Negatory

SIBO test results: Negative!

NEGATIVE! SIBO GONE!

My methane was zero; my hydrogen was low enough to be normal, or at least non-SIBO. I feel like a Beagle Freedom Project dog - hesitant, tentative, eating things I want, but still sticking to what I know best most meals.

It's been a crazy almost-two-weeks since the news. Not so much because of the food, although that's interesting to explore, albeit obsessive in terms of tracking every bite at every time and connecting that to bowel movements to see what things agree, and which don't. But more than that, it's Life with Reno that's kept things a challenge.

My house is dirtier. My clothes sometimes have hair on them. My mornings start earlier and involve a walk. I check the clock at work and think about what he might be doing. His anxiety and leash aggression are not especially better, though I think we're more used to it. He's an inside dude - he is the gentlest, sweetest, most timid dog inside a house. Outside, we've discovered, his threshold for nervousness is literally a blowing leaf. One leaf? He's at a one. A blowing leaf and bicyclist? He's at a two. Add another dog? He's off the charts. So we've started having walks where we aim to keep things at no more than a one or two. This involves standing still on the sidewalk a lot, as he sniffs and stares, keeps his ears tippy-top tipped up, until he calms down a little and we can move on. It's very Zen.

When we get back, all that sniffing, stopping, seeing, staring, sighing, startling, skittishness and sensing… it results in a bunch of this:

Teeter Totter

I have been so sure the SIBO is going to be gone. And then I get struck with fear, and am so sure it is not gone. I can't do this diet for much longer; well, in fact, I'm not doing it now. I have been sneaking little cheats more days than not. So my punishment will surely be SIBO forever, right? So it goes - back and forth, back and forth - or as my brother said when he was a toddler, "Back and thorf, back and thorf."

The results are not in yet, and today is a day where I am certain it is gone. I have noticed that I "recover" digestively from the cheat foods faster and faster; it must be gone, then, right? But I still need a little time to recover, so it must not be gone then, right? Gah!

And in the middle of it all, we're getting used to Reno. And he's getting used to us. He looms large in my daily existence; I think about him (ahem, I worry about him) when I'm away from the house. Is he bored? Is he getting into trouble? Is he eating the rawhide bone and not just chewing it properly? If he's in the house, does he have to pee or poop? If he's outside, is he scratching at the fence or digging? All the anxiety, at this point, is outweighing the fun parts. Yes, he's cute. And yes, it's lovely to sit right now with him curled up on his blanket at the end of the couch (we're doing pretty well with keeping him to his 'place' there). He is funny when he's in sniff-mode on our morning walks. But he also could give two shits about loose-leash walking most of the time, and pulls all of his 19 pounds against the leash, and then barely acknowledges my existence when John is around, he is mostly too timid to go up the stairs, and he sheds like a bastard. Life was a lot easier before he was around. I can't remember why I wanted to get him so bad in the first place.

He also hates the rain, which is really funny. He stops every third of a block to shake - which makes walking a long process - and sometimes will not come out from under a tree when it's raining hard. He stood under my legs the other day and looked me so plaintively; what the heck is this wet crap?! So the natural next step is... to buy him a raincoat! Tah dah:

But even I question - does a doggie raincoat really need a hoodie on it? 

And no - we have not used it yet. 

Third Time's a Charm?

Coming up this Tuesday, I take my third SIBO test. Drumroll please. It hardly seems fair to be eager to take it, and it seems foolhardy and pride-goeth-ing-before-a-fall to say I think the bugs will be gone… but eager I am, and gone I think they shall be.

It seems unfair and foolhardy because the little bit out there on this issue online shows that many people require a year, or two or three, to get rid of their SIBO. Who am I to think it is going to be gone 3.5 months after starting treatment?

But the proof is in the pudding. Or in the toilet bowl, my friends. My world there is a very different one than it was for the last year or longer, and I just feel like the bacteria is gone. Come Tuesday, I'll take the test, and in another week or so after that, I'll get the results - and if it's there, or if it's gone, I have no idea what comes next.

