Sunday, July 12, 2015

Semantics

Maybe we've got the wrong word. Those of us in the DOC (Diabetic Online Community) often discuss the promise of a "cure". A supporter of JDRF, our family walks for a "cure". Don't get me wrong, my beautiful young man needs that cure, and in its absence for now, better and better technology to manage a life threatening disease.  You don't know how desperately I want that cure for him. But I also desperately want that no one else joins our "club".

As in a lot of medicine, treating the symptoms and the disease after the fact is standard. Our walks, our drives, our focus needs to be on prevention and causation. Though getting the word out about the symptoms and recognizing Type 1 Diabetes is critical, preventing it from happening in the first place is paramount.

Yesterday, a beautiful family lost their only daughter. Diagnosis of T1D came only after her brain had begun to swell causing irreparable damage. The doctor thought she had had a virus. Though she and her parents fought hard and well, supported and followed by thousands, she lost that fight, a fight she should never have had to fight if we knew what caused T1D. We need a cure, but we also need eradication.

Think that the medical community will know if someone presents with T1D?  Think again.  Many older patients will be thought to have Type 2 Diabetes by doctors and sent home with T2D medications, not life saving insulin.  Just this week, I read on Facebook about a mom whose 23 year old presenting with excessive thirst, frequent urination, and blood glucose that read "HIGH", was sent home with a T2D diagnosis and she wrote about it on a T1D Facebook page.  T1D moms urged her to fight back - T1D presents with sudden symptoms, T2D more slowly.  Surely, her son was T1D (though we were sad to say).  She pushed, and got T1D diagnosis, though the doctors did not at first agree.  T1D is an urgent situation.

Younger children will be thought to have a virus or flu.  Two other posts today, one of a four year old in a similar situation to poor Kycie, brain swelling, unresponsive. One of another small child who lost the battle.

Until the day that they can find that cause, it is critical that parents and pediatricians are on the alert for T1D.  Though still considered rare, it takes less than 50 cents to test at each sick visit.  Fifty cents that could save someone's life. Tell those you know with young children to either buy their own meter or demand a quick blood draw at sick visits. It is that important.

Update:  Today, a 4 year old boy died of undiagnosed T1D.  He was sent home because they thought he had a virus.  By Friday, he was in critical condition.  He died today.  It didn't have to happen.  A fifty cent blood test and these two beautiful children would still be here.

Thursday, July 09, 2015

Gluten Free Bread

One of the first questions asked at the hospital during William's diagnosis for Type 1 Diabetes was if there was a history of celiac disease in our family.  While there is not, there is a history of autoimmune diseases including IBS, skin, and thyroid disorders. (T1D diagnosis was, however, out of the blue.) The doctor indicated that some studies show a link between autoimmune diseases, inflammation in the gut, perhaps the microbe population there, and some environmental trigger.

We pursued genetic, vitamin level, and food allergen testing for several family members. One of the outcomes was the recommendation to go gluten-free. (Because dealing with Type 1 Diabetes isn't challenging enough.) Yes, I know many consider it a fad diet.  We have empirical data, however, in our family that the diet does help with headaches and other symptoms.  With markers for thyroid disease but not yet having it, my goal for William is also to prevent more autoimmune diseases from developing. It is not unheard of for those with T1D to develop additional autoimmune diseases.

But What About Bread?

My son loves bread, and was not happy about giving it up.  I went in search of a recipe that would appease him during the six month gluten-free, and to up the ante, casein (dairy)-free, trial.  My first few attempts were miserable.  The results were spongy, tacky, fell while cooling, and dense.  After a while, I came up with a recipe based on the Namaste recipe, but a bit changed in technique and a few ingredients.  Below is the recipe, which while it is a little different from wheat bread, is soft and delicious. It contains no milk products. The best price I have found for the flour mix is at Costco, where a five pound bag is about $9 and will make about 4-5 loaves. Compare this with off the shelf, prepared loaves at the grocery that taste dry and powdery for as much as $7 a loaf.


Cathy's Gluten Free Bread

Yeast mixture:
1 tablespoon yeast
1/4 cup warm water

Wet Ingredients:
3 eggs, room temperature
1.5 cups water, warm 
1 tablespoon vinegar
2 tablespoons olive oil
2 tablespoons honey

Dry Ingredients:
3.5 cups Namaste Gluten-Free Flour Blend
1/2 cup cornstarch
1 teaspoon salt
1 tablespoon chia seeds
2 tablespoons ground flax seed

Directions:
  1. Mix yeast in 1/4 cup of warm water for 5-10 minutes.  It should be bubbling after that time.
  2. Mix remaining wet ingredients in a stand (like KitchenAid) mixer with the egg beater attachment.  I mix well until very foamy.  
  3. While your wet ingredients mix, stir together your dry ingredients in a separate bowl.
  4. Add the yeast mixture to your wet mix.  
  5. Add about half of the dry flour ingredients to the wet mix.  Allow to thoroughly combine.
  6. Change the attachment to the bread hook if you have one. Add remaining dry mix.  Mix on medium-high speed for eight minutes.  (This is a change from the original recipe.  I found another recipe that said thorough mixing is very important.)
  7. Prepare your pan: You need a bread pan with fairly high sides.  Coat the inside with olive oil. It is even okay to have a little extra oil in there.  
  8. Pour in the batter.  It will be the consistency of mashed potatoes and will be sticky.  
  9. Wet your fingers and gently guide the dough to the corners of the pan and even out.  Wet fingers as needed to not stick, but don't want to add too much water.  Do not push down or compress.  When it is somewhat where you want it, add a bit of olive oil to the top and continue to smooth the dough.  
  10. Let sit 30 minutes uncovered.  It will start to rise above the pan, and if you start seeing a little crack here and there, it is ready to bake in a pre-heated 350 degree oven.
  11. Bake for 30 minutes uncovered.  After 30 minutes, cover loosely with aluminum foil and bake an additional 30 minutes.  Although difficult to wait, let it cool in the pan a bit before removing (it needs the support of the pan or may fall) and before cutting.  It still may sink a little, but by waiting, it will reduce the amount.  
  12. I recommend mixing one loaf at a time, though of course you can measure out the ingredients for two loaves at the same time.  
That's it! If you see any errors or have questions, shoot them my way.  I want to continue to improve this online version of my recipe.

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