"On the Throne With Diarrhea"
From the book of poems Oops! by Catherine Cottel Duus
I have a very bad case.
It's a disgrace.
To the toilet I must run.
I can't stop for anyone.
I look for every short cut.
I find a throne and sit like King Tut.
There I sit and moan and moan.
Groan and groan.
What if I don't get over this disease?
What will happen if I cough or sneeze?
I'll spend the rest of my days,
Bent over and walking sideways.
Wherever I may go, I'll have to find,
A pot for my behind.
I hope nobody will ever know,
That I have to go,
Because I have diarrhea and I must trot,
Searching frantically for the nearest pot.
Note: If this is happening to you for more than a few days, then you need to come see me!
Tic Disorder and Dairy Allergy, Patient Story
In an effort to share some of the interesting things that I get to see at my clinic, I'll try to make a better effort to talk about cases.
I recently saw a 10 year old boy who had a tic disorder. He would experience involuntary twitches and other muscular movements, or sometimes make a regular hiccup like sound. He had been to many many doctors, including allergists and neurologists, and no one could tell his mom what was wrong.
He had also had a history of emotional swings, irritability, and difficulty concentrating and sitting still in class.
His mom had already figured out that his diet was related to his health and his behavior, and she noticed that removing dairy from his diet made a huge difference in his health and resolved his tics. But she was having trouble finding a doctor who could support her diagnosis. When they came in I never doubted her, and I suspected that the proper kind of food allergy testing would provide her with the support she needed.
Sure enough, when we got the lab work back it demonstrated that he had a dairy allergy. He also had a gluten allergy, but it was clear that the dairy was the primary trigger for his tics.
This is just one example of how food allergies can affect health. I do not believe that all tics are caused by dairy allergies. In fact, I'm confident that there are many different causes for tics, and I suspect that there are many other food allergies that trigger tics in certain people. Everyone is different. And different people get different symptoms from a food allergy. Don't confuse the food with the individual reaction to the food. That is the important part.
I recently saw a 10 year old boy who had a tic disorder. He would experience involuntary twitches and other muscular movements, or sometimes make a regular hiccup like sound. He had been to many many doctors, including allergists and neurologists, and no one could tell his mom what was wrong.
He had also had a history of emotional swings, irritability, and difficulty concentrating and sitting still in class.
His mom had already figured out that his diet was related to his health and his behavior, and she noticed that removing dairy from his diet made a huge difference in his health and resolved his tics. But she was having trouble finding a doctor who could support her diagnosis. When they came in I never doubted her, and I suspected that the proper kind of food allergy testing would provide her with the support she needed.
Sure enough, when we got the lab work back it demonstrated that he had a dairy allergy. He also had a gluten allergy, but it was clear that the dairy was the primary trigger for his tics.
This is just one example of how food allergies can affect health. I do not believe that all tics are caused by dairy allergies. In fact, I'm confident that there are many different causes for tics, and I suspect that there are many other food allergies that trigger tics in certain people. Everyone is different. And different people get different symptoms from a food allergy. Don't confuse the food with the individual reaction to the food. That is the important part.
Full Tilt Ice Cream in West Seattle
Yesterday I learned about a new ice cream shop in West Seattle that makes all of their own ice cream, including coconut based vegan (dairy and egg free) ice creams! Wow. Why didn't someone else think of this before?!
Full Tilt has all kinds of creative flavors, or at least names of ice creams, such as Mexican Chocolate, Thai Tea and Blackberry Dark Chocolate. But they don't just have ice cream.
Full Tilt is named for their pinball arcade. You'll find Mr. and Mrs. Pac-Man, Jacks Open, Twilight Zone, No Good Gofers, Funhouse, Sinbad and Ready Aim Fire. You'll also find other arcade games, including a sit-down Missile Command, Tron, Ms Pac Man, Pac Man, Dig Dug, Super Mario Brothers, Centipede, and Road Blasters.
Full Tilt is actually in White Center:
9629 16th Ave SW
(between 98th St & S Delridge Way)
Seattle, WA 98106
(206) 767-4811
Visit their website at www.FullTiltIceCream.com. Who knows, maybe they'd even consider making ice cream on request?
Full Tilt has all kinds of creative flavors, or at least names of ice creams, such as Mexican Chocolate, Thai Tea and Blackberry Dark Chocolate. But they don't just have ice cream.
Full Tilt is named for their pinball arcade. You'll find Mr. and Mrs. Pac-Man, Jacks Open, Twilight Zone, No Good Gofers, Funhouse, Sinbad and Ready Aim Fire. You'll also find other arcade games, including a sit-down Missile Command, Tron, Ms Pac Man, Pac Man, Dig Dug, Super Mario Brothers, Centipede, and Road Blasters.
