Journal of Bone and Joint Surgery
If you want to read the article I refer to in my previous blog post, here's the URL: http://jbjs.org/article.aspx?articleid=10287
This gets you to a page where you can download a PDF of the article.
There are plenty of sources on the internet about the connection between joint pain or stiffness and allergies. Keep in mind that you should seek medical advice and not try to diagnose yourself. But if doctors can't find out what's wrong or treatment doesn't help you, consider the possibility of allergies.
And the fact is, eating well may not cure what ails you, but it's never going to hurt. Eating nourishing food while avoiding foods or substances that may cause problems for you is cheap and non-invasive.
If you know me, you may have heard me talk about my allergy, or whatever it is, to grapes. I used to work in a winery. Now I can't even drink wine made from grapes. While I worked at the winery, I gradually developed general stiffness so severe, I had a hard time getting out of my car or getting up off the toilet. No pain, just stiffness and a kind of weakness. I had other problems at the time I was seeking medical help for, and once I felt better, I realized my life at this time was a haze of misery.
I had a sinus infection that wouldn't go away, sleep problems, stiffness in all my joints and eventually, I injured myself and had to stop working. I had 6 weeks of physiotherapy, yet the inflammation and weakness continued. My doctor kept insisting I was depressed, even though two psychologists and a counsellor said formally that I wasn't.
Long story short, I discovered I was having allergic reactions to a number of things, the most urgent being wine and grapes. I googled "allergy joints," and the first result was an article in the Journal of Bone and Joint Surgery from 1946. A rare but recorded reaction to certain foods or drugs is joint pain or stiffness, even psychological reactions. It can mimic arthritis and muscle or nerve problems, and can drive patients to see orthopedic surgeons. It's actually the sheaths covering the tendons and ligaments, occasionally even nerves, that swell and cause the pain and stiffness. This is called angioedema. It used to be called angio-neurotic-edema (neurotic referring to nerves), but people thought their doctors were saying they were making this up, so the name was changed. This reaction has been noted as far back as 1895, by no less a light in the medical world than Dr. William Osler. Case Study #1, a woman who was initially dismissed as neurotic, who turned out to be allergic to grapes and grape wine.
Bingo! I have a link to that article on the desktop of my computer and on my iPad. I even printed it off for my doctor. She refused to read it, insisting I was just depressed. Fast forward 4 years, and it turns out I have severe obstructive sleep apnea and assorted food sensitivities. I got a C-PAP machine for the sleep apnea, I watch what I eat, and I have a new doctor. I sleep well, I have no more sinus issues, and I have so little pain and stiffness I never need pain killers, although I do take a natural anti-inflammatory every day.
Yet I still have trouble believing that something as nice and innocuous as grapes can be bad for me. Grapes? Who doesn't love grapes? And grapes are in everything. If it's wholesome and good for you, chances are, it's got grapes in it. "Sweetened with fruit juice" means grapes. Trail mix has raisins in it. Raisins are wholesome and full of iron.
Raisins and grapes are GOOD for you!
Well, not for me, unfortunately.
Yesterday morning, I took a shower and tried a new skin oil from one of my favourite companies. I've used lotions and bath gel from the same line, very nice, very soothing.
On and off yesterday, I worked on cleaning up my front entry, a landing between two floors. I'd been using the front closet as a catch-all spot as I moved in, and things just stayed there for, well, a while. While I was at it, I set up a work table in my basement and unpacked a big box full of Christmas stuff to clear space for the bins of art supplies I brought down from the front hall. Nothing strenuous, and I never lifted anything really heavy.
Later last night, I had a lot of pain and stiffness in my upper thighs and lower back, to the point I could hardly get up from a chair or the couch. I thought, "what the heck? Did I really work that hard? Man, I must be out of shape! This is pathetic!"
I took a shower before bed, and I was shedding an awful lot of skin from a couple of spots. I also felt achey stiffness under my arms as if I was coming down with something. I thought, "wait a second, I haven't been exposed to anything infectious lately, this has to be a toxin my immune system is fighting. What is it?" I mentally ran through everything I'd eaten. Nothing different, except one new jar of olives. But, I mean, olives? Not one of the foods I have trouble with. Not a likely suspect.
Then I remembered that new massage and body oil. Checked the label, and the first ingredient? Grapeseed oil.
I'd never read that label. I ordered it online, just got the product and barely even read the main label, let alone squinted at the fine print. This could not have been power of suggestion.
I love the products from that company. Unfortunately, they don't publish full ingredient lists on their website and the store near me has closed, so now I have to stick to products I've used before, or accept that a new one may be a crapshoot.
This is one of the pitfalls of using products with organic ingredients. They could contain something in its natural form that I react to. But using only synthetic ingredients or highly processed ones isn't a good alternative. Then I'd be thinking, "WHAT am I absorbing into my body NOW?! Sodium glycol? Yum!"
The good thing, in a funny way, is this proved to me, yet again, that grapes and grape seed oil DO cause a reaction in me, and I'm right in avoiding it. It also showed me I feel good enough now, that my baseline is health and feeling good, I was able to pinpoint a reaction the same day.
Nutrients: Macro- and Micro-
I'm halfway through reading Michael Pollan's book, In Defence of Food. It's a great read, an interesting and entertaining overview of the modern Western diet and how we got to where we are, in a society where Type 2 Diabetes has become so common, it even has its own magazine. The book is not too scientific but he cites sources so you can read the original book or document he got information from. I always like that in an author.