This sort of intense dietary restriction can't be done if you're looking ahead. It can only be done one day at a time. So I don't know what I'll "get" to do and eat and experiment with come May; I just gotta get through Tuesday first, and then waiting on the results.

But in the meantime, nothing like a true distraction… how about… a new dog!

Meet Reno.

He likes to sleep, and bark at other dogs when he's on the leash. (We're taking a class for this soon. We're registered.) He's about 4 years old, they think, and was a stray from Los Angeles who must have had a family at some point, since he's housebroken. He's also terrified of anything in your hands, and was clearly hit with things, but he's coming around to us. We're getting to know each other. He does not like the rain. He does like the fireplace:

Two weeks after the two weeks.

Oh, the two weeks were glorious. The things I dined upon! Pizza, breadsticks, ice cream, frozen yogurt, a bagel, a biscuit, a slice of sour cherry pie a la mode. Potatoes - french fried, mashed, and fingerlings a-roasted. The kati roll from Bollywood Theater, a polenta soufflé, a chocolate brioche and lemon tart from Maurice. (Bill, if you're reading, the polenta soufflé was worth writing home about.) Bread, bread and more bread. With butter, and jam. A slice of so-chocolatey-it-was-almost-black cake.

And then there were the things I forgot to eat. Pasta. I didn't think of it, not once! And no Frank's noodles, and no sweet potatoes. No oatmeal!? Indeed, no oatmeal. I didn't bake because I didn't want to restock any flour, sugar, or chocolate for just one recipe.

And then there were the things I ate that were not good. No surprises here: a Chips Ahoy cookie, a granola bar, a Fig Newton (that was ok, but not great). Anything processed tasted like nothing; like cardboard and sugar. If my eyes were closed, I'd never have known it was a Chips Ahoy. It could have been shortbread.

But alas, even two glorious weeks come to an end. There were exactly three things I think about still. One, the biscuit and two, the cherry pie from Lauretta Jean's. I mean, if this Captain of Team Cake is thinking about a slice of pie, you know it's out of this world. And the biscuits. Oh, the biscuits. They are worth every calorie of butter, worth every bit of gluten. And Three, ice cream.

Look, there's nothing like ice cream when you've not had sugar in 9 weeks, and neither dairy beyond hard cheese, butter or kefir. Ice cream is amazing. Ice cream is everything Anne of Green Gables thought it would be at her first picnic, it's everything you waited for at the beach as a kid. Ice cream is the miracle at your grandmother's World's Fair and I take back any time I didn't appreciate ice cream for the glory that it is. I work with a group of folks who have ice cream every day at 3 PM - it's one of the engineering groups' rituals - and I'm not precisely accusing them of not appreciating ice cream, but I am saying that generic Safeway brand creamsicles can't, just can't, hold a candle to real Rocky Road. Or a premium vanilla-bean-flecked vanilla. Or Salt and Straw honey strawberry balsamic with cracked black pepper. Or a Ruby Jewel sammie.

But I digress. I had a bit of ice cream, it's true.

Then the two weeks ended. And I had to strictly go back on the SIBO-approved diet. Which I've been on for two more weeks. And in about two MORE weeks, I'll get to take the bacteria test again.

Much like last time, where I thought it would show I made progress but was not healed, this time, I feel it's going to show that I beat it. The bacteria will be gone. And what comes after that? I haven't asked yet. This whole process only works if you stay in the day you're in, and not think too far ahead - I mean, I never could have said I'd eat meat, eggs, fat, veggies and some fruit for months. So I can't say what will happen and how I'll do, but I'll tough it out another couple weeks and then test, and then tough it out a week while the results get analyzed, and in the meantime, I'll share some of my infinite variations on meat-and-sauerkraut with you!

(I actually won't because that would be terrifically boring. But I will post some regular updates on life and health, and to the four people who still read along - thanks for sticking with me and my microbiome!)

Attitude of Gratitude.