Full Tilt is actually in White Center:
9629 16th Ave SW
(between 98th St & S Delridge Way)
Seattle, WA 98106
(206) 767-4811
Visit their website at www.FullTiltIceCream.com. Who knows, maybe they'd even consider making ice cream on request?
Vance's DariFree Potato Milk
Guess what? There is another dairy free milk alternative out there that you probably haven't heard of before. It is called Vance's DariFree, a fat free non-dairy alternative.
Vance's DariFree is a potato based powder. Yes, a non-dairy powdered milk. This has many promising applications, such as for traveling, camping, backpacking and the like. I had it several years ago and found it thin, but I suppose you could use less water.
It is free of soy, rice, gluten, dairy, and even rice. It contains as much calcium as milk, and can be used in baking and even as a coffee creamer.
It is also free of protein and was designed for people who require a low protein diet. So if you are looking for a protein source, this certainly isn't it.
Vance's DariFree comes in both Original and Chocolate flavors. It contains potato starch, fructose, honey, and carrageenan, and many vitamins. For more information visit www.vancesfoods.com.
Vance's DariFree is a potato based powder. Yes, a non-dairy powdered milk. This has many promising applications, such as for traveling, camping, backpacking and the like. I had it several years ago and found it thin, but I suppose you could use less water.
It is free of soy, rice, gluten, dairy, and even rice. It contains as much calcium as milk, and can be used in baking and even as a coffee creamer.
It is also free of protein and was designed for people who require a low protein diet. So if you are looking for a protein source, this certainly isn't it.
Vance's DariFree comes in both Original and Chocolate flavors. It contains potato starch, fructose, honey, and carrageenan, and many vitamins. For more information visit www.vancesfoods.com.
Dr. Bob Sears on Vaccinations
If you've ever wondered about vaccinations and were looking for a good resource for a candid and thorough discussion on the topic, I think I've got one for you.
Dear Bob Sears is one of the few doctors who is willing to discuss all of the facts when it comes to vaccinating your infant. He is not anti-vaccine, but he is willing to acknowledge both the good and the bad of vaccinating, and even more importantly he openly addresses what we don't know about the consequences of vaccinating.
He is criticized by some colleagues for not towing the party line, and highly respected by others, including me. This is just the kind of doctor you want when you want to know the whole story on a subject.
I highly recommend reading his book, "The Vaccine Book." And visit his website at http://www.askdrsears.com/thevaccinebook/.
Dear Bob Sears is one of the few doctors who is willing to discuss all of the facts when it comes to vaccinating your infant. He is not anti-vaccine, but he is willing to acknowledge both the good and the bad of vaccinating, and even more importantly he openly addresses what we don't know about the consequences of vaccinating.
He is criticized by some colleagues for not towing the party line, and highly respected by others, including me. This is just the kind of doctor you want when you want to know the whole story on a subject.
I highly recommend reading his book, "The Vaccine Book." And visit his website at http://www.askdrsears.com/thevaccinebook/.
My Story
Recently I was going through some old papers of mine and I ran across something that I thought would be worth sharing with you. The following is a paper that I wrote for a class in medical school in May of 1996. It is the story of how I dealt with my IBS and finally discovered that I was gluten intolerant.
"About four years ago I began experiencing intermittent pain in my abdomen. I assumed that it was stress since I figured that I usually localized my stress and it didn’t seem to be anywhere else, so it must be there. At the time I was working in a position with great responsibility and under pressure to correct multiple deficiencies in a program that is closely monitored by the federal government. Also, my boss was a (beep)hole. Fortunately I left this job after 2 years, but only to find myself working for (beep)hole II. After 2 years of that persecution I quit and came to Bastyr University. Medical school is a cakewalk compared to (beep)holes I & II.
"My symptoms gradually increased over those years. I assumed that after quitting my job that I would finally be relieved of my problem. I had tried to remain as stress free as possible and this seemed to help, but I couldn’t find a 100% correlation. Most interestingly, after I came to medical school I found that my symptoms worsened. I found that I was getting more gas, my stools were getting softer and smaller, and I constantly had to go to the bathroom with diarrhea. In school I was enjoying what I was doing and although under pressure to learn 5 billion bits of new information a day it certainly wasn’t the negative kind of stress I had previously experienced.
"This began to concern me and I decided to make it my first priority while visiting the student clinic. At my first visit I described the history and nature of my distress. I was instructed to keep a diet diary and see if I could find any correlation between what I ate and my distress. I also received an herbal tea and we did a blood test.
"Upon returning to the clinic my clinicians suggested that my liver might not be working properly and that we treat it with herbs. I did notice a difference in my stools, however that was probably because my liver was being forced to work harder. During that second visit there was mention of possibly looking for an allergy relation and doing an elimination diet. Unfortunately this was not pursued.