Something I learned seems pretty basic, but I'd never known this before. I've heard about micronutrients a lot. These are vitamins and minerals we get from our food that we need for healthy functioning, but we don't need a lot of. We need some salt, but not too much. A deficiency of iron is anemia, and that's bad, but too much iron is also bad. Most nutrients come from our food, but one of the major micronutrients, Vitamin D, comes from the sun. Actually, from sunlight on our skin, and the interaction creates Vitamin D. We need to maintain the proper ratio of Vitamin D to Vitamin A and other micronutrients in order for our bodies to function properly.
Okay, so I already had a sense of what micronutrients are, those mysterious little substances we need but can't see.
What I'd never quite grasped is macronutrients. It turns out this is very obvious, we just rarely use this term. Macronutrients are the primary nutrients in food: protein, fat and carbohydrate. Oh. Well, I guess i *DID* know that!
Macronutrients were the first elements in food to be identified, as you might imagine. What I didn't know is that the scientists who discovered them also said, now that we knew this about food, there was nothing else we needed to know. One scientist created an infant formula based on his knowledge of macronutrients, but infants did not do well on it. It turned out there were, in fact, other things left to discover about food.
Micronutrients were discovered, and with each discovery, scientists often claimed we knew it all, there was nothing else we needed to know. Based on the science of nutrition, food manufacturers began to break foods down into their component parts, and if something seemed to be lacking in the refined or processed version, they would add that back in. Based on the assumption that what we know today is all there is to know about this topic.
This notion that we know all there is to know about food, so we talk about food in those terms, Pollan calls "Nutrition-ism." All of us talk about food this way today: "low carb diet," "low fat," how many calories something has. And we've lost touch with the food traditions of the past, that told us too much dessert made people fat and too much red wine gave you gout, if you planned to get pregnant, eat more liver and so on. Now we talk about how much protein and how many carbs something has. We read labels on food as if they mean something.
Pollan is saying that perhaps food cannot be reduced to macro- and micro-nutrients. Perhaps there is more complexity in any food than we can analyze in a scientific way. One of the advantages of the scientific method is the way it can formulate a question so that it can be answered. This often means isolating something so it can be measured, even if that's not how the thing actually functions in real life. One of the disadvantages of the science of nutrition is that how humans (or animals for that matter) fare on certain foods or with certain diets is very complex, not easily broken down into simpler forms. If you eat a whole fruit, say an apple, your blood sugar will not rise as quickly as if you made the same apple into juice and drank that. If you break that apple down into its various nutrients, and consume the equivalent sugars and starches and micronutrients in pure chemical form, your body will react entirely differently than if you just eat the apple. Well, why? What's going on in a whole fresh apple that isn't going on with its simplest building blocks?
Pollan says that real food is complex. Far more complex than any amount of science has so far been able to analyze. As time has gone on and science has progressed, we've realized that plain white flour is lacking in nutrients, so most flour is now fortified. But is even that the same as wheat that includes the wheat germ or kernel?
The problem for us in the industrialized West is that, for various reasons, we've been led to see food as components, as sources of nutrients rather than as complex, tasty, nourishing food, that maybe cannot be broken down into simpler elements without missing some essential point about it as food. Recently I said to someone "there is no possibility that 100 calories of steak can have the same nutritional value as 100 calories of jelly beans." They replied, "that's a very political statement." And it is. Because the food industry spends a great deal of money developing new products and improving old ones, hoping to tempt us to buy what they sell. A lot of people benefit from having us believe that a processed food is the same nutritionally as a whole food. Somebody somewhere would be very happy, and very rich, if they developed a jelly bean that could be marketed as having the same nutrition as a steak,.
Researchers have studied how people ate in other societies than our own, and whether they were healthy or not. It turns out human beings have adapted to widely varying diets, from almost 100% animal -based to mostly plant-based, and humans can thrive on very different diets. However, science itself testifies that the one diet we cannot thrive on is the modern Western diet, which is the fundamental point of Pollan's book. We're seeing epidemics of Type 2 Diabetes, obesity, cardiovascular disease, increases in Alzheimer's and cancers, that were unknown in previous centuries and are much less common in cultures that eat differently. It seems clear diet has a great deal to do with health.
Pollan makes the case that real food is more complex than processed food, and likely contains nutrients that haven't been discovered by science yet. Sometimes, it's not the nutrient in isolation that we need, it's a dynamic balance between nutrients. Omega 3 fatty acids are all the rage right now, but it turns out it's not so much that we need X amount of Omega 3 so much as we need to maintain the correct balance between Omega 3s and Omega 6s, along with other fats. Just as we'll get more benefit from eating that apple or orange than from the juice made from it, and way more than if we eat the same nutrients in an artificially created form, we can't possibly keep track of all the nutrients we need to eat al the time.
And it's even less likely the average person can keep track of all the different studies being undertaken by scientists, or the advice given out by experts.
Maybe we just need to eat food, not worry too much about calories or macronutrients. Food is about more than nutrition, as narrowly defined by scientists whose job is to define things as narrowly as possible. Food is comfort, it's family, pleasure, culture and tradition.
I haven't finished In Defense of Food yet. I've just started the section on how to escape the Western diet. Stay tuned....
I just made, and ate, my first Meatsa pie. THis is the Paleo answer to pizza: ground meat mixed with seasonings, spread thin and baked, then topped with pizza sauce and toppings, then baked again. I got the recipe from Melissa Joulwan's Well Fed cookbook.
I have to say, I'm liking her book more and more as I continue to use it. She has some great ideas. More importantly, every recipe turns out the way I expect it to. I can't say that about many cookbooks. Her descriptions match the result, the methods and measurements all work out.
