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I Finally Went To A Naturopath: Part 1

You guys. I don't know where to start. I finally went to a naturopath after many years of considering it. The fact that insurance doesn't cover it put me off and I thought I was managing things pretty well on my own. But the past few months my RA has been feeling pretty crappy, and even though it always feels bad in the fall I always have a desire to rid myself of all of this completely, from the source, instead of just telling the symptoms to chill til they come back. 

So I went! I found this amazing woman who is literally a block away and part of UPMC, Pittsburgh's largest healthcare group, and she actually agreed to talk to me on the phone for ten minutes before I scheduled my appointment. I wanted to make sure I was seeing someone whose diet plan for me would be on par with my own. There's a bit of a fad happening right now called the Autoimmune Paleo (#AIP) diet and I'm just not into it. I know from research and my own experience that meat is an inflammatory. And the whole point of eating to cure an autoimmune disease is to get the body to stop being inflamed. So that just doesn't add up, does it?

Anyway, my first appointment exceeded my expectations. Her office was more like a lounge than a doctors office. She started by asking me to just tell her my entire medical history and took amazing notes. For the sake of me not rambling on forever with all the details, here are the highlights of what we covered in the two hours she spent with me (yes, seriously, two hours) and $175 I spent on the first session:

  • Goal: First she asked me what my goal for being there was. I told her my conventional medicine (Enbrel) is working but I know deep down it's not a good idea longterm. I know the side effects heighten your chances of lymphoma by 3x and being so young, I know that the longer I continue on the medicine, the higher those chances probably are. I told her my goal was to be well enough that I could lessen my medicine intake over time until I possibly don't need it anymore. She was supportive of this and told me she would never ask me to stop taking a medication without having me talk to my rheumatologist about it first. At this point, I knew I liked her. We agreed to not talk about when or if I'd ever be able to stop taking a conventional medicine but just kept the goal in mind to lesson the amount a bit at first.
  • Medical history: I told her all about my RA, family history, other misc. health problems like allergies, UTIs, frequency of colds, etc.
  • Supplements, vitamins and medicine: She had me bring in everything I was taking so she could evaluate it. She tossed my daily vitamin in the trash right in front of me, saying it was literally the crappiest of crap. I loved her for that!
  • Typical diet: She wrote down what I typically eat for breakfast, lunch and dinner. In this realm, I think I am a pretty easy patient for her since I'm already gluten and mostly-dairy free. She laughed when I said I made raw beet ravioli with cashew cream cheese for dinner the night before (I'll post on that delicacy soon!).
  • New diet recommendations: I had two options. An elimination diet challenge that would take me months of torture to take about 96 foods out of my diet and slowly add one back in at a time to see if it would cause my symptoms to flare. First of all, NO. Secondly, I told her it would be hard to notice an arthritis flare due to one food because I typically flare for a month and then don't for another. It's not a day-by-day thing. She agreed, so instead, I am going to do option two, a $225 blood test. I will do it at home by pricking a finger until I can fill five circles on a piece of card stock the size of my thumbprint with blood, let it dry and then send the kit back to a lab. The results will come back with 96 foods and graphs for each that measure how much that food causes an immune response in my body. Fabulous. Worth the money. I am waiting until January to do this to spread out the expense and also so I have all the holiday party junk food in my system. My doctor said that in order for the test it work its best I need to "eat all the foods" beforehand. Yes, she really said "eat all the foods." Gluteny-cheesey pasta cheat day, here I come. The test is called the US Biotek Antibody Assessment and you can read about it here
  • Health plan: Two days later she sent me a two page health plan that she typed up and sent to my email directly from her. It had instructions on where to buy the new supplements (I'll do another post on that soon), how to take the blood test, and a summery of the other things we talked about... like how she wants me to eat more fish. 

All in all, I cannot say enough. I ordered my first round of supplements and received them today. They were a bit pricey but I know she's going to get me back on track. I'm most excited about a strong anti-fungal with oil of oregano, garlic and caprylic acid that will rid my body of any bacteria or candida that could be lingering. Bacteria (from UTIs) and candida overgrowth can actually cause autoimmune diseases. I'm starting to think there's a chance that could be what's happening to me. Check out this article I found tonight that talks all about that and how to cure autoimmune diseases by curing the cause instead of putting a band-aid on symptoms. Its author is totally in line with what I'm planning to do with the help of my awesome new naturopath. Updates soon!


