Cook once, eat twice: Pork chops

Having SIBO and food intolerances means that I have to cook a lot of my meals myself. As demonstrated when I ate out last week, I often get unexpectedly sick when eating other people’s food. But I hate making dinner! So much that we refer to dinner as “the D word” in our house. Kids aren’t allowed to ask what is for the D word. Parents dread the D word.

I have tried the meal prep thing where you spend your whole Sunday cooking and then reheat meals all week. I found the meal prep day exhausting and reheating meals a mixture of gross and boring. Some days after work, I am just too tired to cook and my husband is often gone for work. Sure I have a few places I can go to eat out but pizza and hoagies don’t have much nutrition!

In this phase of my SIBO healing and nutritional deficiency recovery, I am trying to eat nutritious food at every meal, even on my very restricted diet. This week when I felt very ill, I made chicken and rice and enjoyed eating left overs for lunch and dinner the next day. It got me thinking that steaming vegetables is easy, it’s the protein portion that is a pain to cook on a weeknight.

So, I’m trying a new idea where I cook double the meat I need, then I will always have enough protein waiting in the fridge. I hope even when cooking double, that I will eat it all within two dinners and two lunches so it won’t be the same meal all week AND I’m only reusing the meat so the meal itself maybe won’t feel like leftovers. I hope!

Cook once

Meal one was pork chops with roasted red potatoes, red onion, carrots, and Brussels sprouts. I’ve tossed the veg with some olive oil and Herbes de Provence, salt, and pepper. They are roasting at 450° for 30 minutes. I’m starting the pork chops on the stove top to brown them (medium-high heat about 7 mins each side) then finishing them for 15 minutes in the oven until they are up to 165°. I’ll have this for dinner, then again for lunch the next day. I can also have the vegetables with eggs for breakfast.

I did eat all these vegetables but I only eat half a pork chop for one meal!

Breakfast the next morning!

Eat twice!

For the second D word, I am chopping the pork up to cook it with jasmine rice, broccoli, corn, and fried egg. I add earth balance soy-free butter and my kids add stir fry sauce to make a SIBO fried rice. For lunch the next day I can have leftover fried rice!

If I really wanted to save time, I could have made a pot of rice while I was roasting the vegetables for the first meal. I use frozen corn and broccoli for the fried rice, so by making the rice early I can mix all the ingredients for meal 2 together in 10-15 minutes. This would also eliminate the stress of having the dreaded “What’s for dinner?” conversation.

*Broccoli and Brussels sprouts do aggravate some people with SIBO. So test yourself to see what works. Luckily for me I can tolerate broccoli. It is one of the most nutrient dense foods I can eat.

Results

This does seem to make weeknight cooking more manageable. My kids are in play practice, swim team, and martial arts. I have a few work meetings in the evenings this week so I hope cook once, eat twice will make things more manageable. The only negative to this trial was that my kids and friends ate so much for dinner that we don’t have many leftovers for lunches!

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SIBO staple salad

Here it is! My favorite SIBO salad. I have to admit, this started with inspiration from Healing Histamine.

I’m my SIBO salad I add:

  • 1-2c Arugula
  • A thin slice of red onion, minced
  • Half a cucumber, diced
  • Carrot, cut into sticks
  • Hard boiled egg, diced
  • 1-2T. Sunflower and pumpkin seeds
  • Dressing (when I couldn’t tolerate any dairy, I just put a little olive oil on top. Now that I tolerate it, I indulge in a buttermilk ranch dressing from wegmans.)
  • Bacon, if I have any leftovers, crumbled on top.

This salad has a lot of things many of my other meals miss, Vitamin C, carotene, and magnesium to name a few. I love the bitter astringent arugula with the peppery red onion. The arugula is rumored to be good for being anti-histamine. Although I can’t find any supporting research, I know that this does calm down my stomach which is kind of surprising for a raw vegetable salad.

That’s lunch!

Great SIBO resources

There are so many websites out there offering advice or services to people with IBS and SIBO. Here I have compiled a list of my favorites. I read research and these bloggers and researchers have science based solutions. If they recommend herbs, there is a study to support their safety and efficacy.