I guess it's her background in the restaurant business. She knows how to cook, she's a fanatic for measuring (I'm not!) which is essential if you want to keep duplicating your results. And she loves good food, especially ethnic styles.
What I also love are the suggestions for changing a recipe, You Know What You Could Do With That? That's how I like to cook, start with the recipe, get the basics down, then improvise.
I already have ingredients in my fridge for a salad in her book, that I'm hoping will be like one I had at a potluck in university (art historians cook and eat wonderful food! Our grad school potlucks were the stuff of legend). Two of us washed the dishes, then sat in the kitchen eating the last of this amazing fennel and orange salad out of the salad bowl with our fingers. If Melissa Joulwan's salad can match that, I will be a happy cook!
She also has a great blog, The Clothes Make The Girl.
Thought on Nutritional Philosophy
This week I read Minding My Mitochondria by Dr. Terry Wahls. She was diagnosed with Multiple Sclerosis in 2000, which advanced to secondary progressive MS. She was confined to a wheelchair and couldn't walk even short distances.
She did research on nutrition, particularly on the micronutrients in a wholesome diet that will help nourish the brain and nervous system, the primary problem underlying MS. Her main concern is to nourish her mitochondria, sub-units in each cell that convert glucose to ATP, which fuels cell activity in our bodies. The mitochondria also clean up toxins and allow our cells to heal and renew themselves. And when a cell's life is done, which is pre-programmed by genetics and partially influenced by nutrition, it's the mitochondria's role to tell the cell to die. Without that, the cell becomes "immortal," even if it's not healthy, and this is cancer. Cell death is a crucial factor in ongoing good health. So we need to keep our mitochondria functioning at their best to keep our cells healthy.
With intensive nutrition based on her research, and a program of exercise and electrical stimulation of her muscles and nerves, Dr. Wahls is now walking without canes, she uses a motorized bicycle and is leading an active life. She's not "cured." She still has to follow her exercise regimen and stick to the diet she's developed. If she skips either of these components, within a day or two, she can feel the difference.
Her book is interesting. She explains a lot of science in fairly simple terms. She includes recipes. She provides information I haven't seen in any other book, so it was worthwhile reading hers.
For my own needs, too much of her information was focussed on MS, and she includes soy products in her recipes, which I don't tolerate well. For me, the big factor (besides intestinal problems and obvious allergic reactions when I eat it) is that soy is antagonistic to thyroid function. I'm hypothyroid as it is, so I can't afford to eat something that will depress my thyroid's function even more. In a pinch, I'll eat a soy product over a dairy product, because dairy has a much more immediate and severe effect.
Dr. Wahls also includes oats, quinoa and other grains as substitutes for wheat. I'm trying to avoid all sources of gluten, and even though these grains do not contain gluten by nature, they are often contaminated by gluten because they're processed in the same facilities that process wheat, rye or barley, that DO contain gluten. For anyone trying to avoid gluten completely, it's essential that they ascertain that oats or quinoa are processed in a completely gluten-free way, or simply avoid them altogether.
I'm glad I read her book, because she's often cited as an expert in this area, and she certainly explains the science as clearly as anyone I've ever read. I'll add it to my library of nutritional information.
Possibly the best thing, though, that I got from her book was a philosophy that seemed to underlie much of what she said. Maybe it was just my take on it. She never really articulated outright, yet it underlies a lot of Paleo thinking. It's important to keep this in mind, in my view.
There are certain foods to avoid because they have detrimental effects for most people. Other foods are detrimental to individuals and they should avoid them for optimum health.
But beyond that, there's no sense being paranoid about food. Don't get stressed or panicked making sure you always get only the purest, most organic and nutritious foods. Focus on eating RIGHT, on including a variety of foods and those foods we know are beneficial. Try, whenever possible, to get organic produce or grass-fed meat or free-range eggs. But any whole food is still better than a processed food, even if it's an egg from a battery-farm chicken or hothouse vegetables or green beans in a can. Do what you can, within your budget, your time, your interests, your abilities.
If you eat well, you're giving your body, right down to your cells and the hard-working mitochondria within your cells, the best possible selection of micronutrients to support healthy functioning, so then your body can take care of itself. It can rid itself of many toxins, it can repair damage from environmental factors.
Eliminate the negative. Accentuate the positive. Eliminate the bad stuff where you can, but in working toward the positive, including the best possible foods while reducing or eliminating foods that are detrimental or of no benefit, you will support your body and yourself to cope with the less-than-optimal situations and nutrition you may encounter in a normal, active life. Enjoy your food, enjoy your life.
Good Health Makes Good Teeth!
I went to my dentist yesterday. In my regular semi-annual checkup, he found several minor problems. This was my second visit to fix those. It turned out that, even in 3 weeks since my checkup, some of the issues had corrected themselves, or the work he'd done last week was enough to let other problems resolve themselves. Your mouth is a very dynamic place and your teeth and gums are always repairing themselves and shifting around.
He commented on how my dental health is really reflecting the choices I've made. Now that I've moved back to the town I lived in for 20 years, improvement is visible even in a short time. I'd noticed myself that I used to have decent teeth but my gums were a concern; now my gums seem to be fine, especially for someone in their 50s, but my teeth needed work. So the soft tissues in my mouth had gotten healthier, even as I was going through all the work and stress of sorting and organizing my parents' house to sell it, buying a house, worrying about money and all the decisions that come with buying and selling a home. The minor issues with my teeth reflected this, through teeth-grinding at night, as well as clenching my teeth when lifting boxes and furniture.
