Monday, March 29, 2010

The fishy wabbit diet

Between the acupuncture and some diet changes, I am way better than I was last week. At my last acupuncture session I told the doctor I was 50% better, but I think I am closer to 80% or 90% now.

I've started walking exercise at a local track with a fellow dog owner, I can barely keep up with her but I do manage to complete the entire 40 minute session without collapsing in exhaustion. The dogs love it.

The Chinese medicine doctor is saying he still has concerns about my kidneys and pancreas. Chinese medicine is very different from western medicine, I would never have associated my kidneys or pancreas with the symptoms I have been having.

The only dietary change the doctor has mentioned was to cut out refined sugar. I have to say that I have not been entirely successful in that, I still use sugar in my tea, albeit not as much.

I have tried to follow the conventional dietary changes recommended for acid reflux, but that is really hard to do. Basically, they recommend you cut out all the good stuff: coffee and black tea, alcohol, sugar, chocolate, cheese, fried food, dairy products, anything crunchy.

When I first read these restrictions, I thought, how on earth does one eat? There's no way I am going to turn into a herbal-tea-and-tofu nut!

But I have managed to make some significant changes. The trick has been to go looking for what I could eat rather than what I could not eat, and be experimental with it. The novelty factor got me through the first few days of deprivation.

I have cut back on cheese, so far I have had no chocolate (waah!), I've cut out coffee (but kept the black tea), and have pretty much stopped frying food.

I do keep a bag of potato chips and occasionally treat myself to a chip or two.

I read that what I need to do is reduce production of stomach acid and try to allow my esophagus to heal by avoiding anything that will irritate it (crunchy or scratchy food). One website I read said that if you can increase digestive enzymes in your stomach, that will tend to decrease the need for stomach acid. You can get digestive enzymes from supplements or from eating dark leafy greens and other foods that are high in those enzymes. So I have been eating a lot of rabbit food: chard, lettuce, spinach, that kind of stuff. One recommendation was for carrot soup to soothe the esophagus and add enzymes, I found a great recipe for ginger carrot soup (ginger is good for the stomach too).

To make the soup, chop up carrots and celery, and grate some ginger. I think the ratio is roughly 2 cups carrots, 1 cup celery, 1 tablespoon grated ginger. Cook together until soft in approximately three cups of water (or more, my first batch I boiled dry and had to throw out). Then run it through a blender. You can substitute broth for half the water if you need salt in it, I just add a bit of miso when it's done. Serve with a dollop of yogurt, maybe a sprinkle of parsley. You can also add other vegetables to the soup.

For the first week or two, all I ate was fruit, fish, leafy green salads and carrot soup, but now that I feel better I am adding other foods.

I started eating fish because cutting out all the cheese and dairy products pretty much eliminated my normal protein sources. But I have no skill in cooking fish, the first few meals were terrible. Then my neighbour Fatima gave me a fool-proof recipe for fish at the dogpark, so the quality of my meals has vastly improved.

Fatima covers a fish fillet in a sauce made of mustard, soy sauce and maple syrup (trust a Portuguese-Canadian to put maple syrup on fish!), I substitute miso for the soy sauce. Then you pop it into a toaster oven set at 400F for 10-12 minutes. Presto-pasto! Instant fish! Doesn't matter what kind of fish, the sauce works for them all.

An apple a day: eat a golden delicious apple at the end of each meal to ward off heartburn. Don't know why it works, but it does.

Drink lots of water, but not with food. Eat more smaller meals. This is hard to do, trying to fit in copious quantities of water between numerous meals is tricky and time-consuming. Plus you can never go anywhere: between eating, drinking, food preparation and bathroom breaks, that's pretty much a full day. Good luck with that.

Your stomach is the size of two open fists (make a fist, open it up so only your thumb and one finger are touching), each meal should be no bigger than that, otherwise you are putting needless pressure on the sphincter that keeps the stomach acid from going up the esophagus.

Restore your gut flora, eat foods with live good-bacteria cultures in them. Probiotic yogurt is an obvious source, but certain misos and sauerkrauts are too. That's why I use miso instead of soy sauce on the fish. These days, miso is just about my 'sole' (ha ha) source of salt (trying to keep the blood pressure down too), so I have become a big fan of the stuff. There's just no way I can cut out salt altogether, I am too much of a salt-lover. At least with miso, I am getting good nutrition along with the salt.

Miso that comes packaged in a soft plastic wrapper is probably pasteurized and therefore not a good source of good bacteria. Look for miso in yogurt tubs or jars with lids. I was told to use Tradition brand three-year-old rice miso (from your healthfood store refrigerator). Look for Eden brand organic sauerkraut, I can't eat the stuff because of the vinegar (I react rather strongly to that), but it's another good source of good bacteria.

I never gave up the yogurt but I did switch to skim milk probiotic yogurt. I continue to eat oatmeal and rice and a slice of wheat toast every day. I've switched my biggest meal to midday and I try to eat my last meal a good 3 hours before bedtime. No more chocolate macaroons for desert (waah!)! I grate ginger and carrot into my salad, and make up a vinaigrette and miso salad dressing. I don't drink my morning tea first thing, but have some food first so the tea is not going into an empty stomach. I continue to add milk to my tea, but I have switched from 2% to 1% (can't stand the taste of skim milk and apparently there is a big difference in fat content between 1% and 2%).

Tomatoes are supposed to be bad for acid reflux, but I read somewhere that it's only cooked tomatoes, fresh tomatoes are OK. So I have not cut out tomatoes altogether. If you are a big fan of pasta and tomato sauce, there is a fabulous uncooked tomato sauce in the Moosewood cookbook (or one of them, I don't remember which one). Gretel makes it and puts it on cooked spaghetti squash for a to-die-for meal. I think it has a fair bit of vinegar in it though, so it might depend on how you tolerate vinegar. It also has a fair bit of parmesan cheese in it, but apparently hard cheeses like parmesan are better tolerated than softer cheeses.

I have cut out citrus fruit though. Fresh pineapples, bananas and apples (golden delicious) are my staple fruits at the moment.

I read somewhere that I should try to sleep with the head of my bed raised 6-12" higher than the foot, and ideally on my left side. I did try this but the acid reflux went through the roof and all of a sudden I could not sleep through the night for the pain. I put the bed back to level and went back to my normal sleeping position (on my stomach) and the pain disappeared.

Moral of the story: everybody is different, you do what works for you.

I have tried eating cheese on occasion, I figure that at this point I can probably get away with small amounts. I have also had a glass of wine or two with little ill effect. I might try the sauerkraut again, although a life without sauerkraut is not nearly as dismal a prospect as a life without wine.


Barbara Anne said...

Very interesting!

A good, common sense book that also says everyone is different, so try what you like and it may be okay for you. The book is called "Eating Right for a Bad Gut" by James Scala.

I wish you well!!


Annie said...

Thanks, Barbara, I'll look for it. In this age of scientific and medical expertise, we lose sight of the fact that ultimately we are our own best experts, we get dependent on expert authorities to tell us what is right for us. It's a revelation that we may actually know something about what's good for us!