May 18, 2012

au⋅to⋅im⋅mune [aw-toh-i-myoon]

Dictionary.com definition

adjective Immunology.
Of or pertaining to the immune response of an organism against any of its own tissues, cells, or cell components.

Celiac Bites Translation:

word that my doctors say a lot. Being sick as all get out.
Your own self gets a hankerin’ to beat the crap out of its own dang self when you eat Pop-Tarts.

Gilligans Island cast

Gilligans Island cast

Last week I posted a deeply scientific essay on the fact that Celiac Disease is not an allergy.  This week, let’s take a closer look at what Celiac Disease really is – an autoimmune condition.

The concept of “autoimmune” is pretty simple. Basically, your auto-antibodies have a terminal crack habit. Either that, or they have spent too many days watching re-runs of Gilligans Island and have lost all short term memory as a result.

There’s really no other logical explanation. You see, unless you are a committed masochist, your own antibodies would have no real reason to attack their own home and the villi that live there in peace and harmony. So the only other explanation is that they don’t recognize their own kin, your villi. And there we are, right back to the crack habit or Gilligan’s Island theory.

Auto-antibody: “Have we met?”

Villi: “Yes, we’re related remember? We grew up together in Jersey City.”

Auto-antibody: “You’re full of it. I’m going to kick your @%#!”

There you have it. The Celiac autoimmune response happens simply as a result of your auto-antibodies failing to recognize their own relatives. So, being cantankerous fight club types, they commence beating the tar out of their own kin.

Any questions?

Dying out, oops, I mean Dining Out

The hardest thing about living with Celiac disease, besides the weight loss, non-stop and lifelong flu symptoms, not being able to eat Krispy Kreme doughnuts, weird neurological disorders, tooth enamel breakdown, pizza moratoriums, general weakness, pain, abstinence from beer, perpetual tiredness, elevated risk of cancer, looking longingly at other peoples birthday cakes, ban on fried cheese, and a couple hundred other assorted things, is the inability to just go out to a restaurant and get something to eat.

Chilis Restaurant

Chilis Restaurant

If you’re a Celiac, going out to Chilis is kind of like making the decision to have kids. First you have to try many different restaurants to learn which ones have any potential of feeding you without causing your untimely death. Then, after dozens (or hundreds if you like to play on the wild side) of restaurant dating encounters, you have to start thinking about which one you are going to consider “marrying.”

Happy helpful server waiter

Happy helpful server who wants to kill you

Once that decision is made, a new courtship starts all over again.  You have to get to know your server in a really intimate way. Kind of like getting to know your in-laws. It’s going to be awkward, and worst of all, its going to be a public encounter. Somehow or another, you have to blurt out that you have a medical condition. Usually, at the moment you work up the courage to do this, background noise in the place suddenly dies down so that the whole dining room can clearly hear your detailed medical history.

In a perfect world, you’re done after the initial embarrassment. In the Celiac world, your dutiful server goes back into the kitchen, talks to the chef, then returns to ask you some more questions – in front of everyone. I guess this is good if you like being the center of attention, but I would rather get my notice for some more impressive reason, like inventing a new punctuation mark.

At this point, you’re at the mercy of the chef. And unfortunately that’s not a comforting place to be. Not to knock professional chefs and the importance they place on learning their craft, but its just unrealistic to expect anyone to know the thousands of details that can make you sick. Training on gluten free diets is certainly a good thing, but it hardly compares to the fact that it took me two years to really learn how to eat gluten free. And that’s when the consequences of making mistakes were life and death, or at least two or three days of intense illness, misery, and general grumpiness.  That’s the school of hard knocks.

So work with your chef, understand that many do have some basic knowledge, but don’t let that prevent you from asking confirming questions. A good chef will take pride in learning how to work with you and helping you to find a safe, and delicious meal to enjoy.

I’ve found that the best way to work with your chef is to be the kitchen. Look at the menu and take a minute to imagine what goes on in this particular restaurant place. Then consider how the dish you intend to order will be made in that environment.