My dentist took an impression of my front teeth, because some have shifted and may need some orthodontal intervention, but with the obvious return to health he's witnessed in even 3 weeks, he felt it was best to wait and see if things will shift back again in time.
He commented on what a strong clear arch I have in my lower jaw, that this is really rare for a Canadian woman. I asked him to clarify, and he said that most women in Canada (and presumably men, but their bones are generally bigger and more robust, so the effect is not quite as drastic) eat so much sugar, their teeth collapse into their jaw and the bones deteriorates, so their lower jaw is, essentially, a mess. Mine is not.
We talked about the importance of nutrition. I told him I've decided to "go Paleo," which he applauded. I said that I still eat more fruit than they recommend, because I find myself craving fruit if I don't get enough. Better to eat more fruit than turn to something really unsuitable out of desperation! I said I think I crave the acidity even more than the sweetness. He talked about how whole foods, fruits and vegetables in their natural state, are factories of nutrients, and "Monsanto can't compete with that."
I should point out that I do not have good genes when it comes to teeth. My mother was one of five children, and of the 5, 4 of them had full dentures, none of their own teeth, by the time they turned 25. Only my mother had any of her own teeth left. My Mom had two bridges with artificial teeth, and at least one implant. I have no artificial teeth, only fillings, and all of my own teeth, except for my wisdom teeth. I'm 55.
My father had none of his teeth left by the time he was 45. He was hit in the mouth with a baseball when he was young, which broke several teeth. He lost those and the decay that set in claimed the rest, so after decades of constant pain and dental work, he and his dentist decided removing all of his teeth was the better option. We don't know if this was an environmental problem caused solely by that early accident, or bad genes or both.
My point, though, is that whether bad teeth have been caused by genetics or environment, nothing in my family history says I should have good teeth or dental health. I have a mouth full of fillings. I wear a guard at night to stop me from grinding my teeth and to prevent the teeth drifting from clenching my jaw in my sleep.
So, if I have an unusually good, clear, strong lower jaw, it's not because of good genes in the jaw department. It's because of what I've done in my own lifetime to take care of myself and my teeth.
Personally, I find it frightening to think that a lifetime of what we'd call a "normal" Canadian diet can cause not just cavities, but actual visible bone loss or deformation. Hearing this made me ever more determined to carry on eating whole foods and avoid sugar!
A basic introduction to dementia and Alzheimer's from HealthBC:
SeniorsBC, a page with links to many resources on advance planning, care for seniors, information on housing and housing assistance, and many other useful topics:
Financial strain on caregivers:
Family Caregivers Network Society in Victoria BC, with links to resources:
Caring for Someone with Dementia, from the Alzheimer Society BC. This provides capsule descriptions of many topics, from Self Care to understanding symptoms, planning and so on.
The Alzheimer Society of BC. You are not alone. Whether you've been diagnosed with dementia, or someone you love has been diagnosed, and whether it's Alzheimer disease or another type of dementia, this is the best place to start. The Alzheimer Society runs support groups and courses for caregivers (I took one that was attended by people whose parents had recently been diagnosed, to a woman who was caregiving for 8 elders, to care aides who wanted more understanding of the people they worked with daily. One principle we learned is that "everything we know about Alzheimer's we've learned in the last 10 years. Whatever horror stories you remember about your great-grandfather wandering down the railroad tracks or people in care homes being sedated comatose, the state of care for dementia sufferers has advanced, our grasp of what it means to have dementia has changed, and the support for caregivers is much, much better than it was. The focus now is on "person centred care," and for you or your loved one, that focus begins with you.
How to prepare for talking to your doctor or your loved one's doctor:
I wrote a two page letter to my mother's doctor, outlining various things my mother had done, said, not done that would be normal to do. While modern privacy laws prevent someone's doctor from talking to you about their medical conditions, nothing prevents you from providing information to their doctor. Keep in mind that a person with dementia loses judgement, and they lose their ability to monitor their own behaviour. They may not know how much their abilities have declined. They may not want anyone to know, because they think it's temporary or they're ashamed that they can no longer do things they used to do. They may tell their doctor everything is fine, or that their children/friends/spouse are concerned, but it's really nothing. Fear is entirely normal, for a person who suspects they have dementia, and for their families and friends. And a doctor sees each patient for only a few minutes and goes on what patients say. Unless their attention is brought to a certain symptom or problem, they have no way of knowing it's going on.
Document specific behaviours, including times of day, what she said or did, what else may have been going on (did she just wake up, when had she eaten last, who else was present, unusual circumstances or stresses, distractions). Don't try to interpret or edit, just document, then compare your list with a checklist for dementia.
At the same time, don't assume that all memory loss or confusion is dementia, or that all dementia is incurable. There are 80 known types of dementia, 50 are reversible. Many other illnesses and conditions cause confusion, disorientation, memory loss, even psychosis in the elderly. Seek medical advice, don't make assumptions.
The elderly may not display illnesses the way younger people do. Urinary infections can cause what appears to be dementia or even raving psychosis in a senior. Low levels of salt or elevated calcium can cause confusion and memory loss, and can be life-threatening. I said at the memorial service for my parents, "there is nothing to be gained from denial or delay." The principle in all elder care is "sooner rather than later." Don't wait for a crisis to force you into making a decision.
Bridges of Imagination
I often think about bridges. My father was an engineer, working for the Department of Highways in the Canadian province of BC for 37 years. His working life was spent dealing with bridges and roads.
