Gluten = my enemy

At the very beginning of May, two of my best friends were in town. It was an awesome thing to hang out Luther-style in South Florida. It's a wonderful thing to have friends around whom you can completely be yourself. I got to walk around in my tank tops and flip flops and feel like I fit in. No high heels, clubs, or fancy drinks here! A sinkful of beer and years worth of memories - it was a fantastic weekend that I was sad to see end! Jane - wish you were there instead of fending off the swine flu in Mexico!! I'd like to think that within the next ten years, we'll all live just a short drive away from each other. During that fantastic weekend, I enjoyed lots of beer, a hamburger on a bun, onion rings, and a giant chimichanga that I continued to stuff down even after I reached full. Little did I know, that was the last chimichanga I'd ever eat at Tiajuana Taxi Co., and likely anywhere else for that matter. It was beyond delicious. I think I will remember it forever.

Our last morning together at Tiffany's hotel on Ft. Lauderdale beach, Jo and I watched Good Morning America, a habit that I picked up from Jo in college. Elisabeth Hasselbeck was featured this particular morning. She was discussing her battle with celiac disease and her new book about it.


Jo said, "Hey - maybe that's what you have!" Jo has known me for a long time, and lived with me for a year in college. I'm pretty sure that I remember a particular incident when her and Josh actually heard me farting from the other room. The more Elisabeth described the problem, the more it sounded like myself. Bloating, burping, extreme fatigue. I bought the book and 2 related ones at Barnes and Noble the next day.

I guess I had come to accept swelling up to the size of a 7 month pregnant lady after meals was normal. Since my freshman year of college, I'd been blaming it solely on dairy. I've been purchasing Lactaid or lactase enzymes since college, although I didn't always remember to take them when I had dairy. The milk in our fridge is lactose free. Yet my problems persist. Could it really be GLUTEN that causes my gastrointestinal system to act so much differently than everyone else's? Gluten - the same thing found in beer, bread, tortillas, cookies, cakes - my favorite foods and drinks??? Also found in BARLEY, the name of my dog?!?!? In my four years of medical education, I don't remember even a single mention of Celiac Disease or Sprue. However, a certain future M.D./Ph.D. that I live with had suggested a few years ago that I may suffer from such a condition. I wish I had taken him more seriously back then. Since that Monday, I've maintained a gluten free diet with only a few rebellions.

I'll try to explain a little bit about the condition.

Definition of Celiac Disease from Mayo

Celiac disease is a digestive condition triggered by consumption of the protein gluten, which is found in bread, pasta, cookies, pizza crust and many other foods containing wheat, barley or rye. If you have celiac disease and eat foods containing gluten, an immune reaction occurs in your small intestine, causing damage to the surface of your small intestine and an inability to absorb certain nutrients.

Eventually, the decreased absorption of nutrients (malabsorption) that occurs with celiac disease can cause vitamin deficiencies that deprive your brain, peripheral nervous system, bones, liver and other organs of vital nourishment. This can lead to other illnesses and stunted growth in children.

No treatment can cure celiac disease. However, you can effectively manage celiac disease through changing your diet.

SYMPTOMS

There are no typical signs and symptoms of celiac disease. Most people with the disease have general complaints, such as:

• Intermittent diarrhea
• Abdominal pain
• Bloating

Sometimes people with celiac disease may have no gastrointestinal symptoms at all. Celiac disease symptoms can also mimic those of other conditions, such as irritable bowel syndrome, gastric ulcers, Crohn's disease, parasite infections, anemia, skin disorders or a nervous condition.

Celiac disease may also present itself in less obvious ways, including:

• Irritability or depression
• Anemia
• Stomach upset
• Joint pain
• Muscle cramps
• Skin rash
• Mouth sores
• Dental and bone disorders (such as osteoporosis)
• Tingling in the legs and feet (neuropathy)

Some indications of malabsorption that may result from celiac disease include:

• Weight loss
• Diarrhea
• Abdominal cramps, gas and bloating
• General weakness and fatigue
• Foul-smelling or grayish stools that may be fatty or oily
• Stunted growth (in children)
• Osteoporosis
• Anemia

