my stomach.

I've had reflux since I was 17. It had never gotten to this point.

So I made an appointment to see my gastroenterologist, whom we call Dr. Rockstar. He looks like one with his jeans, studded belt, boots, gelled up hair and a rock star's swagger. But he's a good doctor who knows his stuff.

So he sent me for a scope which I was already prepared for. I had fasted since the last meal last night which was at 10pm. I had a light supper. 

The scope was at 11.30am and I opted for a 'no-sedation-procedure'. I had gone through a colonoscopy sedation-free and also an endoscopy. I can do it again.

He did spray my throat with an anesthetic spray, Xylocaine. I had this spray in mu throat too 4 years ago when I had both the scopes done under him as well. 

And then they gave me a mouth guard to bite on and in went the tube which was the size of my pinky. As I saw the tube go in I could feel myself gag. I quickly closed my eyes. And then opened them again out of curiosity. It was like a black snake entering my mouth. I gagged three times and kept telling myself to breathe in and out. The nurse was awesome as she held my hand and comforted me. This is my third endoscopy and this was the procedure that I was most aware of everything that was going on. I could feel the tube entering. I could feel it when it reached my stomach. I could feel the expansion when Dr. Rockstar pumped air into my stomach to check for cracks. I felt the metal tweezer pluck tissues from my stomach lining. I don't know why I was more attuned to everything that was happening. 

When I had both the endoscopy and colonoscopy done 4 years ago, they did not allow my husband to go into the procedure room. But today was only an endoscopy procedure. So they allowed him in once the tube had gone in. He didn't know. When the nurse went to get him, he panicked and thought I had gone into an anaphylactic attack. You should have seen his ashen face when he entered! His first remark was, 'You nearly caused me to give up the ghost!' As in I almost gave him a fatal-heart-attack. 

Dr. Rockstar said that my upper esophagus has eroded slightly. I am to be on Nexium, an acid blocker for 2 months. 2 tablets twice a day for one month and 1 tablet daily for the following month. He reiterated that there is no cure for this reflux disease. It's a life long thing. And it needs drugs to control it. 

So at this point, I have to access my diet and try to 'adjust' my already very limited diet to cater for the salicylate and chemical sensitivity and now this very persistent reflux problem. 

Well, if life throws me shit, I'll make manure and compost out of them. But I'll be taking a short break from the battles of life. I'm tired. But like a famous Hollywood line which is so overused goes, 'I'll be back!'

Thursday 24 April 2014

It's Negative

Both the blood tests results are negative. Which means we are back to square one. It's still idiopathic. And they haven't got a clue with what is wrong with me.


Monday 21 April 2014

Baking Soda & The Hard Boiled Egg

Don't you just hate it when you have hard boiled eggs and when you peel it, chunks of the egg is stuck to the shell and you get a really gross looking egg?

I found a solution on the internet!

The remedy? Baking soda!

Just add a teaspoon to the water when you are boiling the eggs.
And voila!

You have perfect, smooth as a baby's bottom hard boiled eggs!
Try it!

Wednesday 9 April 2014

What is the Solution??!!


I am currently in Singapore as I had an appointment with an allergist/immunologist in Tan Tock Sing Hospital on Monday.

I shall call him Dr. B.

It was an exceptionally, extremely interesting appointment as he does not believe that I have a salicylate sensitivity. Instead he believes that the anaphylaxis was triggered by peanuts which were in the soup which I had boiled. (Those of you who follow my blog will know that I had my first anaphylaxis after drinking home-boiled peanut soup 5 years ago). I did tell him that the worst wasn't after the peanut soup though my throat was closing up, my tongue and lips swelled up and my BP dropped and they had to give me oxygen. The worst anaphylactic attack where I went into shock was a result of drinking Joel's Isomil milk. Doctor B said that it could be a carry-over reaction. It happens. OR Joel's milk had traces of peanuts in it as the factory processes nuts too.

Anyway, I had blood drawn for peanut test and also for mast cells degranulation. 

