“Do not be too moral. You may cheat yourself out of much life. Aim above morality. Be not simply good; be good for something.” –Thoreau

18 September 2013

Eating with Crohn's Disease

This is part one of a two-part essay. Part two (Affording Good Food) is coming later this week.

Look, guys, I'm not a doctor. I haven't even had Crohn's Disease as long as a lot of people, since I developed it as an adult. But what I am is an obsessive researcher. And I've been doubling down on research since I've begun breastfeeding my daughter in the middle of a flare. That's why this post is so long. I always listen to my doctors, but I don't take my doctor's word as gospel. I read the news reports and the medical journal articles and wack-a-doo naturalist websites. If I'm going to confront something like this, something which affects my health and future happiness, I'm going to do it with as much information as I can. Information is power. That's why I'm sharing some of mine with you.

Let's get started.



According to WebMD, any of these foods might trigger the symptoms of Crohn's disease:
  • alcohol (mixed drinks, beer, wine)
  • butter, mayonnaise, margarine, oils
  • carbonated beverages
  • coffee, tea, chocolate
  • corn husks
  • dairy products (if lactose intolerant)
  • fried foods
  • foods high in fiber
  • gas-producing foods (lentils, beans, legumes, cabbage, broccoli, onions)
  • nuts and seeds
  • raw fruits
  • raw vegetables
  • red meat and pork
  • spicy foods
  • whole grains and bran
I challenge you to name a food not on that list. Although, to their credit, they did say might. Chocolate, tea, and coffee don't trigger anything for me if I consume them in moderation. I have no trouble with butter or oils. Raw fruits, veggies, and whole grains can be balanced out with healthy fats to help them digest easier. I saute all of my onions and cook all my beans very soft. Broccoli, uncooked cabbage, and high-lactose dairy products are out, though. I don't drink alcohol or carbonated beverages. Fatty foods go down easier than anything else, unfortunately, but they also cause diarrhea. I mostly avoid them.

Foods Crohnies (and everyone else) should be eating include:
  • almond milk -- high in protein, calcium, and vitamins D and E but low in fat and cholesterol (although commercial varieties might also be high in carbohydrates, so look for unsweetened)
  • eggs -- easily digested protein; poach them to avoid additional fats
  • oatmeal -- tons of soluble fiber but best eaten when you're not in a flair
  • olive oil -- normalizes blood clotting and benefits blood sugar control
  • vegetable soup -- roast the veggies, because they retain their nutrients better than boiled, and puree smooth
  • salmon -- high in omega-3 and easily digestible, although most fatty fish is good
  • tropical fruits -- vitamin-rich, easy to digest, and papaya even helps the body digest protein
  • poultry -- stick to white meat so it's low in fat and easy to digest
  • avocado -- full of good fats, vitamins, potassium, and soluble fiber... pretty much the perfect food
  • butter lettuce -- the greens of choice for Crohnies
  • bell peppers -- roast them, and remove the skins when in a flare
  • rice -- not much nutritional value but always easy to digest
  • nut butters -- choose smooth varieties, not chunky, and it's a good source of protein and fat
  • coconut oil -- helps the body absorb magnesium and calcium, eases heartburn and bowel movements
  • low-lactose dairy products -- if you cut out dairy altogether, you'll develop an intolerance so stick with dairy below 2% lactose (check this list for reference)
I eat all of these things regularly (although salmon ends up on my plate less than I'd like!), and I often combine them with foods which are healthy but difficult to digest. For example: I drink my black tea with almond milk. My green smoothies usually include banana and low-fat Greek yogurt, and sometimes avocado, and I puree them really smooth. I like risotto, so I can get some protein from chicken stock, some nutrients from added veggies, and some calcium from butter and parmesan cheese. I eat my salads with at least two healthy fats on them-- usually poached eggs, avocado, olive oil, or tuna-- to help me digest the raw veggies. I also salt my salads to provide my body with enough sodium. I often include low-sugar dry cranberries, which provide antioxidants and help prevent urinary tract infections. Bonus: My salads are absolutely delicious!

