We were still reeling from the celiac diagnosis when we met with the dietitian. Ashley greeted us warmly and got down to business. As she addressed Grace, I faded into the background, content to be on the sidelines taking copious notes. From the get-go Ashley and Grace connected; Grace, having just been accepted into her undergraduate nutrition program and Ashley, well established in the field yet still cool and young enough to give Grace the 411 on all things nutrition program related. And if that wasn’t enough, Ashley is gluten-free, so she spoke from a place of knowledge, and personal experience.
Connection established and small talk complete, it was time to talk celiac, food, and wellness strategy. Ashley confessed that Grace was the most acutely gluten-sensitive person she had worked with to date. The hair loss and skin responses Grace was experiencing were not as common. This meant the issue needed to be attacked both inside and out.
To round out her understanding of Grace’s symptoms, Ashley asked Grace to indicate which symptoms she experienced that weren’t evident in bloodwork. Grace’s responses are checked below.
Symptoms of Celiac Disease:
- Chronic fatigue or Weakness
- Abdominal pain, bloating & gas
- Indigestion/reflux (heartburn)
- Nausea and vomiting
- Diarrhea, constipation
- Lactose intolerance
- Weight loss
- Bone/joint pain
- Easy bruising of the skin
- Swelling of hands & feet
- Migraine headaches
- Depression
- Mouth ulcers (canker sores)
- Menstrual irregularities
- Infertility (both men & women)
- Recurrent miscarriage
She checked off every symptom except the last two, for which she had no frame of reference. There was certainly tremendous room for improvement.
Handouts and charts were incredibly useful. We were able to vividly understand what happens internally for someone with celiac. She spoke at length about the gut, nutritional absorption and villi, and the hope to regrow damaged villi through adhering to a gluten-free diet.
Normal villi (l) resemble a sea anemone happily trapping nutrients. Celiac’s villi are blunted, looking kind of like egg crate foam.Next, we dove into the gluten-free diet. We spoke of brands, products and things worth trying (and even some that weren’t). She cautioned on the inaccuracy of food labels and the need to be hyper-vigilant by always checking labels, even if you already know the product. Quite simply, manufacturers change facilities and practices, so you must err on the side of caution. We discussed cross-contamination, hair and skin products, medications, and what items in the home are compromised and need to be relocated, duplicated, or replaced.
Ashley outlined an eating plan for Grace so that her weight would stabilize. She shared Kaiser Permanente’s packet, Celiac Disease and the Gluten-Free Diet, which contained information on gluten-free cooking, shopping, and meal suggestions.
We left with a packet of incredibly useful information, a sense of direction, and a heck of a lot of work to do.
KEY TAKEAWAYS:
- AVOID grocery store’s bulk bins! They are a cross-contamination minefield!
- ALWAYS read labels! Manufacturing processes can change.
- BEWARE of hidden gluten! (toothpastes, medicines, cosmetics, especially lip products.)
- SPEAK UP and DO NOT TAKE RISKS! When in restaurants or in groups, it can be uncomfortable and awkward, but this really about one’s well-being and health!