Hospital Safety

Hospital Safety Information: Allergies to Gluten and Corn


General Information:

• NO hand sanitizer - hands should be washed with soap and water

• Gloves must be powder-free nitrile variety

• Cloth gowns and bedding instead of paper covers. I have an emergency gown and my emergency contacts can provide clean linens.

• NO powdered rubber instruments - metal or glass only

• Any tools disinfected with alcohol should be rinsed prior to use

• NO dissolvable sutures - only use non-dissolvable nylon or polypropylene sutures that have been rinsed to dispose of corn starch.

• Saline IV only! No dextrose!

• For ANY medication given, check the inactive ingredients against the list below!!

Ingredients to Avoid:

• wheat, barley, rye (anything with gluten)
• corn (anything with the word corn, like corn starch, corn syrup, etc)
• maltodextrin
• dextrose
• citric acid
• sorbitol
• glucose
• aspartame
• fluoride
• glucose
• sucrose
• fructose
• non-specified starches
• modified starch
• glycerin
• natural flavors

**See the corn allergen list for more ingredients/derivatives to avoid.**

Anesthesia Information

For local anesthetics, use only carbocaine or preservative-free lidocaine. No inactive ingredients other than water and/or sodium chloride!

Safe General Anesthetics:

• Versed (Hospira)

Avoid General Anesthetics:

• Propofol

Antibiotics Information

Safe:

• Keflex (Cephalexin) - red capsule. (potato starch)
• Rocephin (Ceftriaxone) - injection. (Check that it isn't treated in ethanol. It should be mixed with sterile water or saline only. Also check that the lidocaine is corn free.)
• Zithromax (only brand-name. The generics usually have corn starch.)

Avoid:

• Cipro
• Levaquin
• Bactrim (and the Qualitest generic version as well)

Blood Products/Transfusions

Check the inactive ingredients and anticoagulants, as many are corn-derived. Please discuss information with patient or emergency contact before using blood products. If a transfusion is absolutely necessary, please take necessary precautions to prepare for possible allergic reactions.

Inhaled Medications

Safe:

• Xopenex
• Albuterol-only nebulizers

Avoid:

• Ethanol propellants
• Anything with added ingredients included on the above-mentioned list

Injected Medications

Safe:

• Saline IV
• Diphenhydramine Hydrochloride injection (check inactive ingredients)
• Ranitidine Hydrochloride injection (check inactive ingredients)
• Rocephin injection (without dextrose!!)

Avoid:

• Lactated Ringers
• Dextrose in IV

Wound Treatment and Disinfectants

Safe:

• Saline
• Betadine solution (if it contains only water, povidone iodine, and sodium hydroxide)
• Purdue brand Betadine is safe
• Isopropyl alcohol (only if necessary)
• Non-dissolvable nylon or polypropylene sutures (rinse to remove corn starch)
• Carbocaine or preservative lidocaine for local anesthetics (the only inactive ingredients should be water and/or sodium chloride)
• Cotton gauze
• Kerlix or Coban Tape

Avoid:

• Citric Acid
• Glycerin
• Pareth alcohol
• Ethanol
• Dissolvable sutures
• Local anesthetics with inactive ingredients other than water/sodium chloride
• Most adhesive bandages
• Steri-strips

antibiotics and anti-inflammatories: a story and a "pudding" recipe

Some of you may know that I have been battling an awful kidney infection since early December. I was lucky that the doctors diagnosed it so quickly when I finally broke down and went to the emergency room!

What followed, though, is what I find to be the biggest difficulty of living with non-top-8 food allergies, especially while being overseas. I needed an antibiotic  in order to heal, but everything the doctor tried to prescribe to me was full of either corn or gluten. Most of the time, the labels did not say "corn," so alerting the pharmacist and medical team that I had to avoid corn made no difference. The doctor gave up pretty quickly, so Ben and I had to spend hours after my appointment on a late Sunday night, researching the medications they had in stock at the pharmacy. Luckily, the pharmacist was patient and did not seem to mind taking out all the pill-based antibiotics there so we could examine the ingredient lists, check websites, and compare them to the very small database of possible "corn-safe" and "gluten-safe" medications others with my allergies have been able to tolerate. The few we did find were cross-reactive to penicillin, and I have a penicillin allergy in my file. (Later on, we did a lab test, since I had a bad allergic reaction last time I had penicillin. The penicillin  test came back negative a few weeks later, so I finally have confirmation that the previous reaction was due to the corn in the meds and not the penicillin itself!) We finally found one, and the pharmacist convinced the doctor to write out another prescription.