What I personally experience: FATIGUE, pot-belly bloating, anxiety, irritability, belching, farting, anemia (borderling), lactose intolerance, problems with enamel on my teeth, decreased padding on the bottom of my feet, family history of auto-immune disease... all findings associated with CD

The only treatment: gluten free-diet. Perhaps I wouldn't have been as likely to go G-free if I hadn't seen that a possible side-effect of untreated CD is infertility (we all know I have baby fever), GI cancer, and increased liklihood of auto-immune disease. I should make it clear that we're not 100% certain that I have this actual disease. And actually, I really hate even calling it a disease because of how some people interpret that word. What I can tell you is that after going gluten free, I've had much more energy. I'm in a better mood in general. I can fall asleep without burping and farting. When I have broken down and snuck a little gluten back in my diet, I have been awaken in the middle of the night multiple times due to pain from my abdomen swelling up. I can only imagine what is going on with my intestines in those situations. At the very least, I have a sensitivity to gluten. Eventually, I will go see a doctor to get the proper diagnosis (celiac disease vs. gluten intolerance), but I am unwilling to give up the time or the money at this point. Especially when all the doc will say is "eat G-free and you'll be just fine" for both situations. I'm already doing that, although it's hard to accomplish.

No more homebrew for me. Brian brewed 4 special kegs for my graduation, and I didn't get to have any of them. I have to make special gluten free pizza at home rather than ordering delivery. No more Honey Bunches of Oats in the morning. Eating at restaurants is very difficult. If I order a hamburger and it comes with a bun, I can't just take the bun off and eat it. Gluten contamination happens very easily. I scoffed at this at first. I couldn't be that sensitive to gluten, right? Well, certain experiments at home have showed that I am. Although this G free thing is somewhat of a pain in my ass, I'm really, really happy to have discovered this diet. I'm feeling great. As my family and friends who will be eating with me at any point in the future - please don't feel burdened by my new diet. I'm able to find something I can eat at almost any restaurant, even though I may have to have a conversation with the waiter or cook about keeping my food safe. I'm getting used to bringing my own food along with me, just in case where I end up doesn't offer anything gluten-free. At my graduation dinner last Saturday, I chose the chicken meal months before starting this diet. I came hungry. When they sat chicken wrapped in phyllo dough with stuffing in front of me, I caved and ate it. My stomach immediately started churning and I was awake in bed burping with a swollen stomach much of the night before my actual graduation. I won't make that mistake again. Well, at least I think I won't. I'll concoct ways to make Grandma Deegan's macaroni and Hunerdosse lemon cookies in a G-free way, but that doesn't mean I want anyone else to give up the G-full versions!! I really don't want to burden anyone. Now it's just a little more complicated. Brian is extremely supportive, eating all the G-free stuff I'm cooking at home. And he seems to really like it! And we've both lost weight. I finally feel full after meals. I suspect that's because I'm starting to absorb nutrients.

For the record (because I know you all were worried, haha) - I have found some gluten free beers. I'll teach you about them sometime. (=

Well family and friends, now you know about my gluten free adventures. I feel happier and healthier than ever.

New Condo

Firstly, I'd like to apologize for the long absence from blogging! This happened to be one of the busiest months of my life. What a ride!

We found a beautiful new condo to rent that's just down the street from where we currently live. Two bed, two and a half bath, and TONS of closet space. We're looking forward to having 2 covered parking spaces and our own washer/dryer - things we've been without the last 2 years. It has hardwood floors - which look sharp and will be good for Barley (and her sister Hops - which we hope to be getting soon!). We are completely thrilled and can't wait for the move!

Above: View from master bedroom

If you'd like to see more pictures of the condo, they can be found at this link. New condo pics

I got the residency!!

I'm hired!! The new low vision / primary care resident at Nova Southeastern University College of Optometry!! Woohoo!! The interview was just a formality, they made it pretty clear that they'd already decided to hire me. The more I learn about the position, the more I love it. I'll make the next blog about the details of the residency. I know many of you have no idea what an optometry residency is all about - I didn't until just a few weeks ago! Tonight I plan on relaxing a little bit. I just finished part III of the national board examination for optometry. I had a written exam on Friday and a clinical skills exam today. Everything went nice and smooth, except for the fact that I forgot to remove the soft contact lens before inserting the hard contact lens - but I soon realized my mistake and had time to repeat that part of the station at no penalty. Oops!! Now all that's left is the Florida boards in June, and a multidude of state boards when we're figuring out where Brian might match when he graduates from med school in 4 years. Sorry this is such a short blurb - more details soon!!