It's My One Year Gluten Free Anniversary!


It's My One Year Gluten Free Anniversary!


In honor of my one year anniversary as a gluten-free-mother-fucking-goddess (Sorry, had to. I'm proud!), I'm posting a little hindsight of what I've learned in the last 365 days. So, here we go:

5 Things I've Learned After 365 Days Without Gluten:

1. It's not as hard as you think.
I was terrified. I figured I was putting myself in culinary exhile for the rest of my life (how dramatic). But honestly, I quickly learned to shop and cook differently and I barely notice the gluten is even gone. Instead, I've devoured gluten free bread, rice pasta, copious amounts of quinoa, fancy san-gluten Bisquick, flour, crackers, pretzels, bagel chips, cookies, brownies, muffins, etc. There is not one food that I find myself missing that I cannot find a gluten free replacement. So when you put it that way, what am I really giving up? The way I see it now, not much. 

2. Cheating is acceptable and a must (if you're able).
I have not gone 365 days without gluten. My goal for the upcoming year is to cheat less while remaining sane. This year I probably (and this is a big generalization) had about 8 donuts, a dozen (or more) office cookies, one bowl of regular wheat-y pasta at my favorite italian restaurant, and traces of gluten in things you would not expect like soy sauce, among other things. This seems like a lot of gluten, but if you think about it in the span of a whole year, it's nothing. My rules for cheating are these: 1. "Will you regret it after?" and 2. "Does the occasion warrant it?" If the answers are "No" and "Yes," respectively, then by all means, go for it.

3. When I cheat, I feel it...
But I don't get a stomachache. Instead, my physical reaction may not be what you'd expect. I get a foggy brain, fatigue or drowsiness, tightness between my shoulder blades and a feeling similar to a caffeine withdrawal. When I think about it, I was always experiencing these things when I used to eat gluten all the time, now it's far more apparent how much better I feel without all these symptoms hanging around on a daily basis.

4. My RA flare ups have severely lessened.
In a previous post, I explain gluten and its relation to leaky gut syndrome, and leaky gut syndrome's relation to auto immune diseases. Well, I'll say it again and 100 more times, I fully believe that gluten is a cause (not the only, but a big one) of my RA. Two months ago my doctor did RA blood tests we hadn't done in two years. My RA factor is in the negative range (!!!! - that doesn't mean it's gone, but still! ... !!!!) and my inflammatory markers are weak positive down from moderate positive (again, !!!!). Sure, this could have to do with my medication working, but holy shit, do I notice the swollenness in my hands the morning after I've had gluten? YEP. Remember that cheat criteria, "Will you regret it?" Yeah, the more I see the obvious shift in decreased swelling, the more it is not worth indulging.

5. It's been totally worth it.
A year and a week ago, I rolled my eyes when someone told me they were gluten free by choice. I literally thought it was just a made up, bandwagon fad in food. I understood that those with Celiac do not get that choice and wow, do I admire what those who have it must do to eat safely! Having Celiac requires so much more restraint, attention and caution, when even trace amounts of gluten can cause upheaval in the gut. I am so lucky that I get to choose this diet and that I get to choose to cheat if I wish. But that's a whole other story. Overall, I see the difference. I no longer feel so bloated and tired after a big meal that I just want to sleep (apologies to those who I've made rub my belly after too much pasta — not kidding, wish I was). I no longer wake up with insanely puffy knuckles and inflamed feet. My knees hurt rarely. I don't have afternoon tiredness or brain fog and I feel more productive at work. My skin is clearer and more even. So is it worth the overhaul at the beginning and the extra effort, time, money to upkeep? Yep, every bit.