Because of the severity of my allergies, she suggested that I take the meds under a doctor's care, so I had to make a follow-up appointment with a family practice doctor before I could start my course of antibiotics. This appointment also took hours, but this time the doctor and pharmacists worked with me to try and find something that was effective and also safe! The issue is that we didn't yet have the penicillin results back, so I was limited by the food-allergies in addition to a possible penicillin allergy. I did have some minor allergic reactions, but after several hospital visits and hours of research, we finally found an antibiotic that was safe for me to take! Unfortunately, though, it was not the best antibiotic for getting rid of a kidney infection. We finally agreed that I would take the full course and then make a follow-up appointment in January if it didn't work.

Fast-forward two weeks, and the kidney infection that had started to go away was now back in full force. Luckily, I received the penicillin labs the same day as my doctor appointment (negative, yay!) and I was able to get a large (4 shot) injection of a strong antibiotic that I was assured should do the trick. The medical staff also recommended taking anti-inflammatory medication (which, of course, I can't take because of the allergies) and to use any home remedies for inflammation that I could find to help the antibiotics do their job.

So, here is the reason for this post! I did some research on several anti-inflammatory foods to help kidney functions, and then put a bunch of them together to create some new recipes. Below is my favorite - even once the infection is gone for good, I'll definitely be using this one. It makes a great, healthy breakfast or snack!

Anti-Inflammatory, Paleo-Friendly Pudding (it's not actually pudding...it's more the consistency of fro-yo or ice cream. I have no idea of what to call it! If any of you dear readers end up making it and can come up with a stellar name for it, let me know!)

Ingredients:

- 1 cup thick coconut milk (I use this one!)
- 1 frozen banana
- 10 frozen cherries
- 1/3 cup fresh ginger, grated
- 1 tsp ground cinnamon

**Optional:
- 1 tbsp flax meal (great anti-oxidant with lots of Omega-3's, and excellent for inflammation)
- 1/2 tsp D-Mannose (excellent for treating a UTI in case you ever have one)


Directions:

Simply place all of your ingredients in a blender and blend until smooth! If you want a thicker, fro-yo sort of texture, put it in the freezer for about 20 minutes before eating.

**Optional: Since I've been making this concoction every day for the last week or so, I've been experimenting with some ways to change it up a bit.

- Exchange 1/3 of the coconut milk for 1/3 cup of Greek yogurt, especially if you're taking antibiotics! That "good" bacteria is important!
- After blending, add some mix-ins! I like to add some crunch to mine, so I've added different combinations of the following: cashews, almonds, pumpkin seeds, granola, or even a few chocolate chips to satisfy a sweet tooth!

parties with panache: pizza recipes!

I've learned a great deal of things since finding out about my food allergies, and one of them is that social gatherings almost always include food of some sort! It was something I never really put much thought into before it became a matter of survival, and I think it's only when someone is put into that position that they realize how much of our sociality revolves around food. Holidays, birthdays, reunions, family gatherings, parties, end-of-week work gatherings, and even staff meetings include snacks, potlucks, meals, barbecues, and even restaurants. Because of this, those with food allergies have a lot more to think about and prepare for when it comes to being social.

Some venues are easier than others. Potluck picnics and beach barbecues are easy because the allergic person can simply bring their own food. When it involves work functions, friends' houses, and restaurants, though, things can get a bit more difficult.

There are definite social changes that happen when you develop food allergies. Those weekly meetups with friends at the local restaurant become awkward, either on the part of the allergy person who can't eat anything on the menu, or the friends who then feel sorry for them. I noticed this shift when I was finally diagnosed and suddenly had no safe restaurants. The invitations became few and far between in the name of not making me feel bad that I couldn't eat anything on the menu. Instead, it felt isolating to be constantly left out of fun events.