Let's talk protein for a second:

A lot of people with Crohn's avoid protein because it's hard to digest. I totally get that... when I'm in the middle of a flare-up, the last thing I want to eat is a big, rare steak. But protein is really, really important. It's what helps our body heal, and that's what we need to be doing.

My gastroenterologist says the protein sources that are easiest to digest are eggs, well-cooked fish, and skinless chicken breast. I've found that good-quality, natural lunch meats (like these) go down pretty easily as well. I slice them into strips for my salads. I do eat bacon and mild sausage, which don't bother me but seem to be triggers for other people. And when I'm not in a flare, I eat a lot of beef. When I'm flaring, though, I eat it sparingly because it definitely causes me pain.

So protein. Eat it. Eat meat (or a substantial serving of high-protein plant food) at one meal a day, every day. As I've discussed before, don't gorge yourself on it. You're not a lion. But don't skip just because your sick and it's easier.

Okay. Now some of you will have noticed that I haven't mentioned gluten-free products yet. That's because gluten-free products taste gross. I'm sorry, I know I'm generalizing, and I wish it weren't so. But I've tried E.V.E.R.Y.T.H.I.N.G. and none of it was worth the money. The best thing out there is Rice Chex cereal, people. That's just sad. If you have Celiac Disease, or you are a Crohnie who knows for sure that gluten aggravates your symptoms, you have my sincere sympathies. I'm not minimizing your struggle. But as for me? I can eat limited gluten with no repercussions. I stick to low-gluten foods, for the most part--corn tortillas, sourdough bread, and the like--but I require that they taste good and contain no weird chemicals. If my universal eating philosophy could be summed up in one sentence it would be this one:

I'd rather eat a little of something that tastes good than a lot of something mediocre.

Actually, I guess it can be summed up in one sentence. Huh. Seems this long post was all for naught!

Part the second, coming at you soon.

Eat well, friends. Bless you.

09 September 2013

How We Cloth Diaper

Fiona has been battling diaper rash since she was born. She inherited her mother's super-sensitive skin. This makes cloth diapering particularly difficult because they don't wick away moisture they way disposable diapers do. But disposables actually make her rash worse--we aren't sure why. The only disposables that have worked for us at all are Pampers Sensitive. At $0.33 per diaper, around $14 per week, they are definitely for occasional use only. Also, they leak! Why do disposable diapers leak so much?

We use Oso-Cozy Cotton Prefolds inside Thirsties Duo-Wrap Diaper Covers. We have added Bummis Fleece Diaper Liners in every diaper to help keep moisture off her skin and protect the diapers from diaper rash cream. We also use flannel cloth wipes, which we spray with a solution of water and a few drops each of tea tree oil and calendula extract.

 

We change Fae every two to three hours during the day. She wears Cotton Babies Stay-Dry Diaper Doublers in her prefolds at night, which gets her through without a change. Is this system working? Mostly yes. We've only had a couple leaks, and they were the result of user-error (as in, putting her diaper cover on too loosely) or leaving her nighttime diaper on too long. The diapers are easy to care for and Fae seems comfortable enough, aside from the rash. But the rash is a real problem and not easy to fix. We started by using Boudreaux's Butt Paste on her bum at every diaper change.


This worked on her rash but wreaked havoc on her diapers. It isn't cloth diaper safe, so I had to strip the diapers of residue at every wash. Also, it seems like a pretty heavy-duty solution for everyday use. Should she really have Zinc Oxide on her bum 24/7?

We switched to Grandma El's Diaper Rash Cream.


It is safe for her diapers (no stripping!) and it works to prevent her rash, but it is expensive. One tub lasts a month, at $14.99 a tub. It also wouldn't heal an existing rash. I didn't like that it included Petroleum and Salicylic Acid--it seemed unnecessary to me. So I searched for yet another solution.