The doctor also told me that the IgE blood tests that were done immediately after the anaphylaxis attacks were inaccurate as they were done too soon after the attacks. When the body has had an anaphylaxis, the blood tests that was done immediately will either give a false positive or negative. It needs a period of SIX WEEKS after an anaphylaxis attack to get an accurate reading. How the hell was I supposed to know?! He also said based on all the blood tests that were done, he can tell that the doctors were all grasping in the dark trying to find out what was wrong with me.

Doctor B also asked me to tell him the history of my health in great detail while he busily typed everything into the computer. 

Unfortunately, there are no tests in the world for all these chemicals or food sensitivities. He said the ALCAT test is bullshit! Haha! He said that if we eat a particular food in large amounts, it will turn up in large amounts in our blood. So that ALCAT test is totally inaccurate. 

Dr.B said that somewhere along the line, I had become hypersensitive after the anaphylaxis attack. He said it happens. I have food intolerance and smell sensitivities too. 

Dr. B said that at some point of time, I would have to re-introduce foods into my system as I can't go on living like this.

That being said, he told me that I have to avoid herbs, spices as they can trigger a reaction. 

It never sank into my brain all this while that I already had a drug allergy when I was small. My mum told me that I was allergic to a pain killer called 'Viseralgin' when I was a small child. I remember carrying a card with me at all times when I was a kid in primary school. Dr. B said that it's all under the NSAIDs groups. 

He said that currently I do not have any medication to take in the event of a high fever as all the fever medication that are available are under the Cox-1 inhibitor which I am allergic to. There is the Cox-2 inhibitor which Celebrex and Arcoxia belong to. I'm allergic to Celebrex. This hospital is trained to conduct challenge tests for Arcoxia. Though I am able to take Tramadol which belongs to the opioid group, Tramadol does not function as a fever reduction medication. It only functions as a pain killer. The Arcoxia challenge test is done over a period of one day. The patient is given a small dose over a period of about 3 hours which begins at 8am and will continue to be under observation until 5pm. Arcoxia peaks during the early part of the test. If the patient is unable to take it he/she will react during the morning and not later as the peak will slowly descends after it reaches its height. I have not come to a decision on whether I would want to do this challenge test or not.

After speaking to him in detail, he sent me to see an allergist nurse. She is a lady with so much information inside her brain concerning allergy immunology. I was sent to her so that they could educate me on allergy and much more. 

From her I learnt that there are 3 areas where our immune system could have a 'reaction'. The first would be a 'TRUE ALLERGY'. The second is 'FOOD INTOLERANCE'. And the third 'PHARMALOGICAL EFFECT'. There is also the 'virus effect'. More on that later. 

The 'TRUE ALLERGY' is where even a minute amount of allergen that the person is allergic to can kill him/her. If the person is allergic, there is no such thing as giving him/her 'a little bit of it won't kill you'. It will.

The 'FOOD INTOLERANCE' is where the body cannot produce enough of the enzymes to digest the particular food product. An example would be lactose intolerance. The digestive system is unable to produce lactase which breaks down lactose into glucose and galactose. Thus, bloating, abdominal pain, diarrheoa, vomitting can happen after ingesting large amounts of lactose. This does not kill you although it can make you sick. 

The 'PHARMALOGICAL EFFECT' would be the body reacting to enzymes that are released by the body to digest or breakdown the food products that we consume! An example would be the 'Chinese Food Syndrome'. 

When the body consumes MSG, which is basically salt as in sodium, (and the meal is loaded with MSG), the body will retain water. This causes a strain on the heart and the kidneys. And when there is an extreme spike in sodium, there will be a drastic drop in potassium. The body will try to cling into the potassium. The thing is sodium and potassium come hand-in-hand. Thus, the body will go all out in a craze mode trying to balance its system and you will get palpitations, dizziness, migraines, etc as side effects!

The 'VIRUS FACTOR' is such that sometimes during sickness, hives or swollen eyes are not an allergy reaction to the medication that have been consumed but rather an effect which was caused by the virus!