For this reason, we often hosted the parties and game nights at our house. We always had a "safe" area for my food and a potluck area for everyone else. It worked for a while and we loved being able to play host and hostess on special occasions and book clubs and get togethers. This became a nightmare though, when I realized that I was so sensitive that the food my friends brought over was causing cross contamination issues. Ben and I started experimenting with snacks and meals that could be made fairly easily and would feed several people so that having a get together didn't have to be food-less, but also wouldn't mean a Thanksgiving-like event with a whole day of cooking involved. It had to be something that adults would enjoy, but their kids would also eat. It had to be free of multiple allergens and something that could also be served for our vegetarian friends. We started with pizza: the quintessential and easily-customizable party food. After our first party serving the pizza, we had several friends requesting to come over again so they could partake again! Each time, we make a few favorites and try something new, so I thought I'd share some of our favorites in case you ever find yourself in a pizza rut!


The Basics:

For most of our pizzas, we prefer to use the Chebe flour mixes, because they are grain free and are pretty versatile. Many other blends are too watery or too starchy (or don't hold up well as leftovers). Each pizza also uses about a cup of sauce and 1.5-2 cups of mozzarella cheese (I use the Organic Valley brand).


The Sauce:

My favorite prepared sauce is the Organicville pizza sauce. It's got a nice flavor and thickness, and the vinegar is sourced from sugarcane and not corn like most other sauces. I purchase it from Vitacost, and for those of you in the states, I've seen it at Whole Foods, Sprouts, and Natural Grocers as well.

I often prepare my own sauce, which is great because I can adjust the thickness and spices as needed. Because we have typically lived in places where fresh, organic tomatoes were not always available, I had to search for a while to find a good substitute. I love the Bionaturae tomato paste, an organic product from Tuscany.

Ingredients:

• 1 can tomato paste
• 1 cup water (adjust for preferred thickness)
• 1/3 cup extra virgin olive oil
• 1-2 cloves minced garlic
• 1/2 tbsp basil
• 1/2 tbsp oregano
• 1/2 tsp rosemary
• 1/2 tsp thyme
• salt and pepper to taste

Directions:

Mix all ingredients, adding the water last. Stir and add water to the thickness you prefer. For the best results, let the sauce rest for an hour to enrich the flavor. Then, spread it on the dough. Remember not to add too much sauce, as you don't want your dough to become soggy! I add my favorite spices to the following toppings and then bake the pizza at 400 degrees for 20 minutes.

**Tip: If you're going for a more creamy sauce, substitute the water with a nice, thick coconut milk! These are the two I use most often: Native Forest and Aroy-D.

The Toppings:

There are several different topping variations we've used with the basic sauce and cheese combination.

• Pepperoni and black olives. Before I was as corn sensitive as I am at this point, I was able to use pepperoni. This is no longer an option for me, but I still do have a safe brand of sausage, so we use sausage with black olives now.

• Pineapple and peppers. This has been a favorite with our friends - simply dice some different colors of bell peppers along with some pineapple slices for a colorful and tasty combination!

• Yakiniku meat. We make yakiniku pretty frequently (thinly sliced, grilled beef) and sometimes use the leftovers as a pizza topping. This tastes delicious with black olives, pineapple, and/or bell pepper slices!

• Cream cheese. This is an idea we got from a Japanese pizza shop. After putting the sauce on, but before adding the cheese, drop some small dabs of cream cheese around the pizza (no need to spread!) I use the Organic Valley cream cheese, as it's the only one I don't seem to be allergic to. 

• Cream cheese and kabocha. A bonus addition to the previous entry that we recently discovered is kabocha (Japanese winter squash). Slice the squash into quarters and then slice one of the quarters into thin slices. After layering the sauce, cream cheese, and mozzarella, add the squash slices and some garlic to the top before baking.