And, as often happens for me, I decided to make my own. Most of the barrier creams I was looking at were made of ingredients I already had at home; I've made my own body lotion for about a year now. I added calendula extract because it is anti-fungal, anti-inflammatory, and soothes irritation. The anti-fungal component is important because it helps prevent yeast rash.

This is working remarkably well so far. It took about a week for her skin to clear up. It seemed to be acclimating to the new cream. After it did, though, she has stayed rash-free for longer than any other cream we've tried. It's also really cheap to make.

If you want to try the diaper cream, I've included the recipe below. A word of caution: As with any new skin product, you should test a little of this on your baby's skin first, to be sure he or she isn't allergic.

As far as our washing routine goes:

Our apartment building's machine doesn't work well at all. I can tell that it leaves soap residue behind in our clothes. Not enough to cause the diapers to repel water, but enough to give Fiona and I heat rash. I always get it when it's too warm and there's detergent residue on my skin. Apparently, Fae does too. It's normal for a public washer to get build up from all the different soaps from different tenants. I've never had one do such a poor job rinsing, though. And that makes washing diapers a bigger pain than it needs to be.

We use Biokleen Bac-Out, which is an eco-friendly cleanser, in the first cold soak.


It combats ammonia odor and stains. I use it for lots of different cleaning tasks. Every three days, I dump the whole wet bag full of dirty diapers in the tub and fill it with cold water. They soak for an hour or more. I wring them out and take them to the laundry room, where I run them on the hottest setting with my homemade laundry soap. The prefolds, liners, and wet bag go in the dryer. The covers usually air dry. Every once in a while, I add a second hot wash with no soap, just to clear out any residue. I also scrub the tub afterwards. This isn't difficult, and would be even easier if we weren't paying for laundry by the load. Then I could do my cold-soak in the washing machine.

Verdict? The benefits of cloth diapering are more than worth the learning curve. There are easier ways to do it than ours, although you probably can't do it cheaper. We paid less than $250 for our diapers, which will last until she is about a year old. Factoring in the cost of washing twice a week, and the upfront costs (including wipes and wet bags), this comes to under $10 per week--$4 per week cheaper than disposable diapers, not including disposable wipes and trash bags. Plus, we aren't putting 2200 non-biodegradable diapers a year into the landfill.


UPDATED LAUNDRY POWDER RECIPE

3 cups of washing soda
3 cups of borax
3 cups of Oxiclean
1 lb. box of baking soda
1 bar of Fels-Naptha soap

Grate the bar of soap into flakes. Mix together all five ingredients. Store in an airtight container.

Use 2 tablespoons for each regular-sized load. More for heavily soiled loads, less for delicates.

This will last over a month. If I could store a larger container in the laundry room, I would.



CLOTH DIAPER SAFE DIAPER RASH CREAM

1/2 cup ivory shea butter*
1/4 cup coconut oil
1 tbsp. beeswax pellets (or grated from a solid bar)
2 tbsp. vegetable glycerin
10-20 drops calendula extract

Melt together the shea butter, coconut oil, and beeswax. I have a glass jar dedicated to this purpose, which I put in a pot of water on the stove. I then heat the water to a low boil and let everything melt. You can melt everything in a pot, but it's a bit difficult to get clean afterwards.

Remove from the heat and add in the vegetable glycerin. Use an electric mixer to beat the oil until it turns into a thick cream. This takes a long time. I have a stand mixer, and I just let it run for 5-10 minutes, depending on how hot and humid it is in my house. Eventually, it always gets there.

Scoop it out and store in an airtight container at room temperature. It's shelf-stable for months. The beeswax in it will react to temperature, becoming more solid at cooler temps, but it will melt again once it's on your baby's skin. So don't freak out if it gets a bit grainy.

Spread it all over your baby's private parts. This is a barrier cream, so you must put on enough to form a good barrier. Put on extra at night.

*A note on shea butter: Only white or ivory shea butter is real shea butter. The "yellow" or "gold" varieties are actually African butter, which comes from a totally different tree. They are both very good for your hair and skin, but the African butter smells much stronger and can stain white clothing.