Consider things like the following:

  • Is it a brick oven type of place that makes pizzas or calzone’s? If so, there’s likely to be flour on countertop surfaces.
  • Are the meals you’re interested in prepared in a baking dish of some sort? If so, there’s likely to be pan spray coating. Much of the restaurant grade pan coating is a mix of flour and oil.
  • Is the food you are considering cooked on a griddle? What else does the restaurant offer that might be cooked on the same griddle? Pancakes, toast, or other breaded items?
  • Are there a lot of fried food items on the menu? If so, assume any gluten free fried items you order are going to be cooked in a contaminated fryer.
  • Is the restaurant a moderately priced place or maybe a chain? Think about what items may arrive pre-packed, and possibly, pre-marinated before the restaurant staff does anything. You would be amazed at how much food is pre-processed before it arrives at the restaurants back door. Burgers can have fillers, steaks and chicken can be pre-marinated whether fresh or frozen, and “homemade” items may be only blended on site and use pre-packaged ingredient kits.
  • What else might come on the plate? I’ve had in depth discussions about the source of steak or chicken and possible marinades only to have my dish arrive covered with a sauce or gravy of unknown origin. I once had eggs, cooked in a separate pan for me, arrive with slices of toast laid on top!

While I can’t list every possible consideration here, I can share the idea of how to think about the environment in which your food will be prepared. Picture the kitchen, consider the preparation of your menu choice, then ask relevant questions.

Happy dining!

Truth or Consequences: La Choy Soy Sauce

La Choy Soy Sauce

La Choy Soy Sauce

La Choy Soy Sauce

Is it Gluten Free?

___  Yes!
___   No!
___  I’m afraid to find out!

Post your answer in the comments below.  We’ll let you know how you did!

Are you allergic to bread?

Question (from pretty much everyone): “Are you allergic to bread?” 

Me (over and over again): “No, but I am allergic to being asked if I’m allergic to bread.”

Next Question: “So can you eat donuts?”

Me: “Can you eat rocks?”

No allergy

Celiac Disease is an autoimmune condition, not an allergy. There’s a big difference between the two, the main one being that autoimmune sounds a lot more impressive. So impressive in fact that most people have no idea what an autoimmune condition is.  That’s what makes it kind of fun if you’re one who thrives on the pity of others. When I tell people that I have an autoimmune condition, they tend to immediately take two steps back in case its contagious. Then there is that saaaad look…

From a practical perspective, there’s not much to be gained by trying to tell people that I have an autoimmune disease, and not an allergy. I have to confess that when in restaurants trying to explain what I can and cannot eat, I always tell people that I am “allergic” to gluten. It’s just a lot easier, even if my illness does not sound nearly as cool.

So what’s an allergy?  Technically, allergies are highly sensitive reactions by ones body to certain, and usually normal, substances. Allergies are also a little bit like shoes. You can get them most anytime during your life. It’s also possible that you can outgrow them, but not always. While allergies can be quite serious, and even fatal, they can be described as a reaction to exposure to wheat or other allergens. So, yes, there are people who are actually allergic to wheat, and therefore share a necessary gluten free lifestyle with people diagnosed with Celiac. Life is not very pleasant for those poor folks either.

On the other hand, Celiac, being an autoimmune condition, is more like a chain reaction. If you read my post on Vikings and Blazing Saddles fight scenes, you’ll understand the comparison, where the presence of gluten, and more specifically gliadins, create a full scale war between auto-antibodies and your hapless, and helpless, villi.

So the next time someone asks if you’re allergic to bread, you can answer with confidence…

Yes!

Trust me, it’s a lot easier to explain than the truth!

Truth or Consequences: A&W Root Beer

A&W Root Beer

A&W Root Beer

A&W Root Beer

Is it Gluten Free?

___  Yes!
___   No!

Post your answer in the comments below.  We’ll let you know how you did!

Truth or Consequences! Prego Traditional Sauce

Prego Sauce

Prego Sauce

Prego Traditional Italian Sauce.

Is it Gluten Free?

___  Yes!
___   No!

Post your answer in the comments below.  We’ll let you know how you did!

Got Celiac? Allow me to explain…

*** Warning! There is a better than even chance that the following post contains satirical content. The authors of this site cannot assume any liability for potential public backlash against Oompa Loompas, Mel Brooks movies, and/or the good people of Norway. Thank you for your understanding. ***

Just been diagnosed? Don’t quite understand what Celiac is and what causes it? Have a broad range of really annoying symptoms and don’t know why? Unless you have an obsession with transglutaminase’s and antigliadin’s,
the nuances of Celiac Disease can be a little difficult to digest.
Ahem, pun intended. Boy I crack myself up sometimes.