Stay tuned for some non-red sauce based pizzas, coming up soon!

tokyo tasting: a gluten free guide to traveling and eating out in tokyo

Having celiac is not easy, and having it in a country that does not really recognize it as an issue makes for an interesting situation. I definitely feel lucky that we figured all of this out while living in a country where the people are extremely helpful and accommodating, but it doesn't help things that most Japanese have never heard of "celiac" or "gluten" and have no idea which foods contain the ingredients I need to avoid. Explaining a "wheat allergy" is simply not enough, since there is hidden gluten in just about everything here.

It's taken a while, but we have finally figured out our "system" here at home. Traveling, though, has been a different story. We originally transferred to Japan so we would be able to travel, experience cultures, and see the world. These were easy to accomplish pre-celiac, but they have become incredibly difficult now. When we travel these days, 2/3 of our baggage contains food in case we can't find restaurants that will serve me (this has happened - while it's frustrating, I'd rather they tell me up front they can't serve me than to serve me food that will make me sick).

On our first trip to Tokyo, I really enjoyed the city but didn't plan to visit again. It was too big, and there were too many people. We added other Japanese cities to our list of places to visit, not envisioning a return to Tokyo in the near future.

Then, celiac happened.

Our first post-diagnosis visit to Tokyo was very different than our previous time. Ben's parents were coming to visit and we had plans to join them in Tokyo for a week before traveling with them back up to Aomori. This trip, I had to research EVERYTHING ahead of time. Our schedules and destinations revolved around the few "safe" restaurants I had researched. The time leading up to our departure was full of anxiety, as there were not many resources and blogs out there to help. Those that did exist gave conflicting information. (Examples include whether plain combini onigiri or senbei are always safe bets... FYI, they're not.) Looking back, though, our trip wasn't half bad! We found a few restaurants that were able to accommodate my dietary restrictions, and even one that specifically had fluent English-speakers to help in situations like mine. The city has become one of my "safe places" and we are always excited to travel there now. We have since visited Tokyo multiple times, and continue to go back to our tried-and-true favorite places.

Sadly, some of these restaurants are no longer open. A few are, though, and I wanted to make sure to write about them in case this information can help anyone traveling to Tokyo with celiac disease or gluten intolerance.  I am extremely sensitive to cross contamination, and have never gotten sick at the following restaurants.

The first restaurant I'd highly recommend is Gonpachi. I have visited several locations of this Tokyo restaurant, and haven't gotten sick at any of them, but my favorite is the one in Nishi Azabu. I have written about this place before, but didn't really go into much detail about their allergy protocols. I was a baby celiac at that point, and I've learned that I was doing so much incorrectly at that point. I have, however, been back to this restaurant several times since, and have still had wonderful experiences every time.

While Gonpachi is an izakaya style restaurant, they use very good quality meats and vegetables in their cooking. Their noodles (which aren't gluten free) are made by hand each day, and they try to source from local farms. I won't eat at most izakaya style restaurants, but this one is my exception because of these reasons. Another reason is that Gonpachi Nishi Azabu has an "allergy specialist" to help people like me figure out what they can eat safely.

At the time of the writing of this blog, Gonapchi Nishi Azabu's allergy specialist is named Teresa. She is fabulous to work with and we always check before heading to Tokyo to ensure she will be working when we visit. Teresa speaks English and is well-versed in finding foods that are safe for those with allergies. She is willing to go back and forth between the customer and the chefs to ensure that the correct ingredients and protocols are taken to keep someone from getting contaminated.

If you go, make sure you ask her to remind the cooking staff to clean the surfaces before cooking your food.