I think bridges are possibly the ultimate marriage of imagination and function. Most people just drive on them. A few bridges are well-known landmarks: the Golden Gate, the Brooklyn Bridge, Lions Gate Bridge in Vancouver. Bridges can be seen as beautiful structures even by people who have no concept of what goes into designing, building or maintaining a bridge. Or bridges can be just a way to get to the other side.
Just think about it for a moment. If you look at a river or a canyon, do you see in your mind's eye a way of crossing that expanse, or do you see an impassable obstacle? Most of us see the space, we don't envision any way of getting across it. Yet engineers and bridge builders can imagine a bridge where no bridge existed before. And this is not just a vision or a dream, they also see how to go about building it.
Today, there are 6 main types of bridges. The ones I mentioned above that are landmarks are all suspension bridges. I won't go into all the types here; you can look them up on Wikipedia yourself if you're interested. When you imagine creating a bridge, you probably think, okay, toss a log across the stream. What if the stream is wider than the longest log you have available? Hm. Maybe pile up some stuff in the river to hold up the place where two logs meet. Okay, that can work. But there's a limit to that. You need a lot of long logs, and if you're going to take anything across there, like a wagon, you need a bridge deck, so now this is getting complicated. And how many rocks will you need to hold up all this stuff? If you pile up enough rocks in that river, you might stop the river from flowing so your bridge is now a dam, and you have a bunch of new engineering problems.
Arches are one way of solving these problems. An arch is very strong, so it can support a lot of weight on fairly slender piers. The Romans did this, and lots of Roman and medieval bridges built with arches are still standing.
All bridges are always a compromise, a balance, among several factors: how much traffic the bridge will bear, the length needed to span the river or canyon, the force of the river, the force of wind, the weight and shape of the bridge itself. A bridge has to stand up to the dynamic load of people and vehicles crossing as well as hold up its own weight. Yet the bridge also has to allow water to flow under it.
Building a bridge means planning out every step ahead of time. With some of the ancient bridge building methods, you may just build out from solid ground. Sometimes, you need to create falsework, essentially building a temporary structure that allows you to build the bridge, and once the bridge is complete, the falsework is dismantled.
A suspension bridge is a feat of daring as well as engineering. There are photos of the Lions Gate bridge under construction that show the bridge deck suspended from the middle of the supporting cables, before the deck was extended out from the towers. Other suspension bridges were built by extending the deck out into space from each tower. Imagine what it takes to imagine that. Imagine what it takes to come up with the plans to make that happen. Imagine what it means to be so sure you can do this, that you go ahead and get it done. That entire crews will do what you ask and work long hours hundreds of feet above the ocean, or down in a caisson under the water, to fulfil your vision.
No-one builds bridges alone. Every bridge takes many people, tools, equipment, material, time. Materials need to be tested; on a suspension bridge, even the weight of the paint must be considered.
Yet any bridge begins with the vision of one person who thinks, "we can build a bridge across there."
Below: Nelson Bridge, Nelson, BC, spans the West Arm of Kootenay Lake. It was built in 1957; before that, a ferry took passengers and traffic across the lake. Originall silver, around 1970, it was painted orange under the direction of H.J. Kelsall, Bridge Engineer for Region 3, Department of Highways. That decision was controversial at the time, but later, Big Orange Bridge, BOB for short, became an icon of the City of Nelson.
H.J. Kelsall was my dad. It takes vision to build a bridge. It takes vision, and a fair degree of courage, to paint a bridge orange!
Paleo and Me
A few weeks ago I stumbled onto a Paleo food blog and realized, "this is for me!" Since then, I've bought or ordered about 6 books on Paleo and cooked up a storm!
If you're having trouble tolerating foods, read on. If you just want to know what the fuss is about Paleo diets, there's a reading list at the bottom of the note.
For years, I suffered from unknown respiratory problems every winter. In 2008 I went to Morocco and came back with a sinus infection, went on antibiotics for 14 weeks, on and off, which is guaranteed to devastate your immune system and intestinal flora. That fall, I realized I had food allergies and sensitivities. I went back to Morocco for 6 weeks that winter, which, oddly enough, changed my life, maybe saved it. I HAD to find food I could eat, and there's almost no processed food there. Everything is fresh and seasonal. And if I could read food labels in French, well, surely I could feed myself in Canada!
The next year, my father developed cancer and died, my mother was diagnosed with dementia. I had to move back to my hometown to help her. This was highly stressful for both of us. My hometown is a good place to have unusual food needs, so I was able to find things I could eat there, but I was not motivated to cook, and food was not a source of pleasure. I've been an avid cook all my life, so this was a hard time. It was, at best, a holding pattern.
My mother died in 2011, and that year, I gained 40 pounds. Part of it was diet, I know. I'd started eating grains again, comfort food, and too much fruit and sugar. In healthy forms, but too much for my system.
I'd heard about Paleo before, but never looked at it in depth. When I did, I realized that this method of looking at food avoids all the foods that cause me problems. And the point of Paleo is not just to avoid foods known to cause problems for many people, but to enjoy the foods you CAN eat. It's not about deprivation, it's about seeing food as something that will make you whole and healthy. Food is medicine.
Above all, take control of what you eat.
There are several underlying concepts behind the Paleo diet concept, which is not a diet so much as a lifestyle. A primary one is that for more than a million years, human beings were hunter gatherers. Agriculture is a recent development in our history, and ten thousand years or less is not enough time for all humans to adapt completely to thriving on a diet of mostly grains and grain products. But more importantly, even if our ancestors ate grain, it was in a more natural form than the highly processed products we see in stores now. Stone ground whole wheat or sprouted rye is a very different substance than white flour. I'm not even going to talk about all of the refined starches and sugars we ingest. The single highest source of calories from carbs in the US is high-fructose corn syrup. Not wheat flour or corn or even sugar in a form you can see. It's in food you don't even know it's in, in forms you can't recognize, and it's so highly caloric, it's the biggest single source of calories we get from carbs today.