If you know me, we've probably had at least one conversation about the science behind happiness and gratitude. In case we have not: in a nutshell, science has proved that feeling gratitude lights up the same part of the brain as feeling happy; the two are biologically indistinguishable. So if you can't get happy, you can try thinking of something you're grateful for - and tah-dah! You'll be happy.

The trouble is, all the feel-good articles about this phenomenon, found in my hippie magazines, websites and Wholesome Living blogs, focus on feeling grateful for the usual suspects - your health, your family, your job, your sense of humor, your intelligence, the sun, the stars, the beauty of springtime, the ocean, the nourishing rain.

And I don't mean that it is trouble to be grateful for those things. They're wonderful! They do fill me with gratitude. They are beautiful moments in daily life that can indeed inspire an attitude of gratitude.

But sometimes, the trouble is, we never talk about how it's also OK to be grateful for things much less epic, and much more worldly.

Like the Veronica Mars movie that came out this weekend.

And you can call me superficial, you can call me a pathetic fan girl, you can roll your eyes that I'm going to claim this is a worthy example of an attitude of gratitude. But I'm doing all three anyway.

The movie made me so happy. They did a great job delivering a story for the fans that was still smart, funny, true to the characters, and a great mystery. So here I am - grateful to love things in the world - movies, songs, books, slices of tart cherry pie from Lauretta Jean's. By being in the world, in both the sacred and profane, I get my regular doses of gratitude - and they light up that happy part of my brain that otherwise doesn't get too much attention.

Bring it on, bring it on, yeah.

The results are in.

The time has come - my SIBO test results are in!

I picked up the phone with great nervousness, and heard, "Hi Emily! It's Dr. M!" She was excited and smiling, I could hear it.

"Hi! How are you?" I said in a big rush, as I locked myself into a conference room at work.

"I'm great, I have your test results and it is so exciting!"

Ohmygodwhatisit!?

So my bacteria indicators are down 80% or more. I still have it - and I knew I did - but it's going away, and it's going away fast. I'm not at all disappointed. I knew it would still be there, and my only fear was that it would be, like, 10% gone or something. But 80% gone! Miracle of miracles! Every single bite of food I passed up was worth it!

However.

It gets weirder.

The latest drug regimen, which Dr. M. wants to see me undergo, would be a choice of either herbal or pharmaceutical antibiotics. Herbals are $200 out of pocket and take 40 days. Pharmaceuticals are $850 out of pocket and take 14 days. She wasn't strongly advocating either way, but the pharmaceutical route - as evidenced by the cost - is a pretty incredible drug. It does not build up a resistance, so it should be as effective this time as it was last time. And it's non-systemic, so it does not cross into the blood and body; it stays right there in the digestive tract. If it does as well as it did in January, and I do as well with the diet as I did the last 8.5 weeks, I could be free of bacterial overgrowth and back on a path of healthy well-rounded eating. And so, yes, I'm a Western science girl at heart - I'm gulping on paying the bill and going for it. Round two shall be more pharmaceuticals.

But this is where it gets weird.

The second drug regimen comes with a new instruction. If choosing the pharmaceuticals over the herbals, one should, for 14 days - and not sooner, nor later - be eating, at one or two meals a day, something(s) from the list of "NO" foods. 

!!!

The highly fermentable foods list, aka everything delicious, will become my friend for 14 glorious days - and on day 15, it is cold turkey back to the SIBO diet. The theory here is that you want to feed the bugs while killing them… draw them out and knock 'em down; don't let them hide in dormancy while you take the pills.

As the calendar would have it, I am headed to Florida to see my mom and aunt next week, and frankly, this couldn't be better timing. I have not started the regimen yet, for two reasons. One, I am afraid I will get sick, like I did last time. It was the flu; I know it was. But what if - what if - what if it was a die-off reaction from slaying bacteria? And secondly, because I am making a list of Portland things I want to fit into my 14 day schedule. Any other suggestions? So far I have what is below, and it may well be two more months before I can have anything this tasty again.