Leaky Freakin' Gut: Explained

Alright, time for me to break it down. I've mentioned leaky gut before and the concept of it is pretty simple once you can visualize it. When I first read about it in It Starts With Food, I realized right away I probably had it. I am (was) a bagel, pasta, fresh crunchy baguette loving woman, especially in college, so grain was pretty much my number one food group. I asked a doctor friend of mine if real MDs acknowledge leaky gut as a real thing or if it's just some crazy holistic idea and I was surprised by the answer. Doctors definitely acknowledge that leaky gut (also commonly know as intestinal hyper-permeability) is a problem, but they are just now learning more about how it relates to disease and auto-immune disorders.

The best and shortest way to describe leaky gut is this: 

70% of your immune system is located in your belly, which is hard to imagine since we typically think of our immune system as being, well, everywhere. But think about it, you bring in food, toxins, germs and more through your mouth and into your gut every day, so the immune system is there to fight off those invaders at the front door. If you think of your intestinal lining as a brick wall there are cells and mortar. In a normally functioning gut, the mortar is strong and nothing can pass through the wall, but if a gut in attacked over and over again by things like yeast, parasites, bad bacteria, viruses, alcohol, antibiotics, NSAIDS (Advil / ibuprofen) the mortar starts to weaken and gets leaky causing these invaders and other non-digested particles of food into the bloodstream where they are not supposed to be. 

Think of your intestine like you think of the outside of your body. You put unprocessed food in it to be broken down. So anything that starts on the outside of our body that goes through your mouth and into your intestines is technically still on the outside of your body until digested properly. When the lining of your gut is permeated, those things that belong on the outside seep to the inside.

Let's take gluten as an example since removing it from my diet is what confirmed to me that I had leaky gut. When undigested gluten leaks into your bloodstream over and over again, your immune system recognizes it as bad and attacks it. What happens next is crazy. The gluten DNA looks a whole lot like human joint DNA and overtime, your exhausted immune system confuses the two and starts attacking your joints. In my case, this is why when I eat gluten, my RA symptoms flare up. My immune system thinks my joints are bad foreign invaders. For me, those are the only symptoms of leaky gut I had so removing the gluten improved my joint pain and helped me realize my gut was leaky.

For many though, there are no signs or symptoms of leaky gut. A recent study mentioned in Dr. Blum's book The Immune System Recovery Plan says that the majority of people with an auto-immune diseases also have leaky gut. This is a huge statement that would be basically impossible to prove, but I think it sheds light on how many people are most likely sick because of leaky gut and don't even know it.

The reason why functional doctors like Dr. Blum say they can reverse auto-immune disorders is that once you remove the gluten and heal the gut lining, your immune system should restore itself and stop attacking your body in whatever way it has manifested. It's a long process that I'm working on over time, but I've noticed that the absence of gluten in my diet is helping me more than any other medicine I've taken. That is enough to believe food has a major impact on our health.

I know that being gluten free is seen as very trendy right now. A year ago, I too thought it was a stupid fad that everyone was jumping on, but now I see the benefits. There are a lot of books out there that talk about why wheat and other sources of gluten are not native to human bodies and why they're suddenly making our bodies go nuts. If you want more info and don't want to read the books I've listed above, check out these articles that I think illustrate leaky gut pretty well:

New Research Shows Poorly Understood Leaky Gut Syndrome May Be The Cause Of Several Diseases | The Daily Beast

9 Signs You Have Leaky Gut | Mind Body Green

5 Symptoms Of Gluten Sensitivity You Probably Don't Know About | Mind Body Green




Go Gluten Free

Flash back to the first day I went grocery shopping with a gluten free diet in mind. I spent the 5 hour flight from Pittsburgh to San Francisco last Labor Day reading the book, It Starts With Food. Their approach to diet is strict paleo. No grains, no processed foods, no white sugar, I can go on... I was crazy overwhelmed by such a drastic diet change that just removing the gluten and dairy seemed easy in comparison. But their message was important — I could heal my body of disease by changing my diet. 

It was a scary idea. It would be the biggest change I'd make since being diagnosed but looking back, it's the best and easiest decision I've ever made.