Similarly, modern milk products are nothing like whole fresh milk straight from the cow or goat. The more processed a product is, the less like real food it has become. Low fat milk products are full of carbs and sugars.
If you know anything about food allergies, you know that there are 8 or 9 known deadly food allergens: milk, eggs, soy, peanuts, wheat, seafood, sulfites, tree nuts and sesame. And guess what? Four or five of these are in pretty much every processed food sold in North America. Talk about a recipe for creating allergies, even in people who were only mildly sensitive!
There is a syndrome called "leaky gut," which is not accepted by some medical authorities but has the support of many scientists. Leaky gut happens when you eat foods that irritate your intestinal tract, go on antibiotics and destroy your normal intestinal flora, and some other problems. Your intestines, like your skin, are a primary barrier to toxins, allergens and irritants. Maintaining the integrity of your intestinal barriers is important to good health. You may not be aware of irritation; it may only affect you on a cellular level. In a simple form, think of it this way: the cells lining your intestines have several layers, and as these get irritated and inflamed, they swell away from one another and there will be tiny gaps between these cells. Entire particles can leak through the walls of your intestines into your blood stream, and when they do, they're targetted as invaders by your immune system. This may create more allergies or food sensitivities. It also leads to further inflammation, which may happen in parts of your body unrelated to your digestion. Auto-immune disorders such as hypothyroidism, inflammatory disorders like fibromyalgia or arthritis, even illnesses as seemingly unrelated as heart disease and diabetes may be triggered or made worse by eating foods that irritate your gut.
If you're finding you're becoming sensitive to more and more foods as time goes on, it may not be age or bad genes. It may be the food you're eating that's leading, in a roundabout way, to heightened sensitivities. You may not know which foods cause these reactions; a food reaction can take as long as 72 hours if it's not a direct allergic reaction, so you may not be able to trace cause and effect.
An allergy is a response of your immune system. This will rarely be an intestinal reaction, but hives, itching, swelling, headaches and anaphylactic shock. An intestinal response (nausea, vomiting, dairrhea, constipation) is an intolerance and rarely caused by an allergy as such. There are also food aversions, that you simply cannot get a food down without gagging. And there are sensitivities, which can take many forms. If the problem you have with a food can be treated with digestive enzymes, it's an intolerance, not an allergy.
If you have a problem with stomach acid, see a doctor to be sure you don't have damage to your esophagus caused by acid reflux. But the sensation of acid stomach can actually be caused by not enough acid in your stomach to digest your food properly, which can be caused by an imbalance in your system. This may be the result of recent food poisoning, antibiotics disturbing your intestinal flora, or just eating the wrong foods for a long time.
Practical Paleo (see below) gives some good, concise information about digestive problems and intestinal health.
None of this advice is meant to be a substitute for seeing your doctor or a good nutriitionist or naturopath. There are other factors to optimal health: get enough sleep (it's NOT for sissies!), reduce the stress in your life, find ways to focus on the positive. If you find yourself always cranky or sad or angry, talk to your doctor and see if you have a physical problem or a psychological problem that can be treated. Being in a negative state all the time is a serious health risk, to you and the people around you. Get some exercise, even if it's just a walk. Do something fun. Make stuff so you feel a sense of achievement. And eat good food.
Eating well is more than avoiding the bad stuff. It's about eating a variety of healthy foods that nourish your body, provide nutrients you need, and nourish the good bacteria we need in our systems to help our bodies do the work they do to support us.
One author I read recently said we started to see the onset of "diseases of civilisation" at the same time science began its reductionist way of looking at food, in terms of calories, carbohydrates, proteins and fats.
Heart attacks were unknown as recently as 200 years ago. Cancer was not a feature of life and dementia was uncommon. And this is not because people used to die too young to get this stuff and we live longer; we don't. The notion that people in the past died young is based on skewed statistics. Infant mortality was more common, and even a few people dying before their first birthday pulls the "average" lifespan of a population down quickly. Infection killed people, and accidents often spelled certain death. But the people who DID survive often had just as good a chance of living to a ripe old age as we do. And studies have shown that their teeth were better and their bones were stronger than ours are.
We don't know what the long-term effects of a diet of soda pop, skim milk, burgers, frozen pizzas and store-bought cookies will be. Elderly people alive today grew up on a very different diet than we eat now. I mean, who eats liver anymore, or makes soup from scratch?
The biggest single environmental factor in your health is what you eat. And it's one thing you CAN control.
Food should be about what tastes good, and what has been demonstrated, through millennia, to make people feel stronger and healthier. And if it can be local, fresh and seasonal, even better.
Most of the books below have commonalities. Practical Paleo is great for basic knowledge and a one-stop resource for science, nutrition, shopping tips and recipes. The best books for understanding the science are Deep Nutrition and Primal Body, Primal Mind. Well Fed has wonderful, practical tips for cooking from scratch even if you're living a hectic modern lifestyle. And great recipes from global cuisine!
Most of what's in these books I've read in other places, so this is not weird science. Why isn't your doctor telling you this stuff? Besides the oft-noted fact that most doctors get only a week of nutrition in medical school, doctors also are trained to TREAT health problems, in a practical applied-science way. They are not necessarily trained to track a problem to its root cause. They don't have time to do that in 10 or 15 minutes with each patient.