• a slice of berry pie from Lauretta Jean's
• a kati roll from Bollywood Theater
• something from Maurice (brand new sweet shop near my office)
• half a pizza from Firehouse
• ice cream with hot fudge from Salt and Straw
• chocolate blackout cake from Sugar Cube (I've never had it!) 
• Frank's noodles 
• bread from Fleur de Lys 
• a bagel from Tastebud, now at food carts near my office

Cheater.

So today, I cheated.

Tomorrow marks eight weeks - two fucking months - of living grain- and refined-sugar- free.

And I have not cheated, not once. And if you don't know, I work in a literal candy store. Yes, it's a software firm, but it's all the tales you've heard about these insane, hedonistic, childlike Googlesque workplaces? They're true.

Snack plates are put out once or twice a day in the three most high-trafficked areas. Perhaps brie and summer sausage, perhaps guacamole and chips, perhaps almond mini croissants and a bowl of coconut whipped cream, perhaps peanut butter-filled celery sticks. And that's just those three areas. Then each kitchen (there are also three) is stocked: a cereal cabinet with 15+ kinds. A candy cabinet, a cracker drawer, all the bagels, bread, and muffins you could want (cinnamon raisin, plain, vegan, wheat, etc.). There is a sweets cabinet - Oreos, Petit Ecoliers, Nutter Butters. There are at least ten kinds of granola bars: Kind, Kashi, Nature Valley, PowerBar, Clif. There is, ok, a nod to health, with a fruit bowl. But there is a soda cooler, there is beer and wine, there is endless tea and coffee with your choice of soy, coconut, almond, regular, skim, whole and lactose free milk - half and half. (One guy eats two bowls of cereal a day, with half and half as the backdrop.)

This is meant for us to enjoy, every day, all day, for free, day in and day out. Since the second I have worked there. There is also at least one company lunch each week from the nearby food carts (variety makes it impossible to prepare your defenses against the deliciousness), and I've yet to work a week there when there is not also another pile of leftovers for lunch or at about 3 PM, everyone's best time to avoid high-cal snacks - it is often Voodoo Doughnuts, or Elephants Deli sandwiches, or Pizzicato pizza of six or seven varieties.

Oh, and we have a monthly food holiday - National Milkshake Day was one. Just come order up! The soda jerk is ready to help you out.

And so it is that in the face of this, I have not cheated once. Not one time. I have not eaten half a broken Chips Ahoy as I filled the cookie jar. I have not licked the spoon after slicing up chicken enchiladas. I have not had a Twizzler. Not a Dove chocolate square. Not the edge of a pizza slice. Not a quarter of a doughnut. And yet it's all staring me in the face, for the eight to ten hours a day, sometimes more, that I spend in the office.

But today, friends, I broke.

I came to work to help set up a breakfast buffet for visiting colleagues from the remote offices. French Toast. And pancakes. And look; I love pancakes like Phillip Seymour Hoffman loved speed balls. One is never, ever, ever enough. There were mountains of butter pats and maple syrup. But no, I set it up - and I walked away.

Then I attended a lunch event on behalf of the company. We were served a chicken sandwich on fluffy ciabatta. And if I can't get heroin but I can get oxycontin, to continue the inappropriate and gross metaphor, then bread is the very best next thing after a pancake.

But I didn't eat it. I ate the chicken out of the sandwich. I declined the basket of rolls (yes, rolls, with a sandwich, good sweet Jesus) and I declined the cookie assortment after that. It's true that I love cake more than cookies, but don't get me wrong - I love a cookie, even a bad one, too.

I made it back the office, still slightly hungry. I decided to heat up my almost-cooked-into-baby-food-texture carrots and a little beef short rib. And what is waiting in the kitchen?

A Thai buffet. With a giant hotel pan of fluffy, steamed white rice.

My doctor told me that if I'm melting down, and freaking out, the very best cheat on this diet is white rice. It has no nutrition - it has no fiber to feed the SIBO bacteria - and it goes right through you.