I did paleo for about a week (failed on no grains!), added the dairy back in after about a month (I missed cheese!) but I've kept the gluten free going ever since. I eat plenty of quinoa, rice and even the occasional gluten free bread to make up for what I've given up. I noticed a huge difference in my body without it. I've been tested for allergies to wheat and not even an intolerance comes back, but it still changes everything. 

When you first start, the trick is to learn to eat properly without gluten free products first. They are typically higher in sugar and other junk that replace the gluten in their recipes. Once you've got the diet figured out without them, then you can add those products in as treats without being dependent.

Trust me, I am known to get local gluten free pizza from the local pizzeria once a week, eat a whole loaf of gluten free toast when I'm sick, or cook up quinoa or brown rice pasta for dinner often.

I also cheat on my GF diet altogether sometimes (office donuts are literally the worst temptation!) when the occasion calls for it but I can definitely feel it! Instead of getting a stomach ache like those with Celiac do, I feel brain fog, fatigue and heaviness in my shoulders and upper spine similar to feeling a caffeine withdrawal. The next morning my fingers are usually puffier and creakier. It all subsides but it's enough to keep me from cheating often or with big portions.

I could go on and on about the success I've had with removing gluten from my diet and what I've learned along the way but I'll break it up into future posts. For now, check out my Resources page for resources to get you inspired!



— NEW! —

Cate To Date is back & basically brand new.

What was once a measly tumblr account with very sporadic posts chronicling my RA journey is about to become something much different.

I've moved well past the figuring-it-all-out phase. Now I'm basically kicking RA in the ass with tons of knowledge that I've gained just from experience in the last three years. I understand a lot about the immune system and what impacts it. I'm learning more about diet and how it can truly be medicine. I'm also realizing modern medicine isn't the only answer.

The new Cate To Date is going to be more about my new awesome lifestyle and less about RA. I just don't have too much to say about the day-to-day of the disease anymore (hence the radio silence on the blog for the past year), but I do have a lot to say about food, supplements, yoga and the healthfulness that is responsible for my feeling so great. So this is my new outlet to share all of that. Who knows what will come up. Your guess is as good as mine.



The Fear Project

I still keep in touch with one of my college professors. Julie Elman draws peoples fears and this week, she drew mine.

Here’s what she has to say about my fear and fears in general:

The Fear Project :: What’s Ahead WIth Rheumatoid Arthritis

Catherine, 26, was diagnosed with RA last year. She wrote a lot about what it’s been like to live with this disease, but I was only able to include a fraction of what she expressed here. There are so many unknowns for Catherine, a yoga teacher, writes, “I’ve actually come to terms with everything a lot better than I expected.”

About Julie's Fear Project: 


Admit it. You’re afraid. Very afraid. Of something. Spiders, perhaps? Getting a root canal at the dentist? The stranger out there who will kidnap your kids?

I illustrate people’s fears. Working with their words, I just try to visualize what those fears could possibly look like. I work quickly and post my pieces no matter how I feel about them. It’s a good way to get over any fears I have about the creative process.

Fear not, I keep telling myself. Fear not.

— Julie M. Elman

Got fear? Send it: fearproject (at) gmail (dot) com”



Juice Cleansed

today is day three of three of my first ever juice cleanse. my friend aimee owns embody natural health in lawrenceville and makes these raw, organic juices from local produce. i felt good, not only accepting the challenge of cleansing but also supporting my friend’s small business. that made the price worth it, alone.

i chose to do this cleanse now, along with three of my coworkers, to clear my dependency on caffeine and sugar (recent addictions, probably due to stress, ongoing winter, and a slippery slope), improve sleep (i clench my jaw to the point of waking with headaches frequently), and regain better energy overall (i’ve had horrible mid-afternoon fatigue and mood swings). plus, after the pneumonia vaccine that drained me, i wanted to restart my body in a natural way and see how the clean energy affects my joints.

the first day was not nearly as bad as i expected. i was excited and proud of myself. the second day was hard. i was getting tired of the same juices and the sweetness of them was becoming overbearing. i never really felt hungry, but i was craving crunchy salty foods frequently. after work on day two, i “let” myself eat half an avocado, some cantaloupe, and one stalk of celery with all-natural peanut butter. i felt better, and learned a big lesson: withholding yourself from clean, healthy snacks is ridiculous, even during a cleanse. i figured this choice would also lead to less indulgences post-cleanse.