Our medical system is dominated by a corporate mentality, and by corporations that manufacture drugs. I'm not a fan of conspiracy theories and I'm not an anti-corporate crank. I'm sure most doctors are sincerely interested in making people well. However, when I read that pharmaceutical companies WANT to sell drugs to healthy people, that there's money to be made in promoting illness and no money to be made in making people healthy enough not to need drugs, the penny dropped. We need to take control of what we eat, and we need to stop focussing on poor health and what can go wrong, and focus on good health and what we can do RIGHT!
Even when I was living in my old hometown the past 3 years, living with a lot of stress, I had one cold. Just one. Clearly I was doing something right. I'd like to carry on along that same track!
My husband and I used to save bones and make soup stock. He had clear signs of arthritis, yet no degeneration or pain. After a doctor commented on this, we realized the soup made from scratch was likely why. Bone broth is a cornerstone of the Paleo lifestyle. It puts back into our bodies many of the nutrients we need to keep our bones, connective tissues and even blood vessels strong and supple.
If you tolerate dairy, eat whole milk. Eat real yogurt and real cheese. Don't eat processed dairy, which is hardly even food anymore. "Low fat" foods are full of sugar and other weird stuff. Don't let them in your house. Eat liver once in a while. Eat lots of vegetables and some fruit. Buy local organic produce in season. Use your freezer. Make food from scratch. If you think you're too busy, read Well Fed, which has some fabulous tips on how to eat nutritious delicious food even if you're busy.
There are other principles, but those are the basics. This is not weird food. Nobody says you need to eat a mammoth or crunch down bugs or anything.
Above all, don't take my word for it. Read some of these books. Google "paleo" and see what comes up. There are a few people making money from this, but on the whole, nobody is going to get insanely wealthy from telling you to make your own soup stock and sauerkraut, and buy produce from your local farmer's market.
Ignore the science and this is really just Grandma's kitchen. My grandmother lived to be 97. If you left her table feeling full, it was from too much chicken or roast beef with homemade gravy and Yorkshire pudding, not because you made yourself sick with too many tortilla chips or Dingdongs. Okay, maybe not everybody's grandma cooked like that. Both of my grandmothers were good cooks, they had gardens and grew fruit and raised chickens. They bought beef from the farmer down the road and made soup from bones and scraps. Those Grandma meals made people strong and healthy.
Since I've been shopping for food the Paleo way, I'm bringing home bags and bags of groceries, but because it's all whole food, it costs me $15-25 a bag. Thirty years ago, I figured $20 a bag was good shopping, so this is not costing me a fortune. Seeking out grass-fed or free-range meat and eggs will cost more, high quality produce can cost more, but there are ways of reducing these costs: go in on buying a whole cow or pig with friends, join a CSA to get organic produce regularly, shop at a farmer's market, buy in bulk, get friendly with local farmers, buy a freezer, grow your own fruits, vegetables and herbs. Any or all of these things also help support your local or nearby producers and businesses, and help create stronger communities, which are good things!
The books I've been reading are:
Make It Paleo: Over 200 Grain Free Recipes For Any Occasion by Bill Staley, Hayley Mason and Mark Sisson
Practical Paleo: A Customized Approach to Health and a Whole-Foods Lifestyle by Diane Sanfilippo, Bill Staley and Robb Wolf
Well Fed: Paleo Recipes for People Who Love to Eat by Melissa Joulwan, David Humphreys and Kathleen Shanno
Deep Nutrition: Why Your Genes Need Traditional Food by Catherine Shanahan and Luke Shanahan
Primal Body, Primal Mind: Beyond the Paleo Diet for Total Health and a Longer Life by Nora T. Gedgaudas
It Starts with Food: Discover the Whole30 and Change Your Life in Unexpected Ways by Melissa Hartwigand Dallas Hartwig
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Caring for yourself as a Caregiver
The time you put in as a caregiver for someone with dementia may eat into your life in many ways, it may disrupt your social life and relationships. You may spend your own money on your parent, maybe because they lose the capacity to handle money. My mother began to panic about counting cash, and could not retain sequences of numbers or write cheques without help, but kept her ability to use a credit card until PIN numbers came into regular use. With that, she lost all of her financial freedom and had to rely completely on me or whoever she was with. This is intensely frustrating for the parent, and creates many levels of concern for the caregiver.
All of these factors affect your mental state and your health. I did not live with my mother, for several reasons, but if you live with your family member, your mental and physical health may be even more compromised.
Get support. Find a support group in your area, take a class, find a counsellor. I spent two or three months seeing an Elder Services counsellor with Mental Health, for "caregiver support." Being an adult child caring for a parent brings up many issues. You may have buried resentment or frustration, or issues unrelated directly to your parent, but being in this situation brings them to the fore. Seek help if you need it. If all else fails, try keeping a diary where you write or type out what you're feeling and thinking.
If you have a friend who's been through this, talk to them. There are support groups online if you can't get out. In my community, there was even a caregivers support group held in the afternoon, because many caregivers have to be at home in the evening.
Talk to your own doctor about your situation. Being a caregiver is a significant health risk and your health care provider needs to know that.
You need to do whatever it takes to be healthy, for your own sake and for your parent's sake. And ideally, you want to survive this and go on to have a healthy and happy life.