Easter and iPhones

We had a nice Easter, just the 2 of us (and Barley). I made a giant fancy meal including an 8 lb ham, smashed potatoes, asparagus wrapped in proscuitto, green bean casserole, and corn bread. Oh, and some Angel Lush cake for dessert! It doesn't replace celebrating Easter with lots of family, but we did have a good day!We got iPhones on Saturday!! We've been with AT&T for a couple years now, so we were ready to renew our contract and get new phones. We had seen some commercials for some Samsung phones that were buy one get one, but it turns out that was only if you were a new AT&T customer, go figure. Since the Samsung no longer seemed like such a good deal, we scratched the itch we'd been feeling and got ourselves some iPhones!! This is truly the most amazing piece of technology I've ever owned. When I wake up in the morning, I can check my email, weather, and news without even getting out of bed. It's got a GPS on it. I used it to find a place to grab some breakfast the other day when I was in an unfamiliar area. Last night I used my Dave Matthews Band app to see last night's setlist, as it was happening. The Pandora app is amazing. It creates your own radio station (free!!!) with your favorite artists/music. I have the yellow pages on my phone. I've got games! I've even got a dog whistle application. I'm soon going to add epocrates, which tells me all the information I'll need to know about the medications I prescribe (i.e. what sizes they come in, what different strengths, if any generic available, prices, and known side effects). There's also an app for medical Spanish! Of course that's going to help me immensely. Mira aqui, por favor!! And I've only just scratched the surface... !!!

Residency interview is today at 1:15pm!! Judging from the other docs I've spoken with, chances look good - but I'm not counting my chickens before they hatch. I'll post later today and let you know how it went. (Does anyone even read this blog anyway??)

NBEO (national boards) part III Friday morning and Sunday afternoon. It's a big week!!

Less than a month

Less than a month until my very last day of clinic as a Nova student. I find myself in serious denial. Soon all these people I've seen on a daily basis are going to spread across the country and leave me here. Thankfully, Miss Kinga will still be here! Her fiance, Jesse, is doing a 4 yr oral surgery residency at Nova starting this summer. Yesterday we had a relaxing day by the ocean. I look forward to more days at the beach over the next 4 years!! (and I obviously need to work on my tan!)

The moon looked beautiful over the water last night. Brian insisted I take a picture. (=

spring break

I'm on spring break this week. I'm realizing very quickly that I need to do more studying for boards next week than I realized, so there goes the intense spring cleaning I was hoping for.

We went and looked at that house last weekend. It was charming with an amazing backyard. The house had very little closet space (less than we have now). The windows did not look very energy efficient, so that means a sky-high energy bill and also not much hurricane protection. But perhaps the real killer for it was that the landlord lives in and behind the garage. Although he's a nice guy, that's a little close for comfort. So it's a no-go on this one. We'll keep looking!

It turns out our current apartment is going into foreclosure. We received a copy of the summons a few nights ago. Stinks for our landlords. But from looking at the paperwork, they made a stupid investment. The mortgage they paid for this place was $200 more than we pay them for rent, in addition they pay 7% of the property's value in taxes per year, and have an HOA fee of $300-$400 every month. They've been losing money on this thing since the beginning. They offered to sell it to us at a low price, but we're not ready to buy yet. Foreclosure procedures are taking forever in South Florida, so we aren't going to have to move before the end of our lease (June 24th). And our landlords graciously accepted our deposit as a month's rent, so that we don't have to worry about not getting that money back. So now we're worry free, enjoying our last few months in our corner unit with the lovely view.