today is the last and i’ve almost forgot i’m cleansing. i’m definitely sick of the green and red juices now, but know the end is very near. i’ll probably introduce similar foods as i did last night back into my diet for dinner. i didn’t use all 6 of the daily juices, so i have some left. i’ll freeze a few to use in smoothies or just drink them as energizing snacks for the remainder of the week.

the results have been great. my caffeine headaches and afternoon slumps of tired crankiness are gone. work doesn’t feel as stressful and my yoga teaching has been more energized. i’ve slept better, but i still feel tension in my jaw (time to call the dentist, i think). my skin has noticeably less clogged pores to pick at, and my knuckles are free of all swelling, where on sunday my rings were uncomfortable to wear. overall, my energy and happiness is up, and hey, my jeans are a little loser.

when i do a cleanse again, i’ll approach it differently. next time i’ll likely just buy one day worth of juice instead of three and intermix them with a raw veggie diet. it’ll be more affordable and seem less like torture. i’ll also continue to schedule my cleansing with friends. having a support system was key, if not for more than encouragement and a few laughs about how tough the red juice was to finish after day one (tasted great, just really rich).

these results do bring up questions for me: should i be gluten free? does that have something to do with my joint relief or is it the sugar, processed foods, and dairy elimination as well? i’m going to continue to eat as clean as possible to keep up this energy level. i’m also going to try to notice how certain types of food affect my body. almost a year ago i tried eating for my blood type (basically, the paleo diet). i may go back to that general way of thinking: heavy on greens and good protein. light on everything else. we’ll see how it goes.

glad i could check this off my bucket list! thanks aimee for a great first cleanse.



Really Good Doctors #2 & Introducing Enbrel

it’s been almost six months since i’ve updated, and although i have a lot to say, i want to try to keep it concise. mainly because things are going well!

the major updates:

i dumped dr. d. — i found a new doctor, dr L, and i love him. he sat with me for an hour and said “tell me everything” as he wrote it on a blank sheet of paper. he held a meeting with numerous radiologists just to review my second foot mri and walked me through why it was so strange. he didn’t want to put me on enbrel right away until he understood my case a bit better. all wins.

i started enbrel — after about a month under dr L, my symptoms were coming back (changing seasons perhaps?) and i was getting frustrated. he didn’t know if we’d be able to even get enbrel approved for me since insurance companies require a certain degree of disease and number of joints affected to approve. dr L seemed to sweet talk them though because within a few weeks i was at his office with nancy-the-nurse who was helping me do my first injection. 



A Big Fuck Yeah To Lower Doses of Prednisone

there’s a lot going on and yet nothing going on at the same time but for some reason there is more than enough to say.

when i went off the prednisone completely, symptoms in my right foot (mass/nodule) and right knee came back within 48 hours. i also noticed a bit of swelling in my knuckles in the evenings. enough that i decided to go back on the 5mg prednisone every day. 

when i went in for my check up, dr. d basically told me that meant the plaquenil wasn’t working and i needed to try something else (i questioned this beacuse plaquenil is said to take 3-6 months to kick in and it had only been barely 3). since i am 100% against taking/trying methotrexate (i.e. cancer drug mentioned in previous posts with nasty side effects that you cannot drink while taking), he suggested sulfazalazine. sure. why not.



Prednisone Withdrawl?

so i got permission today from my doctor to come off the prednisone steroid to “see how i do without it.” i’ve been on only 5mg a day for the past almost-three months. i’ve read a lot about how you shouldn’t just stop taking prednisone as your body’s glands go into shock without the help of the steroid and you can experience fatigue and other pretty awful symptoms for awhile… basically predisnone withdrawl.

that said, does anyone have advice on what i should do? doctor says just go right from 5mg to 0 tomorrow, but i’m thinking of cutting down to 2.5mg per day for the next week, and then 0 after that. keep you posted on what and how this changes things. i’ve been symptom free for so long i have no idea if its the prednisone or the plaquenil working, here’s to hoping :)