Here are a few of my favorite things off the menu:

• Asparagus wrapped in bacon. This is quintessential izakaya food if you eat pork. So delicious!
• Rice bowl. Gonpachi has a few rice bowls, but none of them (as they are on the menu) are safe for someone who is very sensitive. They will, however, make one for you that is, as long as you let them know exactly what you need! I get a modified "takana meshi" - without the pickled mustard leaves and with an addition of grilled chicken and fresh avocado. They bring out all the seaweed and spices separately, so I can see exactly what will go into my bowl before it's done. I mix it up and add my safe soy sauce myself, and it's delicious!
• Gyutan. I love beef tongue when it's done right, and it's definitely done right here. I ask for the gyutan without the sesame oil, as I have not been able to confirm that it's safe. I just use my safe soy sauce for dipping instead.
• Chicken on a skewer. I'm not sure that this one is on the menu by itself, but they've never had an issue with making it for me. I love yakitori and rarely get to order it, because it's so difficult to find restaurants with safe cooking practices in terms of cross contamination! I order it shiodake (with salt only) and then use my soy sauce.
• Yuzu Lime Iced Tea. I look forward to coming to Gonpachi for the yuzu tea more than anything else, especially in the summer. It's so delicious! The first post-celiac time we visited Gonpachi, I was very nervous about trying this again. Even with my corn allergy on top of everything, I did not get sick at all.

All in all, Gonpachi is definitely worth a visit!

My other favorite restaurant in Tokyo is Moti. This is an Indian restaurant near Roppongi Station. The owner speaks some English and while he doesn't know much about gluten or celiac, he is very willing to go over all ingredients with you. I can't say I've branched out as far as the menu goes, because the butter chicken curry is so good that I get it every time.

We have visited every six months or so, and the owners always remember us when we walk in. Just make sure you check every ingredient and let the owners know what you're avoiding so they can check it. Also, ask for rice instead of the naan and you'll be good to go. They have offered sticky rice in the past, so you will need to make sure you opt for plain rice (the sticky rice is not safe).

I hope this is able to help you as you navigate your way through Tokyo! Let me know if you have any great gluten free experiences at either of these (or any other) restaurants in Tokyo!

corn, corn everywhere (my search for safe-tea)

(Yes, I'll admit, the pun was intended.)

I know I've shared several blog posts about my journey with celiac disease, but I haven't shared much about my quest to go corn free. It's because, even after a year and a half, I am still learning new things about this allergy every day. There are still things that shock me about the use of corn in America and products that I never would have thought would make me sick.

It's crazy to me how much corn is used in our country. In EVERYTHING.

The weirdest part of this is that most people don't know this. Most people think of corn as an ingredient in bagged tortilla chips or packaged tamales or sweet things with high fructose corn syrup, but in reality you would be hard-pressed to find an item on any American grocery store shelf that doesn't contain corn in some form or another.

This is what has made it so difficult in my journey to health. At first, I thought I would just have to avoid foods that had corn, corn starch, and corn syrup. Boy, was I wrong. I cut out the vegetable oil and the non-dairy butter  and the yeast and the baking powder and the vinegar.

Still, I was getting sick. I did more research and learned that corn can go by more than 170 different names, most of which don't even say the word "corn".

Maltodextrin (which is added to most grain products)
Citric Acid and Lactic Acid (and many other food acids)
Dextrose (a sugar in most packaged foods)
Xanthan Gum (a binding agent used in most gluten free foods)
Vitamin A (used as a fortifying vitamin in juices and milk products)

Ingredient labels for Rice Chex and Greek yogurt. As you can see, both of these gluten
free and considered-healthy foods have a huge number of possible corn-containing ingredients.
(Click the picture to enlarge.)

I don't have all of them memorized. I have a list that I have to check every time I shop for food, which gets exhausting. The worst part is that these ingredients aren't always corn derived. Most of the time, yes, but sometimes no. Any time I find a new product, I must email the company to figure out whether the ingredient(s) in question might be derived from corn. Sometimes a company is straightforward and answers the question. Other times, the representatives refuse to answer because the ingredients are proprietary (or because they just don't know what is in their products).

It's taken the better part of a year and a half to cut out as much corn from my diet as I can. Even now, there are reactions from foods that don't have corn labeled on the packaging that, upon research and shared experiences with other corn allergy friends, do indeed contain it.

Like anti-mold sprays on most produce, anti-cracking agents on egg shells, vitamin enriched bottled water, and cleaning sprays on meat.

Then we move on to packaging. Yes, packaging. As if we corn-allergy-sufferers didn't have enough to worry about, our country is now using corn based plastics and cornstarch based papers in which to package the food. While I'm all for finding new and innovative biodegradable materials, they are usually made from corn and this is a problem for those of us who react to small amounts in our food.

