HEALTH

My food revolution: how I fell in love with the gluten-free diet | Digestive disorders

Published

3 days ago

March 18, 2023

IIt all starts with a strange tingling sensation on my tongue as I board the tube in central London. After about five minutes, I start to wonder if I’m feeling a little faint (or is it just really, really hot in here?). After 15 I know: I will vomit all the contents of my stomach into a bag full of fruit from my friend’s father’s garden. “Get some apples and pears from Normandy,” she said charmingly just an hour or two ago as we sat down to my 40th birthday afternoon tea. She had no idea what horror was about to befall that harmless little bag.

A few minutes later, as I stood on the side of a road in north-east London, vomiting into a trash can in broad daylight, it occurred to me that people must think I was drunk. But alcohol has nothing to do with my current predicament. You can only blame the buns for this. Or maybe sandwiches. I certainly have my suspicions about the dainty little pie whose dough tasted so good, so buttery, so, well, not gluten-free, which I double-checked with the waitress. But the fact of the matter is that you suffer from celiac disease: you are often not quite sure who is to blame. You just know that there was a crime and your poor, long-suffering gut became a victim.

Near the end of a pasta-filled two-year stint in Italy as a Guardian correspondent in Rome, I realized that something was seriously wrong with what my mother would have called my “innards.” I remember calling her after a trip to Venice (I think it was to cover George Clooney’s wedding show – here’s a good contrast) convinced that the excruciating laryngeal spasms and debilitating fatigue I was experiencing were caused by giardia, a tiny parasite, spreading diarrheal diseases. “But it says on the Internet that usually Giardia only gets infected when traveling to remote places where there is no clean water,” my mother said or something, softly and dubiously. “I was in Venice!” I lamented stubbornly that the sharp waters of the Grand Canal had bedridden me. I didn’t cheat on any of us.

A few months later – after weeks of mysterious and relentlessly unpleasant gastrointestinal symptoms – I finally went to see a general practitioner in Britain. I went to the doctor on a gloomy vacation in the US, when I was practically unable to leave the apartment, but they prescribed antibiotics, which did nothing and stung several hundred dollars, so I was not optimistic. But I was in despair: my illness began to dominate my life. I lost a lot of weight. I was so weak that I ended up leaving Italy without telling a lot of people because I just didn’t have the strength – physical or mental – to call them, let alone meet. (If you are one of them, sorry.)

But this doctor was wonderful, and it was only in hindsight that I realized how extraordinary she was. When she heard about my symptoms, she immediately referred me for a blood test, and a few days later she called me at work to break the news: blood tests showed that I was severely anemic and had celiac disease. What did I remember saying, that gluten thing? Never! When I was really sick, the only thing I could stomach was these little salty wheat crackers; I’d eat them in packets and packets… Oh. The gears of my brain began to slowly turn.

I got lucky with my doctor. I have since learned that many people struggle with all the symptoms of celiac disease for years – bloating, diarrhea, vomiting, heartburn, brain fog: a veritable smorgasbord of pleasures – and have never been diagnosed. Whatever the case, I was told to continue eating gluten until I had a biopsy that would confirm my diagnosis by showing damage to the small intestine. And then? What treatment would I like to know? When can I get back to crackers?

A gluten-free diet is the only option for people with celiac disease. Photographer: Jill Meade/The Guardian

The answer was short and straight forward: never. The only way for a person with celiac disease — an autoimmune disease that, if left undiagnosed, can lead to slow organ damage and colon cancer — is to give up gluten forever. Now, given that this protein is found in wheat, rye, barley and, due to the high levels of cross-contamination, oats, this may seem like a giant problem. This means, obviously, no (regular) buns, cakes, sandwiches. That also means no beer, no Colman mustard, no soy sauce. Don’t try this street food, don’t risk a new chip, don’t linger at the holiday buffet.