Dr. B and Mdm Allergist Nurse have given me a diary which is specifically for 'reactions'. It is called a 'Reaction Diary'. I used to keep a food diary. This diary however is only for reactions. And I have to note down everything I used, places that I went to, ate, touched, inhaled, ingredients or brands of products that were used, etc 12 hours prior to the reactions. And I have to write in detail to how my reactions are. From there I guess they will be able to narrow down my triggers and what categories the reactions are from.

Mdm Allergist Nurse also taught me that whenever I have a reaction, in order to abort or stop the reaction from progressing to a full-blown attack, puriton or clorphenamine tablet is to be taken. Not Xyzal. Not Zrytec. Why? Because it is a fast acting anti-histamine. It stops the body from releasing other agents which could progress to an anaphylactic attack. No one ever explained this to me and I never realised it to research about it. At the same time, she also said that at times the anti-histamine is not strong enough to prevent an anaphylaxis. The Epi-Pen is the next course of action.  Mdm Nurse also advised me to keep my Epi-Pens together with the Puriton tablets together in a same pouch. 

I asked Mdm Nurse to whether if there is a possibility of having an allergy reaction to things that we are not when we are well when we fall ill. She said that does not happen. BUT she said that if we have been allergic or sensitive to something when we are well, when we are sick the reaction is multiplied at a larger magnitude! 

Mdm Nurse also taught me how to reintroduce food back into my life/system. It is also called a challenge test. Every single new food that is to be re-introduced will be done in a span of two weeks. The first day would be having a teaspoon amount. It would only involve chewing, and chewing only. After chewing, I would need to spit it out and rinse my mouth with water. And then I sit and wait. If I have no reaction as in mouth tingling or swelling or any adverse reactions which I am accustomed to, I can proceed to the next day. The next day would be swallowing the same teaspoon amount. And this is done till the 7th day when it reaches the size of ONE PORTION. During the second week, I would need to ingest ONE PORTION of the new food everyday until day 14! If I do not react during that time, I am good to go with that food. That being said, this is risky and the Epi-Pen and the Puriton must be on standby. Mdm nurse also advice to steer clear of sauces and flavouring as they contain 1001 different ingredients and that could confuse the outcome of the challenge test. I would not know which was the trigger if I do react. Was it the sauce or the pork/turkey/beef? She said to cook the food in the simplest manner. Salt, sugar, pepper. Nothing else. The plainer/simpler it is, the better. And the accompanying foods must be the ones that I have been eating all these 5 years with no reaction. Basically, it's keep it simple.

Mdm Nurse also told me to never drink herbs or all those Chinese concoction herbal drinks as many contain NSAIDs which unscrupulous business people add. I told her I have not drank a single sip of any Chinese herbal drink since the anaphylactic attack. And I do not see any sinsehs. I basically know what I am allowed and not allowed to do. I mean I survived for 5 years!

I have to come back in July to see Dr.B. As of now I have no answers and my mind is still in the process of digesting all the information that have been given to me. I will still stick to my diet of 5 years and research more about all that have been told to me. 

As of now, I am still 'answer-less'! But there is hope!!!






Friday 4 April 2014

Tofu Minced Chicken

Ingredients:

1. 2 packets of soft tofu (bean curd)
2. 200gm of minced chicken (seasoned with sea-salt)
3. 1/2 bulb of garlic (sliced into thin slices)
4. Sea-salt
5. Sunflower oil

---------------------------------------------

1. Heat a wok.

2. Pour about 2 tablespoons of sunflower oil.

3. When the oil is hot, add the sliced garlic. Stir fry until slightly browned.

4. Add the minced chicken and fry until it is 90% cooked. Break up the minced chicken into fine pieces.

5. Add the tofu and mash them up.

6. Stir and mix the tofu with the minced chicken until well blended.

7. Add sea-salt to taste.

8. Allow to simmer for 15 minutes.

9. Scoop up onto serving plate. Serve hot with rice.

Bon appétit!