Celiac Digest

A publication of the Southern Arizona Celiac Support Group (SACS)
online at WWW.SouthernArizonaCeliacSupport.org
Volume 9, Issue 2
September 2010

DISCLAIMER: This publication is intended as a general information resource for gluten-intolerant individuals. It is NOT intended for use in diagnosis, treatment, or any other medical application. Please consult your physician for professional medical advice and treatment.

In this Issue

September 25 Meeting to Feature SACS Nutritionist Hana Feeney

Hana Feeney

SACS Medical Advisor, Hana Feeney R.D., is slated to speak at the September 25 General Meeting at Pima College District Campus, located just north of Broadway and east of Swan (behind TGI Fridays).

The newest addition to our MAB is sure to garner our attention with her presentation Eating Exceptionally Well (even on a GF Diet)! She will cover the common fallacies rumored about the GF diet and give us fresh ideas for adding nutritious variety to our GF lifestyle.

“Nutritionally speaking, my home life is a bit complex. My husband has type 1 diabetes and I have celiac disease. Balancing each of our unique nutritional needs reminds me how important it is prioritize healthy food and exercise. If healthy lifestyle wasn't a top priority for us, our health could get lost in the shuffle of life. Having celiac disease requires me to think about everything I eat throughout the day. It is a significant challenge, but it makes me aware of how hard lifestyle change can be. I consider myself lucky to so dearly enjoy the science of nutrition and the art of cooking, it makes me healthier and a better nutrition counselor.”

—Taken from Hana’s website www.nourishingresults.com.

Make plans NOW to attend the September 25 meeting and have your questions ready for the Q & A session. Don‘t forget that if you bring a snack to share, please include the recipe or an ingredient list for those of our group who have multiple food intolerances. We look forward to seeing you there!

Back to School Gluten Free

It‘s that time of year again and we always have questions from concerned parents about how to handle all those pesky problems like lunches, sleepovers, class parties, etc. We know your GF children want to experience life with their peers in as "normal" a way as possible. Here are just a FEW of the websites we came across with great GF School Lunch (etc) ideas:

There are lots more out there so take time to browse for yourself!

Improving Communication with Your Doctor = Improving Your Outcome

By Dr. Lindsey Pearson, NMD
Integrative Internal Medicine
Medical Advisory Board Member

I recently heard an increased number of people stating that their doctors are reluctant to order lab tests to screen for either celiac disease or co-morbid conditions in people who have already been diagnosed with celiac disease. In my experience, the reluctance comes from (1) the doctor isn‘t versed in celiac disease and co-morbid conditions and doesn‘t understand the importance of screening and comorbid management; (2) the doctor cannot deem the testing medically necessary for insurance purposes, or (3) there is a breakdown in doctor-patient communication. If it is due to the doctor not being versed in CD, then one needs to find one that is. If it‘s due to a doctor not being able to deem the testing medically necessary, provide your doctor with a concrete story that supports your request for testing. If it‘s due to a breakdown in communication, the patient can improve his/her communication skills to help facilitate optimal communication.

In this article, it is my objective to educate readers about the medical decision making process doctors use so they may improve their communication with their doctors and become active, engaged participants in their healthcare. At the end of the article, a reader will know what needs to be communicated and how to communicate it to a doctor.

Doctors are trained to methodically work up a patient. We first start out by interviewing the patient on the history of the present illness. We ask patients the seven attribute questions about : Locat ion, Quality, Duration, Timing, Setting, Associated Signs & Symptoms, and Modifying Factors. Doctors need to know when signs and symptoms (SSx) started, how do the SSx feel? In what setting or environment are the SSx present? How have the SSx changed since the onset? What makes the SSx better or worse? Are there any other SSx that are associated with your primary complaint? Lastly, what treatments have you tried and what was the outcome of those treatments?

THE SEVEN ATTRIBUTES

  1. Location (Where?)
  2. Quality (What does it feel like?)
  3. Duration (How long does it last?)
  4. Timing (When does it happen?)
  5. Setting (Where does it happen?)
  6. Associated Symptoms (What else is happening?
  7. Modifying Factors (What makes it better? What makes it worse?)