Not long ago, I saw an ad that Kia is now using corn based plastics in their cars. Upon further investigation, I found that these new cars have 53 pounds of eco-friendly, corn-based plastics. I will admit that my initial reaction to this included a groan and a hand to my forehead. While I'm not skin sensitive to corn at this point in my life, I know others who are, and this is a huge concern.

Courtesy of Live Corn Free

The reason for this post is that I recently read a few articles on hidden ingredients in tea. The various writers investigated the ingredients found in tea and teabags, and were shocked to find out how much junk was really there. Pesticides and corn-containing "natural flavors" were in many of them, whether in the tea itself or the packaging. Many of these teas, banned throughout Europe and much of Asia, tout health benefits when they could actually be detrimental to tea drinkers' health.

I used to drink tea, and sadly had to quit when going gluten/corn free. I knew I was reacting to something in the tea, but I could never figure out what the issue was since my teas were labeled as gluten and corn free. (I will tackle the issue of product labeling another day...) After reading the article, I decided to embark on my own investigation to see if there were any gluten free/corn free/pesticide free teas on the market. While doing my research, I learned more about the pesticides and/or GMO ingredients in most of America's tea. I learned about the natural flavors used and where they are derived from (usually corn, but sometimes soy or wheat). I learned that loose leaf teas are often sprayed with dextrose or maltodextrin to keep them from molding and to enhance flavor. I learned about the packaging of the tea bags, which often contain either corn starch or corn based PLA. Honestly, I learned a lot more than I ever really wanted to know (ignorance is bliss, right?)...but I finally found some teas that might be trustworthy and safe to drink!

**Please note, company ingredients can change at any time, so please trial at your own risk!**


Numi Tea: Their teas are organic with no natural flavors and no pesticides. The company is devoted to being eco-friendly, and their bags are made from manila hemp cellulose and directly sourced bamboo.

Traditional Medicinals: This is another company that does not add natural flavors to their teas. They are part of the Non-GMO Project and do not use pesticides on their tea ingredients. Their teabags are made from manila hemp and raw cotton. (Just be aware that some of their flavors include extracts - stay away from these, as they are often corn derived! The representative I talked to mentioned they are in the process of doing away with these.)


If and when I find any others, I'll add them to the list! Let me know if you have any to add. Happy (tea) drinking!

reno refreshments: a gluten (and corn) free guide to eating in reno, part 2

The Reno restaurant scene is growing steadily, especially in the new midtown area. It is this section of town that we found several amazing new restaurants to try out during our stay in Reno.

This is Part 2 of my guide to eating gluten (and corn) free in Reno. Click here to check out Part 1!

One of the restaurants that I have heard about over and over again is Great Full Gardens. A locally owned restaurant, Great Full Gardens makes use of local vendors as well as their own organic greenhouse grown produce. Their restaurant caters to people with various dietary restrictions, as well as those who are looking for sustainable and ecologically-friendly businesses at which to eat.

The first time we visited Great Full Gardens was during breakfast. This being my first time, I asked a lot of questions. Any time the server didn't know the answer, she patiently went and talked to the cooks. They were open, knowledgeable, and flexible. They had several gluten free options, but only a few that were corn free as well. We worked together to create a safe meal out of various menu items, and it was delicious! I basically ordered a combination between the Juli's Saute with lemon oil and the Papusa (it ended up being a mostly Juli's, with eggs and black beans sans salsa, which contains citric acid). The breakfast was delicious and had the perfect blend of veggies and grains/legumes.

The second time we ate at Great Full Gardens was during dinner. We had a large party and I wasn't sure I'd have the same luck with creating something off menu to serve my restrictions, but I was not disappointed! When our server had some questions, one of the owners came to our table and personally answered my questions without making me feel like I was inconveniencing her in any way. We ended up modifying the Chicken Bliss and turning it into a lettuce wrap. They grilled the chicken separately, without their usual corn-containing broth, and I went without the bacon due to cross contamination concerns. Their homemade aioli sauce was more than enough to make up for the lack of broth, and the wrap was fabulous!

