I’m continuing on from the gluten-free years into the WTF-do-I-eat years. These are also the years when my tether to conventional medicine ever-so-slowly breaks loose.
The years when my mind is blown and my entire medical worldview crumbles. #thatsoundsdramatic
My conversion to a crunchy state-of-being was not done in one immediate come-to-Jesus moment. It was a years-long process that continues to this day. I’m wondering how much crunchier I can get before I get stale… #hardeeharhar
Gluten-free eating was getting tougher as I realized that eating just about anything caused me to feel terrible. I’d feel ok sometimes in the morning until I started eating, then it was a downhill slide into brain fog, exhaustion, and anxiety.
As I GFed harder, meaning that I became more and more careful with cross-contamination risk in my own kitchen as well as with processed products, I did see an improvement. It was enough to carry on but not to feel good. I still caught every cold, flu, or random germ floating around in addition to dealing with my remaining autoimmune symptoms.
I felt overwhelmed to start my final year of school—clinical rotations. Every month, I was in a different place with different schedules and requirements and people and germs. Every month except one, I got sick. I managed to show up enough days and do enough decent work to make it through.
Side note: I thought I was going to die during my cardiology rotation in March. I hate March. I got to the hospital between 5 and 6 each morning and didn’t leave until 6 or later each night. I made a paper chain to count down the days. Much as I truly loved cardiology, I knew my body was not going to hold out much longer.
I decided that my PharmD Seminar (an hour-long final presentation required for graduation) would be “Pharmacotherapeutic Options in Celiac Disease”. I learned nearly all there was to know in the medical literature about Celiac, which was supposedly a lot. It was touted at the time as one of the most well-understood disease mechanisms.
This made me even more confused when I didn’t magically recover. I started worrying about refractory Celiac Disease—a diagnosis that brought with it some scary experimental chemo-esque treatments and some even scarier cancer development implications.
I knew an awful lot about my disease process (or so I thought), but I had no idea what was going on with my own body. My case didn’t follow the rules, and I was a rule-follower, through and through.
Graduation brought with it an extra sweetness knowing that I’d been able to persevere. I did it!
Then it was time for residency, during which I continued my “GF harder” attempts in survival mode.
Another extra-sweet graduation!
Then a not-so-sweet job search process. The year was 2009, and the job market was a wasteland. Very few places were hiring, and there were nearly no jobs where we lived due to a saturation of pharmacy schools in the area. I did find a job in my specialty (clinical ambulatory care), but it required moving to Indiana.
I lived by myself in an apartment for not-quite-a-year while I started my job. We worked on figuring out where we were going to live “for real” (So I could entice my husband to join me. With a garage.). My life consisted of working, studying for my Pharmacotherapy boards, coordinating the house search and eventual build, and eating GF macaroni and cheese for dinner nearly every night. Chased with a glass of wine. Then, I would pass out in what I know now is a histamine haze and do it again the next day.
It got old pretty quickly. But I was a PRO at the single-serving mac and cheese from scratch.
Once we moved into my pristine, most-definitely-GF new kitchen (with house attached), I felt like I had to do something more to figure out my health. I started cutting out foods I knew I didn’t tolerate well. I ended up eating no meat except fish and researching places to get grass-fed beef. I stopped eating my beloved Larabars. There was a lot of rice involved. Dairy took a hike. Restriction, restriction, restriction. No particular plan.
I also scheduled a consult with a new GI doctor at a well-known center specifically dedicated to Celiac. I thought I’d hit the doc jackpot being to close to specialists! Hooray! Surely they’d be able to “fix me”!
(If you’ve ever pinned way too much hope on one appointment, you know the feeling of let down when it isn’t quite as miraculous as you’d planned. I’m kind of used to it at this point.)
My continued symptoms baffled them. Their suggestions were to:
- Scope me again (EGD)
- I asked what they were looking for. The fellow basically shrugged. I declined because I wasn’t having GI symptoms. Strike one.
- Consult with the dietitian
- Fair enough.
- Check my vitamin D level
- Hey! That’s a great idea! Woot! Why didn’t I think of that?
Welp, the dietitian didn’t have any suggestions after I sent her my sparse list of foods. Strike two.
The nurse called with my vitamin D (25-OH D) results and told me my level was normal. With all the research I’d done in the meantime about vitamin D, I was pretty surprised. Deficiency seemed like a given.
I asked her for the numbers for future reference, and she told me that my level was 26, with the lab range for deficiency of 0-25.
I won’t get into the clinical controversy over adequate vitamin D levels now, but researchers at the time proposed that anything less than 30 was insufficient, with 40-60 being the sufficient/ideal range.
I didn’t go back to that doctor. Why would I? I felt like I was on my own again, self-supplementing and monitoring and reading every piece of potentially applicable research I could get my hands on. My vitamin D levels did go up, it did seem to help symptomatically, but I still felt pretty lost.
I knew there was more to the story, and I knew that food would be the main character.