And willpower, as scientists are learning, is a muscle. Like any muscle, it can get fatigued. It needs rest to get strong again. I think - side note - this is why I am averaging 8.5 hours a night of sleep right now. I need to replenish the willpower reserves! And by the way, people with kids, plug your ears: that is 8.5 hours of sleep. I measure it with my UP band. I'm actually IN bed a good 9 hours or more. That's the pure, sweet sleep of someone not actively consuming peanut butter by the gallon, hoping to stop thinking about bread and pancakes.

So the willpower muscle was tapped out, and I added about a third of a cup of fluffy white rice to my dish. And Oh. My. Lordy. It tasted like sugar. No. It tasted like nectar. It was like some kind of divine manna. And I am talking white rice, I know. But it was almost funny, I almost laughed - how good it tasted.

And then, about twenty minutes later, I felt like I was on speed myself. I was hyper alert. Vigilantly awake. I was giddy, smiling. I had more energy than I have had in weeks. I was giggly, bright, amazed. What a world! What a day! What a gorgeous life! I'm going to the gym, to my crazy-tough fusion workout class!

Which I promptly did. And I set a new (self) pushup record, which my teacher noticed and was impressed by.

Powered by the blandest thing in the world. I may be a cheater, but I'm definitely a rice rocket today.

A Whole Lotta Nothin' Goin' On

I'm stuck in neutral over here - in the next couple days, I'll get the SIBO Test #2 results. As I've said, I'm certain it's not gone - but I'm dying to know what the reduction is. In half? Less? More? How much bacteria do we think is still in there, wreaking havoc?

But in the meantime, there's a whole lotta nothing going in, dietarily. I've admitted that almond flour and me don't get along. Things seem to be better with coconut flour, but I have more experimenting to do this week. It really is like the universe is trying to take away ALL my food joys. At least I still have peanut butter, and I'll be giving that up with cold, dead fingers, trust me.

I haven't added in many new foods; I'm still figuring out what amounts of the existing list of 25 or so are good, and which cause belly aches or bad poops. And it's getting depressing. I don't get to participate. At work, I ordered ice cream sandwiches - even gluten free ones, and vegan ones. But no makes a grain free, refined sugar free ice cream sandwich. I order lunch for the whole company every Friday, but I never get to eat it. I put out the snack jars a couple times a week, but there are no snacks for me. It's boring. It's isolating. It's frustrating and at some point, if I don't start getting healthier, the depression is going to outweigh the striving for health, and I'll go back to the SAD. (Standard American Diet.)

But know this, friends. Maranatha nut butters? They all contain cane sugar of some sort! Those little liars. Give me Justin's every day of the week.

Almost Done Right: Grain Free, Refined Sugar Free Carrot Cake (SIBO Diet Friendly)

The world appears to have a ton of GAPS, SCD, paleo and grain-free baking websites, books, recipes and Pinterest pins that go on for days.

But if you read the comments on these recipes, this is what you hear, over and over.

"Looks great! Can't wait to try it!"

BOO. You suck. Looks great? I can frost a pile of cat shit and it looks great. Those who comment before trying to bake it should be banned.

But then, it gets worse. I cannot find a recipe measured in weights. And as any person who bakes even once in a while knows, you need weights rather than measurements. Save yourself the dishes, and get it perfectly right. 5 grams of salt, thank you very much - not 1 teaspoon.

So I've been a mad baker the last month, and failing miserably. It's taking something I love and turning into something I hate. It's taking something I was very good at and suddenly teaching it in Cyrillic.

But I've made something good today, and the reason it's "almost done right" is that I didn't weigh my ingredients either! I measured, carefully, and with a bit of my mad baker estimation to round up or down on certain things - but tah-dah! A carrot cake of decent quality! It is, to be sure, VERY carrot-ey. It's not a sugary sweet cake, but it feels pretty close to a cake - a texture missing from my life the last six weeks - and has a nice honey-carrot flavor with the crunch of slivered almonds. Here is the original recipe, followed my version. I'm not crediting the recipe because I think if I made it as-is, it would have tasted like a carrot soufflé and been undercooked. My previous experience with these ingredients has me extremely confident of this pre-judgement.