I highly recommend this restaurant to anyone with food allergies, as they have proven that they will go out of their way to try and accommodate you as long as you know what questions to ask!

reno refreshments: a gluten (and corn) free guide to eating in reno, part 1

We're in the states again, and as such, we are traveling without all of our safe kitchen utensils. I have wonderful in-laws who have created a kitchen space for me and my special food and utensils, but there are times when it's necessary (and let's face it, fun) to eat out. It's been ages since we've been able to eat out safely, so I was very excited about this prospect. With the gluten free fad, though, I have been a bit nervous about the safety of restaurant eating. Even some of the restaurants I frequented last year are no longer safe, so it's taken hours of researching, calling, emailing, and googling to find safe establishments. Here are some of the places I've experienced so far this summer!

(Keep in mind that everything I have ordered has been gluten free and as corn free as possible. I use the Find Me Gluten Free app, call the restaurant, and then talk to a waiter and/or manager before ordering to ensure the food I am ordering will not make me sick. If I feel like the restaurant isn't safe or that the servers/cooks are not taking me seriously, I will leave with no hesitation. I am also considered "corn lite" in the world of corn allergies, so if you have reactions that go beyond keeping corn ingredients out of your food, you will need to do additional research.)

The first place we always visit when we come back to the states is In-n-Out. There are, of course, In-n-Out restaurants all over California, Nevada, and Arizona, so this isn't necessarily a Reno-specific review. I will say, though, that we look forward to visiting and have never had a bad experience. I let them know about my allergies and then order my burger protein style without any spread (the spread has corn syrup). They will wash their hands and use a special dedicated gluten free section of the kitchen to prepare your burger if you alert them of your gluten issues. The fries are also made in a dedicated fryer, so I almost always order fries well done to go with my burger. I also bring my own ketchup, since they use ketchup that has corn-derived vinegar.

Protein Style w/o spread + fries well done w/cheese = heaven on Earth.

One of our favorite local-to-Reno restaurants has always been Pneumatic Diner. Ben and I have both been going there since our high school days and we are so glad it's still open and as delicious as ever. It's a small, hole-in-the-wall type restaurant that has sort of a cult following. Pneumatic is 100% vegetarian with several vegan options and a few gluten free options. This type of restaurant is typically difficult for me to find safe foods in, because they rely heavily on grain-based foods. Pneumatic has a decent variety of gluten free dishes, though! It was easier to eat there before the corn allergy manifested itself, but despite that, I am still always able to find something to eat at Pneumatic and the staff is always willing to find me something safe to eat. This time, I ordered the combo Bayard and subbed the Jack cheese for one without vegetable rennet as well as the rojo sauce for their cucumber garlic sauce. It was delicious, and I had no issues with ingredients or cross contamination. Pneumatic is one of those restaurants where the environment is just as important as the food, and neither was disappointing during our visit!

Pneumatic! ♥

Combo Bayard with all sorts of deliciousness inside

I love the small size and eclectic atmosphere of this restaurant!

The last restaurant review for this blog entry is another of our favorite Reno restaurants: Cafe de Thai. I knew that they had several gluten free options, but I was weary of trying them out because most Asian restaurants use vegetable oil for their stir fries. After talking with one of the servers on the phone, I found out that if I brought my own oil the cooks would be more than happy to use it for my meal. I took avocado oil and red palm oil so they could choose the oil that would work the best with whichever meal I ordered (they opted for the avocado).

Cafe de Thai

When we arrived, the server I had spoken with on the phone ended up being our waiter so he was familiar with my restrictions. He was extremely patient and took notes so he could review everything with the kitchen staff. When I thanked him profusely, he said he was glad to be learning something new, which is always refreshing to someone who feels like they are being high maintenance (despite not really having a choice in the matter).

I was able to order the fresh spring rolls, and they made me a special spicy peanut sauce to go with them instead of their usual vinegar-containing sauces. As an entree, I ordered the Pad Thai. Similar to Great Full Gardens, they informed me that they needed to cook my chicken a bit differently since their usual marinade includes corn starch. I was also able to order a drink, which is rare in a restaurant. I tried their homemade gingerale, which is made with sugar, water, and fresh ginger.