Not everything they recommend was helpful to me but combined they gave me a great understanding for how dynamic the problemS of SIBO can be. They also gave me hope and a list of new things to try.

I am open to suggestions in the comments of others I am not aware of!

Living with SIBO

Disclaimer: This blog is my own experience. Research and outside sources have been linked when referenced. Please do not use this information to diagnose or treat any disease. Many serious conditions have symptoms similar to SIBO. If you are having symptoms, please consult with a doctor.

Recently, some research has shown that as many as 48% of people with IBS are suffering from SIBO (small intestine bacterial overgrowth). Many people with SIBO see a reduction in IBS symptoms when following a FODMAPs diet.

What is FODMAPS?

FODMAPS is an acronym for different types of carbohydrates that may be consumed by the small intestinal bacteria. This diet starts with elimination of these major carbohydrate groups for a few weeks to see if symptoms resolve. Then groups are added back in one at a time to find the offending groups. This is best done with the help of a trained nutritionist but in my area I found few nutritionists were trained in this diet. Monash University has a great app to help people implement this diet. There are also concerns because many people, like myself, end up living on a severely restricted diet when reintroduction causes a rebound of symptoms. (This study raises some legitimate concerns.)

For me, it was important to note that sometimes the quantity of a food matters. A small amount of berries would be low FODMAP but a whole bowl of berries could be high FODMAP. The app was great in learning about foods that were more likely to work for me.

I still had a high recurrence of IBS and many flares of hives but working with low FODMAP foods really improved my quality of life.

Low histamine foods

There is less research about low histamine diets. And this is more difficult to delve into. There are conflicting lists online about which foods contain high histamines (fermented foods, some meats) and which foods are histamine releasing foods (citrus, strawberries , avocados).

A major discovery for me was that foods that were not fueling the bacteria were increasing the severity of my symptoms. It explained why foods without carbs, such as avocados, were causing me to break out into a rash. With this knowledge, I started an elimination diet and slowly added foods back to see what I could tolerate. Like the FODMAPs foods, foods that have high histamines can sometimes be tolerated in small amounts but wreck havoc in high amounts. This was a learning curve for me. I’m still learning. I really like the Healing Histamine for recipes and ideas.

Food intolerances and allergies

The bacterial overgrowth in SIBO can cause damage to the lining of the intestines. (Bacterial overgrowth produces a number of toxic compounds (peptidoglycans, D-lactate and serum amyloid A), which promote inflammation, may damage the brush border of the enterocytes and increases small intestinal permeability.) This lining is one layer of protection from invaders. Normally only digested molecules can get through this barrier. If the lining is damaged by inflammation common to Crohn’s, celiacs, and IBS. This damage to the barrier could allow larger than normal particles into the blood stream where they meet immune cells that can mount a response.

I often tell people I am allergic to foods because that is something that almost everyone understands. Truly, my food problems aren’t allergies. I don’t test positive for IgE reactions in blood or skin tests. But when certain foods hit my intestines, where that barrier is damaged, my body reacts with an attack. This send me crushing waves of IBS-D, usually several hours after I have eaten the offending food. Sometimes in the middle of the night. While this does make me feel like I am having an anaphylactic reaction, usually it is “only” an intestinal revolt. Even my one “moderate allergy” to mango which seemed to have been the detectable start of my food problems could have been a SIBO reaction. I don’t test positive for a mango allergy.

I mention this because you may have food reactions to foods that aren’t on the histamine nor low FODMAPs lists.

Nutritional deficiencies

Because of the intestinal damage, some nutrients don’t get absorbed efficiently. This can lead to deficits. I have had low serum levels of iron, B1, and D3. I could be low in many other nutrients but these are the things I have been tested for. To help get enough vitamins and minerals, I take high potency multivitamins. If your digestion works, I would try to get your vitamins from nutritious foods. I have found that even when I am eating healthy foods, because of my limited diet and limited absorption, I need a multivitamin to be healthy.