Someone Else's Coconut Flour Carrot Muffins

• 6 eggs

• 1/2 c coconut oil, melted

• 1/2 c honey

• 2 TB vanilla

• 1/2 tsp sea salt

• 1/2 tsp baking soda

• 2 tsp cinnamon 

• 1/2 c coconut flour 

• 2 c carrots, shredded
• 1/2 c raisins or dried cranberries, optional

• Preheat the oven to 350 degrees.
• Line 12 muffin cups with liners, or grease with coconut oil.
• Combine the eggs, coconut oil, honey and vanilla in a large bowl or in the bowl of an electric mixer.
• Add in the salt, baking soda and cinnamon.
• Sprinkle the coconut flour over the mixture and then whisk into the batter.
• Mix well so that there aren’t any clumps. Fold in the shredded carrots and raisins or cranberries.
• Use an ice cream scoop to divide the batter evenly among the prepared muffin cups.
• Bake for 20 minutes, or until a toothpick comes out clean. YUM!

Emily's Coconut Flour Carrot Muffins

• 5 eggs (room temp!!)

• 1/2 c butter

• 1/2 c honey

• 1.5 tablespoons vanilla

• 1 tsp sea salt

• 1 tsp baking soda (leave this out for GAPS, and hope for the best)

• 2 tsp pumpkin pie spice blend 

• 1/2 c coconut flour plus 1 tablespoon

• 2 and 1/8 c shredded carrots (measure after shredding, not before)
• 1/2 c slivered raw almonds

• Preheat the oven to 350 degrees.
• Grease a 10 x 6 pan with coconut oil.
• Whip butter with electric hand mixer on high for 3 full minutes, until white and fluffy.
• Whip in slightly-warmed honey for 1 minute on high.
• Add the eggs one a time, mix on medium speed, for 30 seconds each. 
• Mix in vanilla extract on high, for 30 seconds.
• Sprinkle in the salt, baking soda and spice mix; stir in well by hand.
• Sprinkle 1/2 cup of the coconut flour over the mixture and then whisk into the batter with mixer on low-medium for 30 seconds. Let batter rest a 3 full minutes. Then whisk again with mixer for 30 seconds on low-medium and if you feel like it needs the extra tablespoon of flour, whisk it in now. 
• Fold in carrot and almonds gently. Pour into prepared pan. 
• Bake 40 minutes or until firm to the touch in the center, and evenly brown underneath (use a glass pan). YUM!

Hit It Hard

Well, the plan at the outset was to be on this diet for 3 months, and then re-test for SIBO.

But upon a detailed report of my poops - and oh, how I can talk about poop! I could write a cover story for Poop Magazine at this point. I could ID a healthy poop a mile away. The greatest part of my day is checkin' out my poop and seeing how what I'm eating is affecting me, and being able to pinpoint foods and quantities and their effects.

But I digress. Ahem.

Upon this detailed report, and when taking into consideration my extremely high levels of SIBO indicators (hydrogen, especially), my doctor has me taking the test again now! Tomorrow! She thinks I probably still have it… and so do I. I can't imagine, in fact, that I don't.

But seeing where the levels are will be really helpful, and if they are indeed positive, then we can discuss a second round of pharmaceutical antibiotics, or a round of herbal antibiotics. I'm not sure which route I'd choose actually; there is little study on the herbals but the study that is out there says they're equally effective. But my little scientific heart belongs to Western medicine, and so I lean toward the pharmaceutical.

So stay tuned! In the meantime, I get to repeat the prep diet today. It is:

• any meat or seafood
• olive oil
• butter
• eggs
• weak tea
• salt
• pepper

Yup, that's what I am eating all day today, then fasting for 12 hours overnight, and then taking the crazy-ass breath test on Saturday morning. Wish me luck!