Next Wednesday at 1:15pm I have an interview for the residency position at Nova. I am terrified. They said it should be just a "brief" interview. I am still terrified. I think the interview will go absolutely fine, but it is the waiting for the interview to happen that drives me crazy. Anticipation is killer! They sent me information about the school holidays, pay, and general info about the residency. Only 5 and 1/2 personal days for an entire year - that sounds like prison! But then I remember that I was just in optometry school for 4 years, and I wasn't allowed a single vacation day that wasn't already built in, switched with someone else, or had to make-up. So in actuality, this is AMAZING! And there are 5 additional "sick" days. We all know that at least once a year I catch something or another that requires a Z pack.


Last night we had tickets to the Miami Heat vs. New Orleans Hornets basketball game. Our tickets were free and we got to enter/exit through the V.I.P. section. We parked under the AAA, right next to the player's cars. We felt like rockstars. As we were walking in, I see Brian maneuvering his way around this guy to get into the place. I immediately realize that he just went right around Jack McClinton without even noticing. With 3 out of the 4 of us being season ticket holders to Miami Hurricanes basketball - we got very excited! This guy is the all time 3 point leader in the ACC! And this past week, he won the 3 point competition! We wished him well in the draft. It was awesome. And after careful scrutiny, we reluctantly agree that he is 6'1" just as he was listed on the Hurricane basketball programs. But barely.We lost in overtime. That was not awesome. But it was a very entertaining game to watch. Much better than the NCAA championship game!

Residency..... me?!?!?

The job opportunities for a graduating optometrist are bleak out there. Very bleak. Especially in south Florida. And you can imagine that I'm worried since I'm a mere 7 weeks away from graduating. There's even more uncertainty in the equation since I will not receive my Florida state license until August or September. Recently I've been telling Brian that I wish I had done a residency. I would love to specialize in a particular area. Also, if I did a residency at a school, I could also teach. Funny thing happened this week... on Wednesday evening during a late night in my contact lens rotation, I spoke with Dr. Wagner (I did research with her after my first year - she is also chief of the contact lens service). She asked me what I was doing after graduation. I told her I sort of have something lined up for the summer, but I wasn't sure what would be happening after that. She pulled me aside and told me that there is one residency spot left at Nova (my school) and that I should definitely try to get it. This was shocking to me for multiple reasons. 1) More people than ever are doing residencies in optometry this year. They had to apply to a match process by February, and everyone was officially matched by March. I thought that ship had sailed and I had missed the boat! 2) I really really wanted a residency at Nova and viola --- one is available!! and 3) Someone believed in me enough to think that I should be the person to fill that position. Unbelievable. It's just remarkable. (!!!!!!!!!!!!!!!!!!!)

The available residency position is in primary care (the sort of style you'd see your regular optometrist in) and low vision. Low vision is a great field, but one that most optometrists would not choose to partake in. It takes a lot of patience. In optometry school, we called it "slow vision". Considering all of the patients in low vision are legally blind, they have to rely on others to get them to their appointments, resulting in lots of no-shows. They still have usable vision in some cases - imagine that they can only see something as small as the big E on the chart, but of course each case is different. Low vision helps patients with vision loss from various causes - macular degeneration, diabetic retinopathy, Stargardt's, retinitis pigmentosa, albinism, etc. It would be a wonderful thing to have as my "niche" in the world of optometry.

This residency would also allow me to TEACH. I did promise my 2nd grade teacher that I would be a teacher one day. As a resident, I would sometimes work with 3rd and 4th year optometry students when they are seeing patients. I think I'm going to love it. But I'd also have to give a lecture to a classroom full of 100 students, which is slightly more frightening.

So yes I'm thrilled - but it is not yet final. I turned in my C.V. (resume) and a nice cover letter. Since the residency is at my school I have a very good chance (especially since I'm not aware of any other applicants). However, if someone with extensive low vision experience (more than the 1 semester lecutre and 2 weeks clinical that I had), it might not be a sure thing. My next blog might be that it didn't work out. However, so far, so good!! They hope to finalize the position soon. I'll pass on the news, be it good or bad.

Tomorrow morning Brian and I are looking at a house we'd like to rent. It is likely that this house won't still be on the market at the beginning/middle of June, but we are certainly hoping that all the other renters out there hate it (even though that would be completely ridiculous) so that it can be our "home". It is a 2bed/1 bath, 1500 sq ft, 1 car garage, cable/internet/water included, and absolutely at the right price! Here are a few pictures. Wish us luck!