Make a point of thinking about what you eat. The temptation is to eat comfort food, junk food, fast-food. Every day seems like a crisis, like there's never any time to plan, and it all blurs together. But this is not a temporary crisis, this is your life, and you need to be properly nourished. If food is not your thing, ask a friend who likes to cook for help planning meals. Lay in supplies of easy to prepare foods, healthy snacks and so on. Try to plan the food in your house so you aren't tempted to eat stupid stuff. Your community also probably has resources such as Meals on Wheels. Take advantage of this. Meals are offered at cost and delivered by volunteers. Your parent will certainly qualify, and as a caregiver, you will also. You may even find that your parent's meals can be paid for or subsidized by programs such as Veterans affairs. Research the take-out places or food-for-delivery places that offer nutritious tasty food, and keep those numbers handy. Make eating properly a priority.
Get enough sleep. You are not strong enough to act as a caregiver AND go without sleep. No, really. Sleep is not just for sissies, it's how you recover from your day and how your body restores itself. If you have persistent sleep problems, talk to your doctor. Any health issues you already have will be seriously affected by lack of quality sleep. Take drugs if you need to. You may be depressed or anxious during this time, even if you aren't normally.
If you drink alcohol or use drugs in a recreational way, be aware of the temptation to resort to this. Use mood-altering substances with respect. I would sometimes have a one or two drinks, never more, if I'd had a particularly aggravating day, but I didn't keep easy-to-drink alcohol in the house as a rule for the entire time I acted as a caregiver for my mother. Getting blotto or being hungover is not going to help you cope, no matter how tempting it may seem to step into an altered reality. Find other ways of coping, at least until this is over.
Exercise is a good thing, even just a walk around the block. You may try calming practises, such as yoga, or meditation, but you may also find that these make you more anxious. Some people need to be even more physical than they might normally be, to get rid of frustration and pent-up energy.
If you belong to a church or spiritual community, this may be a good place to turn. Ritual can be calming and reassuring. You may want answers and talking to a minister or priest or other spiritual advisor may be beneficial. If your own spiritual advisor is not trained in pastoral counselling, they may be able to refer you to someone who is.
Find hobbies you can use as distraction. This might be knitting or other crafts, computer games, crossword puzzles. I found that watching TV was the worst thing for me, because it was passive. I needed to be more actively involved in order to stay focussed. Colouring books might be good, or doing sports. You may need to find things you can do alone, because your schedule no longer matches that of your friends. But if you can find time to play cards or other games or activities with friends, go out dancing, go for walks, this will go a long way toward keeping you sane and focussed.
Sense of humour is key! Seek out funny movies to watch, funny books, anything that can lighten your mood. Find ways to laugh with your parent. Laugh at yourself.
It's easy to say, "take time for yourself," but incredibly hard to do that when your parent has needs. With dementia, any small thing can become a crisis, because the person no longer has the ability to cope or to find an emotional balance. You have to become the problem solver and figure out what's upsetting them, how to calm them down, and how to fix the problem. Doing this all the time can become exhausting. If you are also providing physical care, doing housework, paying bills, your life can be completely taken over by this role. Even if your parent gets care from others or is in a care facility, there's rarely a moment in the day when you're not thinking about them, worried about various issues you are now responsible for.
I had no other family obligations when my mother needed me. You may be balancing the needs of children, spouse, siblings and other family members, with the needs of your elderly family member. There's the criticism that can come from friends and family, the well-meaning advice, the suggestions, the remarks they make after a visit where they saw "nothing wrong," and wonder why you feel the need to have your parent in care. And then there are the people who can't help but see your situation through their own needs and emotions, of their fears or sense of guilt about their own parents.
You need to find out how to protect your parent in the event of incapacity, such as an Enduring Power of Attorney for yourself, a Representation Agreement for you to make medical decisions for your parent, an Advance Care directive or plan so you aren't faced with making mind-boggling decisions about end-of-life issues when you're in a crisis state. You also need to consider financial planning, for your parent and for yourself. And face the fact that you may die or become incapacitated before your parent dies, and make a two-tier plan to care for your parent if you're no longer able.
You also need to be aware of the perceptions of others, and that caregivers may be suspected of taking advantage or abusing their elder. Keep accurate records, keep receipts, don't mingle your money with theirs. Even if you have to place their groceries on the conveyor separately from yours or write two cheques, keep their affairs separate from yours as much as humanly possible, so you can show the details if there is ever a question.
I cannot provide advice on dealing with difficult family members, but this is very much a problem for many caregivers. You are not alone in this. It's particularly prevalent when some family members live far away and aren't seeing the elder frequently. They may talk to the elder on the phone and hear the complaints and excuses, they may only see the parent when they're on their best behaviour during a visit and they may assume they know more than the people who are handling things daily. This is so common, it has a name, the Sister from Saskatchewan or the Sister from Seattle.
The number one tip I can pass along is that you are not alone in this. Many people have walked this road before you, or are walking it right now. If someone in your family has dementia, recognize that it's a physical illness, not a mental illness, not a character flaw, not an indictment of your family. It's not your fault. You didn't bring this on yourself or wish for it or somehow enable your parent into being this way. It's an illness, like cancer or pneumonia. Tell everyone you know, everyone you deal with, from the banker to the plumber to your friends and co-workers. Sometimes you need time away from that set of problems and you dont want everyone to know, but you'll find that most people are very sympathetic, and may even offer advice or solutions you may not have thought about. You may find that friends have been through this or are going through this, and that you already have a support group or network in place that you weren't aware of, until you needed it.
The Alzheimer Society has some excellent resources, including support groups, classes for caregivers, online classes and groups, and plenty of articles and information online. Google them for information specific to where you live.
I'll add links to pages with information and resources in coming days.
I'm easily amused. I try to be positive about things, yet I am also driven to distraction by irrationality. Especially if the purpose is valid, but could be achieved with less drama. You'll see all of this in my writing!