When I stop taking my vitamins, within a few months I run into deficiency problems. Another piece of the puzzle of my health was figuring out that although I was eating enough food, I wasn’t always absorbing everything from my food. Even when my tests come back showing no anemia and no obvious nutritional deficiencies, if I have been feeling rotten and haven’t been taking vitamins, adding them back in improves my condition. I guess I am often missing something important.

Carry on

Today I had energy and I functioning digestive system and I felt great. There were years when I was sure I was dying of cancer that doctors were missing, the same years that my doctors likely thought I was a hypochondriac. I just kept searching and reading looking for something that worked. If you keep seeking, and are willing to question and change your habits, eventually you will find something that gives you some relief. I was losing so much weight I felt like I was disappearing.

Unfortunately, when you feel your worst, you have high motivation to find something that works but sometimes no time or energy to make changes. For me, first, was fixing my vitamin deficiencies. That gave me enough energy to go shopping and try new foods. I had enough concentration to read all the studies and blogs to glean something that might help.

Keep searching. Keep trying something new. If you don’t change anything, you’ll never find your good days.

The good days and the SIBO days

For the most part, most days I don’t have issues with SIBO. Then there are days like yesterday.

My kids are busy. I fed my son and dropped him off at swim practice then picked up my daughter from play practice. I took her to a local pub because they were having a fundraiser for the play and donating 10% to the drama club. We hadn’t been there before which always makes me a bit nervous.

The menu looked good! A lot of choices, reasonable prices. I ordered boardwalk old bay fries (my favorite!) and a chicken sandwich. Ordering chicken at a new place always makes me nervous because “plain” to me sometimes means something different than it does to the cook/chef. Sandwich came and was plain! I didn’t eat the bun.

The fries tasted weird to me. I had one and wondered if they were fried with fish. I didn’t ask; I just stopped eating them.

Picked up my son and headed home and I start to feel annoyed with everything. This is my first sign that I ate something wrong. I went to the bathroom a few times, sign #2. I thought I was starting to feel better. Got the kids in bed but felt restless myself. Couldn’t sleep. Couldn’t even sit still. Sign #3.

We go to bed early! I had been in bed since 9pm but was still not settled at 10:30. Used the bathroom a few more times and then it starts to hit me. Painful gas. Burps that thankfully did not lead to vomiting. More trips to the bathroom. I got hot socks and Gatorade because these sometimes help me feel better but nothing. My body goes into this weird wired panic where I can’t sit down. But I was extremely tired. So I was pacing my living room. My house isn’t large. I was walking in little circles.

Around 11pm I decided to wake up my 11 year old. My throat felt dry; was it swelling? I couldn’t be sure. I started having a hard time keeping my eyes open. I didn’t want to have an allergic reaction while the kids slept and have them find me unconscious in the morning. So I woke her up. I made her sit with my to keep me awake. It occurred to me that this was child abuse. Wake her up in the middle of the night and make her keep me awake. And of course for her, it was scary. My husband is in London. My body was shivering. I was hot and cold.

We walked circles together for an hour. She had tears of worry in her eyes. I kept saying “I will probably be fine! I already feel better.” But she knows I wouldn’t have woken her up if I didn’t need help.

After 10+ trips to the toilet, I don’t think there was anything left in my intestines. And my body started to calm so we went back upstairs. She snuggled into my bed with the dog wondering what the heck we had been doing.

I kept her up a little over an hour in the middle of the night so I took the morning off work and let her sleep a little. Now I’m cooking chicken and rice and beans so I have something safe to eat for lunch. Obviously, my leftover fries are not a good option.

I know it will be a joke when I get to work today that I am always sick. (Not from my boss but some of my coworkers.) They act like I am shirking my responsibilities. One woman’s daughter had SIBO that was cured with one round of antibiotics and she can’t understand why I haven’t just done what her daughter did. I have. Twice. The second time I lost a lot of weight and was sick for several months. My doctor and I decided that wasn’t a good idea again unless life was unbearable. Is it? Is life unbearable?

Mostly, this little incident adds to my worry. I am not one for anxious thoughts but it does raise concern. My husband is eating a lot of fish for his RA diet plan. What if I accidentally ingest some again? And if eating out is so hard, how am I ever going to enjoy our vacation in Hawaii in June? What can I take to eat that I know will be safe but will also be enough to nourish me.