This is the end of one era of your life and the beginning of another. Of course, there is a sense of loss. But by this point, many people are so excited to finally find the answer to their problems that they’re ready to start over. Of course I was. It was disturbing enough to hear about my anemia, which was so severe that my doctor said that in previous years I would have been hospitalized. (These days, commercial-strength iron pills have done the trick.) On top of that, a bone scan showed that I had osteopenia, a precursor to osteoporosis. I was in my early 30s. The consultant said that I had probably been suffering from celiac disease for about ten years without even knowing it.

So I was desperate to feel healthy and energized again – although I did wonder if it had been so long ago that I forgot how it felt. I rushed to decipher this new and unfamiliar world: one of looking at every label on every food to see if I can eat it or not (at first I was confused, but now I do it without even thinking about it, my brain is like barcode reader). Shopping took a lot longer. Eating out at restaurants was a minefield. (I’m lucky my partner is a fantastic cook – I’m hopeless.)

Going to visit friends was painful. It’s incredibly difficult, especially if you’re a chronic caterer like me, to tell a person who has struggled to make something gluten-free that you still can’t eat it because they added one banned ingredient or used the same the pan for regular pasta and pasta GF or got sprinkled with soy sauce at the last moment or, well, the list of annoying potential mistakes is unfortunately endless. It’s better for everyone if I just bring mine. I do the same thing when I travel abroad for work, which on the one hand is heartbreaking in countries like Lebanon with one of the most delicious cuisines known to man, but honestly it’s easier to report if you’re not trying to vomit in your purse and I’d rather not risk it. Having said that, the best gluten free bread I have ever had was in Bethlehem.

If you are reading this because you have recently been diagnosed, please do not worry. You will feel healthy again! You will enjoy food again! It will be a little different, but in a few years you won’t even notice. It becomes normal. There is a huge variety of gluten-free products in stores that celiacs could not even dream of 30 years ago. M&S Made without wheat the range is my personal favorite although it’s not cheap and I’ve recently discovered Leigh’s Gluten Free Bakerywho makes delicious focaccia and delivers celiac-friendly donuts to my door: a dream! Oh and I know what I said wasn’t soy sauce, but really Tamari also good.

While it may not seem like it at first, you can still eat a huge variety of foods on a gluten-free diet: fruits, vegetables, legumes, potatoes, rice, and, depending on your diet, dairy, meat, and fish. If anything, my diagnosis has made us cook more from scratch and healthier for the whole family. Our children are well aware of the gastrointestinal tract: a five-year-old child has been known to very dramatically mimic with his whole body the collapse of the villi of the small intestine, defeated by a mortal enemy: wheat. I found best gluten free pastries in Paris and mastered the art Sticky Toffee GF Pudding.

One day, maybe I’ll even be able to venture out for afternoon tea again. But not anytime soon; I still have memories of this bag.

Related Topics:diet digestive disorders fell food glutenfree Love Revolution

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HEALTH

Ozempic shortage: Diabetes patients at risk as TikTok and telemedicine prescriptions fuel drug demand

Published

1 day ago

March 20, 2023

Irene Skeete

CNN
—

Telemedicine and social media are playing a significant role in boosting demand for Ozempic, a prescription drug for type 2 diabetes, experts told CNN. The current shortage of drugs is limiting access for diabetic patients who rely on them to control their blood sugar levels.

Digital health companies are making it easy to get medicines like Ozempic by providing online prescriptions. Many advertise quick and easy access—sometimes same day—access.

“Oddly enough, getting a cure is almost easier [via digital health companies]said Dr. Disha Narang, endocrinologist and director of obesity treatment at Northwestern Medicine, Lake Forest Hospital. “But not always the safest.” People who reported average weight on online admission forms were still offered an anti-diabetic drug, Narang told CNN.

Partly because of the popularity of Ozempic, the market for prescription weight loss drugs has grown significantly, according to MarketData Enterprises, an independent research and consulting firm. The market has outperformed forecasters’ expectations for 2022 and is expected to be a nearly $2 billion industry by 2023.