"For the next month I continued with the herbs but was not satisfied with the results. It did not seem to be solving the problem. Then one day I was reading my biochemistry text book. We were studying the gastrointestinal system at the time and I stumbled across something very interesting called "gluten sensitive enteropathy (GSE)[celiac disease]." To my great surprise, the symptoms for GSE exactly matched my own symptoms. (Contrary to popular belief, I am one med student that does not believe he is afflicted with every ailment studied.)
"I immediately committed myself to determining if I had celiac disease. The very next morning I started on a wheat, barley, and rye-free diet. The results were immediate and within two days most of my pain was gone. After a week I tested it by eating wheat bread and ended up in pain. I have been on this diet ever since and continue to learn more about gluten every day.
"Within another 6 weeks we were studying celiac disease in physiology and I was able to learn a few more things and act as the class expert. I have met a couple of other people at school with this problem and we share similar stories.
"I was disappointed in the approach at the clinic. I should think that the first approach would be to "treat the cause," and to "first do no harm." However I feel that the first thing done was to prescribe a drug. Although the idea was to support my system, the logic was flawed. We were supporting my system before we knew what was wrong with it. For the public at large there may be a need to provide a quick fix and give the patient something to walk out of the door with, but this approach didn't fly with me.
"It was very exciting to have solved my problem and one of the things that I was hoping to do at Bastyr Universtiy. I believe that if I can't find solutions to my own problems then I can't be an effective doctor. Fortunately, studying naturopathic medicine led me to a solution. Although any medical student would have read the same material, I doubt that it would have been as evident in allopathic medicine.
"This has changed my life somewhat, but not drastically. What I miss most is being able to eat whatever and whenever I want. Mainly because I need to eat to keep my energy up. I have a voracious appetite.* I am a very disciplined person and don't have much trouble maintaining my diet. It has led me to discover new foods and to experience all kinds tastes I otherwise would have missed. I bake my own bread from rice flour, I eat lots of pasta from corn and rice flours, and I never drank much beer anyway. My wife has taken awhile to get used to it, but she seems to be convinced that it really is helping and is on-board now helping me to maintain my diet. I can almost always find great things to eat that don’t have gluten at any restaurant. Probably the biggest impact is that I can’t go out for pizza."
*Note that since this paper was written I've discovered that once the digestive tract heals you no longer need to eat constantly. This is especially true if you have adequate protein in your diet. However, the full healing process can take many months and even years.
"About four years ago I began experiencing intermittent pain in my abdomen. I assumed that it was stress since I figured that I usually localized my stress and it didn’t seem to be anywhere else, so it must be there. At the time I was working in a position with great responsibility and under pressure to correct multiple deficiencies in a program that is closely monitored by the federal government. Also, my boss was a (beep)hole. Fortunately I left this job after 2 years, but only to find myself working for (beep)hole II. After 2 years of that persecution I quit and came to Bastyr University. Medical school is a cakewalk compared to (beep)holes I & II.
"My symptoms gradually increased over those years. I assumed that after quitting my job that I would finally be relieved of my problem. I had tried to remain as stress free as possible and this seemed to help, but I couldn’t find a 100% correlation. Most interestingly, after I came to medical school I found that my symptoms worsened. I found that I was getting more gas, my stools were getting softer and smaller, and I constantly had to go to the bathroom with diarrhea. In school I was enjoying what I was doing and although under pressure to learn 5 billion bits of new information a day it certainly wasn’t the negative kind of stress I had previously experienced.
"This began to concern me and I decided to make it my first priority while visiting the student clinic. At my first visit I described the history and nature of my distress. I was instructed to keep a diet diary and see if I could find any correlation between what I ate and my distress. I also received an herbal tea and we did a blood test.
"Upon returning to the clinic my clinicians suggested that my liver might not be working properly and that we treat it with herbs. I did notice a difference in my stools, however that was probably because my liver was being forced to work harder. During that second visit there was mention of possibly looking for an allergy relation and doing an elimination diet. Unfortunately this was not pursued.
"For the next month I continued with the herbs but was not satisfied with the results. It did not seem to be solving the problem. Then one day I was reading my biochemistry text book. We were studying the gastrointestinal system at the time and I stumbled across something very interesting called "gluten sensitive enteropathy (GSE)[celiac disease]." To my great surprise, the symptoms for GSE exactly matched my own symptoms. (Contrary to popular belief, I am one med student that does not believe he is afflicted with every ailment studied.)
"I immediately committed myself to determining if I had celiac disease. The very next morning I started on a wheat, barley, and rye-free diet. The results were immediate and within two days most of my pain was gone. After a week I tested it by eating wheat bread and ended up in pain. I have been on this diet ever since and continue to learn more about gluten every day.