Some days are good days and some days are SIBO days.

Kicking Kitchen Clutter

I recently read an article claiming that clutter creates stress in a marriage. I know messes can create arguments!

In December, the same day I took a blood test diagnosing my anemia, my husband’s bloodwork confirmed he has rheumatoid arthritis. He has drastically changed his diet to include more fruits and vegetables, less grains, more fish, green tea, and supplements. While I love that he is finally motivated to make a change, we have been running to the store 3-4 times a week to buy more vegetables.

What I discovered in all this was that to my husband, there was no order to our pantry nor the refrigerator. He just tossed everything in creating a mess. This led to him forgetting, repeatedly, that he had purchased asparagus and put it in the bottom of the crisper, only to be discovered when it was turned into asparagus super stink slime.

The disorganization got the best of me this morning. I have had more energy this weekend than I have had in months so I put it to good use. Here are my before and after pictures of the pantry and the fridge.

The pantry before
After. Labels to help my family help me.
The chaos of the fridge before was making me feel crazy.

The fridge after. I used a dry erase marker to label the shelves. I bin holds extra veggies.

I think it was FlyLady who gave me the idea to just pick one thing that needs tidying and start there. Today it was the kitchen. I also cleaned shelves of appliances and pans we rarely use. It was so nice to have a burst of energy and accomplish something. The best part is my energy and cleaning habits are running off on my 11 year old. She, like me, is messy and creative, but we both love the promise of everything being organized. While I did the kitchen, she worked on her room. And I didn’t even have to force her! Winning!

Can anyone spot what my favorite store is?

How are you feeling today?

I am 5’2″ tall. In 2015 I was getting quite anxious because my weight had dropped to 100.2 lbs on my bathroom scale. I had seen 18 doctors since I started feeling sick in 2013. The best diagnosis I could find was IBS-D, which basically just described that I had diarrhea all the time but did nothing to get at the reasons why it was happening.

Most of my life I have been very confident in my body. I felt strong even though I was small. As a kid I liked to run and climb trees. In high school I was a track and cross country athlete. I always subscribed to the “you are what you eat” philosophy. It hadn’t ever steered me wrong in my 35 years.

I had two great children from healthy pregnancies in 2007 and 2011. Both kids breastfed like champs and we’re for the most part healthy. My daughter, the oldest, was intolerant to dairy as a baby so I was dairy-free for the almost 2 years she was nursing. She outgrew her intolerance around age 6. My son had a few months of screaming and some blood in his stool as an infant which was chalked up to a “typical reaction” to the Rotavirus vaccine.

My health problems started when my son was weaning and my menstrual cycle returned. I had never seen anything like it. Every month near my period I was drenched in sweat, shaking, terrible cramps, heavy bleeding, and upset stomach. I was getting visual migraines and several times almost passed out. Three months in a row I was in the emergency room the second day of my cycle from almost passing out, dizziness, shaking twitching muscles, lethargy. I awoke one morning to find all my muscles twitching like a gentle seizure and was shocked when it took every bit of strength I had to lift myself out of bed. I called a friend to watch my kids, my husband was out of town, and drove myself to the ER where they did a few blood tests and sent me home. My bloodwork was always normal.

I was referred to a neurologist to test for MS. An ENT for vertigo. Normal. Normal. Normal. But I still felt awful. Exhausted. Drained.

My job was stressful. I was teaching at a disorganized and demanding charter school. My kids needed me a lot, they were 2 and 7. My husband is gone half of each month for work and we don’t have family around. The toddler wasn’t sleeping well. I wasn’t getting enough sleep. I drank a lot of tea because coffee upset my stomach. My diet was what I considered great. We ate whole fruits and vegetables, whole grains, no dairy, and little meat aside from wild caught salmon. I had discovered kombucha and was drinking a bottle a day. At night I’d have sometimes several glasses of red wine.