WeightWatchers is also tapping into the field of prescription telemedicine. Last week, the company bought a subscription to a telemedicine service that helps patients connect with doctors who can prescribe weight loss and diabetes medications.

“At the beginning of 2022, these companies were not marketing this material,” Narang said, noting that Ozempic advertising began in 2022. “I think we really need to start questioning our ethics in this regard.”

When it comes to the application processes for digital healthcare companies, there are a few general requirements, says Dr. Bree Holtz, an assistant professor of telemedicine at Michigan State University, told CNN. Once the patient completes the required online forms, the information is passed to the in-state provider, who can write the prescription. Some companies require the patient to switch to a video or phone call with a provider – others require neither.

“It’s a little scary that you can just wake up and make an appointment – or these medications – and you won’t be taken care of,” Holtz said.

Telehealth has been a game changer in providing access to healthcare, especially during a pandemic. And especially for people living in places where high-quality primary care isn’t available, direct consumer telehealth services can help fill the gap, the doctor said. Lori Buis is an assistant professor of family medicine at the University of Michigan whose research focuses on digital health.

However, when patients start seeking selective treatment from select providers, Buijs says it opens the door for issues such as fragmented care or abuse. Telehealth providers may not have access to a patient’s complete medical history and may be less able to provide comprehensive care than a primary care physician would otherwise be able to.

“I have no doubt that some of these services are doing their job well,” Buijs said. “There are also services that don’t take it that seriously. And that worries.”

The U.S. Food and Drug Administration first announced a shortage of Ozempic last August. Supplies are likely to be overloaded until mid-March, according to the FDA drug shortage database.

According to a JP Morgan analysis, Ozempic prescriptions in the US reached an all-time high in the last week of February, with more than 373,000 prescriptions filled. IQVIA Data shared with CNN. This is 111% more than the same week in 2022.

According to a CNN review of JP Morgan’s analysis, more than half of these were new prescriptions.

With so many patients relying on Ozempic for their diabetes, providers like Narang struggle to figure out which alternatives to prescribe to their patients.

“We receive daily reports that patients cannot get their own medicines,” Narang said. “It’s been tough for both patients and providers.”

According to a JP Morgan analysis, Ozempic currently holds over 40% market share in the US for glucagon-like peptide 1 (GLP-1) agonists, a class of drugs that mimic the appetite-regulating hormone. These drugs work by stimulating the release of insulin, which helps lower blood sugar levels. They also slow down the passage of food through the intestines.

Ozempic has grown rapidly in popularity since it was first introduced to the market in 2018. The drug has been used safely and successfully to help diabetics lower their blood sugar levels and achieve diabetes remission, Narang told CNN. According to her, Ozempic is the most powerful of all GLP-1 drugs.

Behind the Ozempic brand is the drug semaglutide. While Ozempic is used primarily to treat type 2 diabetes, another drug called Wegovy – also semaglutide – is approved specifically for chronic weight management.

Although FDA approved in 2021For most of last year, Wegovy was unavailable, Narang said, so people turned to Ozempic. According to the FDA drug shortage databaseWegovy has been in short supply since the end of March last year, but was back in stock earlier this year.

The social media hype around these two drugs picked up in early 2023. Celebrities shared their testimonies of how semaglutide helped them shed those extra pounds. Elon Muskfor example, publicly credited Ozempic and Wegovy in part for his weight loss.

#Ozempic and #Wegovy have been “extremely popular” on TikTok over the past few months. according to company analytics.

The use of Ozempic and Wegovy for short-term weight loss has had real implications for patients who need drugs for diabetes and chronic weight management, Narang says. For example, some insurance companies have reportedly refused to cover Wegovy in the past, some call it the “vanity drug”.

Both drugs are intended for long-term use, not for short-term weight loss. Their appetite-regulating effects disappear quickly after you stop taking them.