Let’s take a stab at explaining this really complex topic in true Celiac Bites fashion. That could be a little dangerous, but here goes…

I think the easiest way to describe Celiac is to compare it to the big fight scene in Mel Brooks’ famous movie Blazing Saddles. Someone punches a horse, things get ugly, and next thing you know, everybody is beating the crap out of everybody else. That’s kind of what happens in your small intestine, only there’s usually not a horse involved. So, given the likely absence of the either a horse or evil villain Hedley Lamarr, how does this battle royale within your small intestine happen?

It’s pretty simple really.When you eat Pop-Tarts, you get sick. Even though Pop-Tarts are mostly made of advanced plastic polymers, they do contain trace amounts of proteins commonly found in wheat, barley, and rye grains.

Thor Viking

Thor

And, as everybody knows, wheat, barley, and rye grains are descendants of Thor, the great viking god of thunder. Thor was a raucous warrior, wreaking havoc and destruction wherever he went. After a while, Thor got bored of being fearsome and plundering things, so he settled down with former Beverly Hills 90210 actress Brittany Ashleigh Spelling. Together they had a whole bunch of kids – so many that they gave up on the idea of naming them individually and instead referred to them collectively as the gliadins. So you might say that the gliadins are little offshoots of wheat, barley, and rye grains. Still with me?  Good, because I’m not.

Over the years, gliadins have taken up residence in Pop-Tarts all over the world.  They also tend to congregate in other forms of yummy food like pizza that have ingredients derived from various grains. While very tiny and seemingly harmless, the gliadins are every bit as irritable and cantankerous as their father Thor – especially when they get eaten. That’s where the trouble starts.

When you eat gliadins, they follow a path straight to your guts – home of the villi.The villi are actually a tribe of miniature people begat by the Oompa Loompas. While Oompa Loompas have a reputation of being hard working and industrious, the villi have no such ambition, so they stand around with their hands in the air waiting for any food that may happen to drift by. Most villi are unemployed and prefer to stay that way as long as they can keep collecting free Pop-Tarts.

Oompa Loompas

oompa loompas

So far, so good, as the often cranky gliadins and villi have no real ill will against each other.  As the gliadins float by, they might overhear mundane conversations like this:

“Hey, do you know what’s for breakfast today?” 

“No, but I sure hope we have Brown Sugar and Cinnamon Pop-Tarts again. Mmmm.”

This perfectly civil process turns outright ugly when the auto-antibodies get involved. Antibodies have a chip on their shoulder as they resent having to work so hard fighting things like botulism and the common cold, while their cousins the villi don’t do much of anything. As children, the auto-antibodies were generally abused and picked on by the irritable gliadins. Now that they are all grown up, but still a little on the immature side, the auto-antibodies tend to fly off the handle whenever gliadins pass through their neighborhood. However, old fears are hard to overcome, so the auto-antibodies – more specifically the anti-tissue transglutaminase antibodies (tTGA’s) – can’t muster up the guts to confront the gliadins directly. Instead, they throw showy tantrums and beat up the mellow villi – who are much easier targets to bully. Once the tTGA’s start fighting the hapless villi, all hell breaks loose. Next thing you know, you’ve got antibodies all over the place chasing after villi, gliadins, and stray Pop-Tart crumbs.

On Strike

On Strike

So back to Blazing Saddles. By the time we get to the climactic cafeteria food fight scene, everybody is fighting everybody else and throwing food and furniture for no particular reason. The problem for you is that you own the cafeteria – and the cafeteria gets wrecked in this scene.

As you can imagine, the villi tend to tire of these free for all food fights and eventually go on strike. Beaten down, depressed, and disheartened, they won’t even bother to get their own food, much less do any work for you. You can eat as much as you want, but no goodness is getting through to you. It’s kind of like watching “Lifestyles of the Rich and Famous.” You can spend hours and hours viewing re-runs, but you most likely will not be registering your yacht in Monaco anytime soon. Ok – back to the villi picket line. In a show of union solidarity, everyone else in your body goes on strike. You get sick, tired, lethargic, and weak – kind of like having that 6am Monday morning feeling all the time. And you know how truly awesome that is.

I sincerely hope I didn’t lose you with all the complex medical and biological terminology. This has been a public service of Celiac Bites.

Join us next time where we will address the question…

“So you’re allergic to bread???”

Thor image: MrDonn.org

Shoutout! Gluten Free World Map!

Just ran across a really cool project put together by the folks at Celiac Chicks. It’s a user generated map of the world designed to capture and share all gluten free friendly eateries.

It appears that there are a couple hundred entries already, so be sure to click the link below to add the places you know about – I’ll be making my updates for Charleston!

To add your own entries, click here:

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