Homemade gingerale

Fresh spring rolls (left) and specialty spring rolls (right, not gf)

My spring rolls and peanut sauce

The Pad Thai was just as great as I remember it 

The appetizers, drinks, and dinner were absolutely delicious, and the restaurant staff went to great lengths to accommodate and make me feel welcome and safe. It's so nice to know that I can once again eat at some of my all-time favorite restaurants, despite having so many restrictions!

This is just the beginning of our trip, and later this week we'll be trying out some newer Reno restaurants! Check back later if you'd like more information on eating out safely in Reno.

getting through the maize

If you are just joining the story, this is the second half to The Journey of a Celiac.

I left off at Christmas. I had finally started to feel like I was coming to terms with having Celiac Disease. I understood that this had been a life-changing diagnosis, and what had been horrific in the beginning was slowly starting to just be...normal. We had sunk into the routines, and they didn't seem so bad most of the time.

I remember the first time I found a gluten free cracker. Ben saw it on a stand at the commissary and bought three bags of them, just in case. (Good thing too, because the store carrying them was just a one-time-thing.)

I actually cried when I perfected a pizza recipe that didn't taste like cardboard.

I was learning to cook with quinoa, brown rice, and other grains that weren't so hard on my system.

And then, around Christmas, I started not feeling well again. We searched EVERYTHING for gluten. I replaced all my makeup, shampoo, and lotion with gluten free versions (which were NOT easy to find from Japan!) That helped a little, but there was still something.

We eventually narrowed it down to our dog groomer, who had given Seamus an oatmeal bath at his last grooming appointment. He licks everything. He would lick himself, and then lick my blanket, the couch, etc. Any time I touched any of those things, I was getting sick. So we had to (very apologetically) ask the groomer to not bathe him before cutting his hair.

That helped for a while, but there was still something. We realized that with Seamus having contaminated everything with his shampoo, it was possible he was the one who was still making me sick. We researched people with Celiac and the possibility of his dog food affecting me. I thought it was silly, but there were hundreds of blog posts about pet owners getting sick, and feeling better after switching over to gluten free dog food. Yep, you heard me, gluten free dog food. Seamus is now the trendiest dog in Misawa, having gone gluten free. But I noticed the change immediately.

And yet, there was still something. Occasionally I'd still get a panic attack, or an unexplained migraine. I'd have the constant stomach pain that was similar to my days before discovering I had Celiac Disease. What now?!?!?!

So we talked about it. Ben and I realized that there was a possibility I had another food allergy.

I've heard of this happening, but I thought I was somehow exempt. (How selfish and unaware we humans are, thinking these things don't apply to us...) A person is diagnosed with Celiac and they cut out all gluten. They feel better for a few months, and then all of a sudden, they don't anymore. While this certainly doesn't happen to every Celiac, it's a pretty common tale.

It felt like beginning all over again. Eliminating everything. Slowly working foods back in to see if they made me sick. Every time I ate anything, it felt like a game of Russian Roulette, waiting to see if this was what was going to make me ill.

Luckily, we started at the right place. A friend of mine had told me months ago that when she had finally started feeling better, she got sick again and realized she was allergic to corn. I sort of discounted this (not discounting her experience, but discounting that it would happen to me, too) because corn allergies are pretty rare.

So of course, that's what it is. After eliminating all grains, I started back with corn. Some Corn Chex with breakfast, some tortilla chips with lunch, homemade cornbread with dinner. And it all came crashing down on me Friday afternoon.

Corn.

Maize.

Corn is in everything. Corn is America's most-planted, most-used crop. And most gluten free foods contain it.

And this is where I begin feeling helpless.(And where I have a temper tantrum like one of my students...I do always say that you are what you teach...) With all the restrictions I've already made, all the things I've cut out of my life, now I have to add corn to the mix (or more accurately, take it out). It feels like I've taken one small, timid step forward and five giant steps back.

It feels like starting over again. AGAIN.