“It’s not a cure to shed the last 5 or 10 pounds to get ready for an event or something like that. It’s not for use within three or four weeks, Narang said. “When we think about weight management, we think about the next 25 years of someone’s life.”

HEALTH

It’s Time to Dedicate Yourself to Raising Children – Chicago Tribune

Published

1 day ago

March 20, 2023

Irene Skeete

Dear Amy! I have a very difficult and tense relationship with my mother, and I don’t know what to do about it.

Now I am 19 years old.

My mother is a drug addict and alcoholic, and because of this, she missed most of my early childhood.

When I was about eight, she finally sobered up, but she still had a lot of psychological problems, most likely from years of substance abuse, and she never matured.

She thought only of herself. She hurt me over and over again. She put her motherhood on hold and wasn’t there for me.

I finally had enough when she missed my high school graduation last year. She then lied to me about why she missed it (turns out she was at home the whole time).

I tried to tell her how much it hurt me. In response, she cried, did theatrics, felt sorry for herself, and, in fact, told me that she was giving up on our relationship because she was “failing all the time.”

I begged her to try to change for me, but it seems she would rather wallow in her own grief and cry about how much I hate her.

I don’t hate her; I would like her to try her best so that we can spend the rest of our lives together.

I didn’t see her for almost a year and didn’t speak to her for several months. I’m completely lost and I have no idea how to deal with this.

– Lost, confused and sad daughter

Dear daughter, you are the child of an addict, and you have taken on the heavy burden that your mother’s addiction placed on you.

And, like many children of drug-addicted and narcissistic parents, you would love to force your parent to change so that you can have the healthy parent-child relationship you so desire.

Unfortunately, your mother is unwilling or unable to change for you.

You can, however, change, and that change must be in the direction of securing your own future health and happiness, as well as accepting the lousy card you have played and its limitations.

Your mother’s erratic and frustrating behavior has taught you to take responsibility for the outcome, but you need to find ways to fold that heavy backpack you’ve been carrying.

Every human being craves love and permanence, and you will find it, but most likely not in your mother.

Now is the time for you to make a commitment to educate yourself (and I feel you will be very good at it).

Trusting and emotionally healthy relationships with others will also help you heal.

I suggest you join a “friends and family” support group such as Al-anon or Adult Children of Alcoholics (adult children.org), and read “Adult Children of Emotionally Immature Parents: How to Heal from Distant, Rejecting, or Selfish Parents” by clinical psychologist Lindsey Gibson (2015), New Harbinger.

Dear Amy! My daughter is engaged to her college boyfriend. Now they live together.

Even though my daughter’s income is well below his, he insists that she pay 50 percent of her expenses. She starts falling behind and goes into debt to keep up.

I would like to know your thoughts.

– Concerned parent

Dear Worried! I’m wondering why your daughter’s fiancé has the right to decide and dictate his family finances?

If they are counting on a marriage in which they will be true partners, then these important issues should be discussed and decided mutually, and not dictated by one partner.

If she manages her money responsibly, but cannot afford to live on these terms, then something needs to change. Ultimately, being in debt is very expensive.

My big point is that this is a red flag. The pressure of duty will add to the pressure of a partner who (at least from this point of view) sounds bossy.

Dear Amy! Like other readers, I was appalled by your response to “Anonymous,” a reader who complained about “free-range” children at family events.

These parents are not only lazy, they are careless. I can’t believe you stood up for them!

– Disorder

Dear Upset! After warning about the dangers and dangers of children running “free range” in other people’s homes, I stood up for these parents.

Anonymous did not mention that these kids were rude or disturbing others – only that they were allowed to run on their own.

(You can write to Amy Dickinson at askamy@amydickinson.com or send an email to Ask Amy, PO Box 194, Freeville, NY 13068. You can also follow her on Twitter. @askingamy or facebook.)