"Within another 6 weeks we were studying celiac disease in physiology and I was able to learn a few more things and act as the class expert. I have met a couple of other people at school with this problem and we share similar stories.
"I was disappointed in the approach at the clinic. I should think that the first approach would be to "treat the cause," and to "first do no harm." However I feel that the first thing done was to prescribe a drug. Although the idea was to support my system, the logic was flawed. We were supporting my system before we knew what was wrong with it. For the public at large there may be a need to provide a quick fix and give the patient something to walk out of the door with, but this approach didn't fly with me.
"It was very exciting to have solved my problem and one of the things that I was hoping to do at Bastyr Universtiy. I believe that if I can't find solutions to my own problems then I can't be an effective doctor. Fortunately, studying naturopathic medicine led me to a solution. Although any medical student would have read the same material, I doubt that it would have been as evident in allopathic medicine.
"This has changed my life somewhat, but not drastically. What I miss most is being able to eat whatever and whenever I want. Mainly because I need to eat to keep my energy up. I have a voracious appetite.* I am a very disciplined person and don't have much trouble maintaining my diet. It has led me to discover new foods and to experience all kinds tastes I otherwise would have missed. I bake my own bread from rice flour, I eat lots of pasta from corn and rice flours, and I never drank much beer anyway. My wife has taken awhile to get used to it, but she seems to be convinced that it really is helping and is on-board now helping me to maintain my diet. I can almost always find great things to eat that don’t have gluten at any restaurant. Probably the biggest impact is that I can’t go out for pizza."
*Note that since this paper was written I've discovered that once the digestive tract heals you no longer need to eat constantly. This is especially true if you have adequate protein in your diet. However, the full healing process can take many months and even years.
PCC Has Gluten Free List
PCC is a Seattle area grocery coop with a long history of providing high quality and nutritious food for the community. Originally PCC stood for something like Puget Consumers Coop. Without getting into the details of PCC and the history of PCC, I encourage you to visit their website and one their stores. They were around long before Whole Foods came to town.
PCC offers an extensive online representation of gluten fee products. They have established a database of the GF foods that they sell, which is searchable on their website by keywords, brand name, and by food category. For example, "Beer" and "Energy Bars" are two of many gluten free food categories. Click on one of those and you get a complete list of what they carry.
Visit PCC's gluten free product database at http://www.pccnaturalmarkets.com/products/gluten_free/
pccnaturalmarkets.com/glutenfree
PCC offers an extensive online representation of gluten fee products. They have established a database of the GF foods that they sell, which is searchable on their website by keywords, brand name, and by food category. For example, "Beer" and "Energy Bars" are two of many gluten free food categories. Click on one of those and you get a complete list of what they carry.
Visit PCC's gluten free product database at http://www.pccnaturalmarkets.com/products/gluten_free/
pccnaturalmarkets.com/glutenfree
Central Market Gluten Free List
I recently learned that the Central Market grocery stores in the Seattle are have a list of all of the gluten free food in their store and where to find it. Or maybe I should say that at least the one in Shoreline has a list.
This list is not available online. Has anyone seen it at one of their other stores? Is it up-to-date?
I know that Whole Foods used to have a list, but I haven't looked at it in a long time. And I believe that Trader Joe's used to have a list too.
This list is not available online. Has anyone seen it at one of their other stores? Is it up-to-date?
I know that Whole Foods used to have a list, but I haven't looked at it in a long time. And I believe that Trader Joe's used to have a list too.
Purely Decadent Coconut Ice Cream
A patient just informed me about a new dairy free ice cream that she discovered. Here is what she has to say about it:
"I happened to stumble across a new coconut milk "non-dairy frozen dessert" at Whole Foods, and thought you'd want to know about it."
"Like Coconut Bliss, it's coconut milk based, agave nectar sweetened. The consistency is exactly like regular ice cream, the taste is excellent, without the coconut aftertaste of Coconut Bliss' vanilla. On top of all of that goodness, it's less expensive ($1 less per pint), and has 3/4 the calories of Coconut Bliss."
You can learn more about it at http://www.turtlemountain.com/products/purely_decadent_Coconut_Milk.html
"I happened to stumble across a new coconut milk "non-dairy frozen dessert" at Whole Foods, and thought you'd want to know about it."
"Like Coconut Bliss, it's coconut milk based, agave nectar sweetened. The consistency is exactly like regular ice cream, the taste is excellent, without the coconut aftertaste of Coconut Bliss' vanilla. On top of all of that goodness, it's less expensive ($1 less per pint), and has 3/4 the calories of Coconut Bliss."
You can learn more about it at http://www.turtlemountain.com/products/purely_decadent_Coconut_Milk.html
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