One day one the second day of my cycle, I ate a mango with my lunch. A few hours later I started feeling really hot. CO-workers were concerned because I was red. My stomach became upset and I ran to the school nurse and used her bathroom. I showed her my rash. My skin was scarlet, as if sunburned, from the top of my legs to the top of my scalp. My throat started to feel itchy. She gave me a Benadryl and called my husband to come take me to the ER. They gave me an IV in the ER, fluids, then Benadryl and a steroid. They kept me for a few hours and sent me home with instructions to take more Benadryl and a prescription for steroids. That did it. I haven’t been well since that moment.

The prednisone gave me high blood pressure, double vision, muscle pain, stole my appetite, searing jaw pain, insomnia, chills, upset stomach, confusion, and dizziness. My body has never been good at processing drugs aside from antihistamines and this was no different. Every side effect I had it.

My doctor at the time was an ass. When I called his office because of side effects for the prednisone the nurse told me I had no choice. When I started having chest pains they rushed me in to do an EKG but found nothing. When the doctor came in to deliver my normal test results he mocked me for wearing a heavy fleece and shivering on a hot August day. I can’t get warm I told him. He rolled his eyes at me. I found a new doctor.

I thought when I stopped taking the prednisone, I’d feel better but I didn’t. I was dizzy and had no energy for 6 more months. My family took a trip to San Francisco in March of 2014. I am not sure if it was the sun or just getting a break from stress and some time to sleep but that trip was really a turning point. I started to feel better and had some hope that I would improve.

I still had a lot of food intolerances but life was livable. I regret that my son asks me how I am feeling before he asks what we are doing for the day. He knows I have good and bad days and unfortunately, he doesn’t remember me before my body rebelled, when I felt strong. He only knows me dealing with illness.

I found a caring family doctor who told me she believed me that I felt bad and she would help me find out why. I saw dozens of specialists but continued to lose weight. I went in an elimination diet, and found that I best tolerate less than 20 foods. I drove hours to UPenn to see carcinoid specialists, had scans and tests. The good news was I didn’t have cancer, celiacs, or Crohn’s disease. The bad news was I was still losing weight and had no energy.

My gastroenterologist decided in 2015 to test me for SIBO using a lactulose breath test. The nurse asked me if u was okay after hour one. She said she wasn’t officially allowed to tell me I had SIBO but she had never seen such a high level and “textbook positive” curve. It was great to have a diagnosis. I took rifaxin (the prescribed antibiotic) and improved! I learned about the low FODMAP diet from Monash University. I restarted an elimination diet using the FODMAP guidelines.

My weight slowly went up then I got hit with another round of IBS-D. I don’t know why but my weight went down to 100.2 lbs. In the midst of the weight loss we tried another round of antibiotics which actually seemed to make me sicker. I read every blog I could find. Tried an elemental diet against advice from my doctors because my weight was already so low. I took herbs (oil of oregano, garlic, enzymes). No one had anything that seemed to be stopping my weight loss.

Grasping for anyone who could help, I went to an endocrinologist. My thyroid, which every doctor is sure is my problem, has always been fine but there seemed to be something weird going on with my blood sugar. It seemed too low many times. This doctor had just been to a nutritional conference and decided to also test my levels of some vitamins. I was deficient in B1! Many people had checked my diet but no one had checked if I was absorbing anything I was eating. I started taking Pure Encapsulations 950 and felt better almost immediately.

Still, I have been stuck for years on a very limited diet. I am living with this SIBO thing. It seems I will be one of the people for whom the bacteria never leave completely. Recently, I was passing out in the lunch room at school and was found to be anemic. (Also on the second day of my period.) I had stopped taking my vitamins for a while because my SIBO seemed okay if I avoided certain foods. But I guess I will always have absorption issues. Taking iron causes the SIBO to flare and didn’t boost my energy like I expected. A month later I was found to be deficient in D3 as well. I am not taking hefty doses of many essential nutrients.

I’m just a mom, trying to feel better. Feeling a little guilty every time I wake up to my sweet seven year old asking me, “Mom, how do ya feel today?” Some days are bad but some days are really really good. I’m just trying to enjoy as many good days as I can.