Past medical history, family history and social history are also valuable to doctors. In your significant past medical history, include all surgeries , medications, illnesses, and reproductive history. Social history includes pertinent information about your job, diet, sleep, stress level, alcohol and tobacco use history, and family/support structure. Write down or type out this comprehensive history. If you write it down, make copies for all of your doctors and for future new doctor visits. By doing this, your doctor will be able to read your history and be able to do it in the limited face-to-face time you have with him or her.

As Dr. Shelli Hanks and I have lectured about before, writing out what you want to tell your doctor prior to your visit makes your visit together much more productive. You won‘t forget anything and your doctor will have it in written form to refer to when charting your visit. Notes on sticky pads are great for doctors, we can stick them in the chart and have them for later when we are ordering labs – it is a really good reminder of your visit together. You will not only be setting yourself up to succeed, but you will assist your doctor in being more successful. Below is an example of a well written history for a chief complaint of gas.

“I began experiencing gas seven months ago an hour after eating a meal. About a month after the onset of gas, I began experiencing bloating and abdominal pain around my belly button about three hours after eating. About that time, I began experiencing more loose stools, mucus in my stool, and increased sense of urgency to have a bowel movement. Now the gas and bloating are almost constant and my abdominal pain has increased in frequency and intensity of the stabbing pain ranges from a 4 out of 10 to 8 out of 10 on a scale of 10 being the worst pain I have experienced. I have tried over-the-counter fiber supplement and antacids, both not giving me much relief. I, however, do feel better when I eat only vegetables and meats and avoid grains. I also had skin allergy testing done five years ago that showed I had several allergies, including foods and environmental allergies. My doctor ordered them because I also suffer from chronic nasal congestion and seasonal allergies.”

The following is an example of past medical history, family history and social history for a 52-year-old woman.

Past Medical History
1982: Birth of first child, son, Jared. Conventional, vaginal birth. No complications. Breast fed x8 months.

1984: Birth of second child, daughter, Jenny. C-section due to umbilical cord issues. No complications. Recovery from C-section went well. Breast fed x9 months.

1990: Hospitalized due to appendicitis. Appendectomy without complication. Recovered well.

Family History
Father: Cardiovascular disease; Type II adult onset diabetes. No insulin use. Controlled by diet. Living in Phoenix.

Mother: Endometriosis, fibroids. Radical hysterectomy at age 39. History of abnormal PAP and mammogram. No history of cancers.

Social History
Married for 33 years. Two adult children. Live with husband in Tucson. Working as a Trust officer for 22 years. Job stress minimal. Never smoked cigarettes. Drink wine and beer about 2 nights per week. Sleep is good at 9 hours per night. Diet is varied consisting of meat, fruits, vegetables and nuts. No dietary restrictions.

In addition to writing down your history of present illness, patients can also utilize communication tools that improve doctor-patient communication. One such tool is a diet diary. A diet diary is a record of anything you eat or drink over a two to three day period and is useful in the evaluation and management of gastrointestinal conditions. It includes food, beverages, medications, supplements, and herbs. It also documents bowel movements and signs and symptoms you experience. All entries should be dated and the time noted. Your doctor then can review the diet diary to see if there are any patterns that emerge. Finding patterns will help your doctor form a diagnosis. Communication tools like the diet diary assist the doctor with information gathering, leading to a final diagnosis. See the chart (below) for an example of diet diary entries.

Other communication tools include menstrual cycle tracking, medications/supplements/herbs flow sheet, and preventive screening logs that document your scheduled screening such as PAPs, mammograms, prostate health, colonoscopies and yearly physicals. Using communication tools will not only allow you to communicate better with your doctor, it will also help you learn more about your condition.

Being an active and engaged participant in your healthcare sets you up to be successful and receive the proper care you deserve. You have a vested interested in your health care, so be proactive and organize your data so it may be readily accessed and utilized by you and your doctors. Having this data organized will not only help out your doctors but help you out by keeping your health history fresh in your head. The more you can communicate effectively with your doctor, the better care you will receive.

Date/Time Food, Beverage, Meal, Medication, Supplement Symptom: Name then describe using the 7 attributes Bowel Movement: Color, Size, Quality (loose, hard), blood, mucus, undigested foods Urination: color, smell, discomfort, increased frequency
8/14/10 11:00 AM Lunch: Salad with vinegar dressing, cheese, peas, spinach, Romaine lettuce, radishes, cucumbers, tomatoes, croutons Experienced bloating 30 minutes after eating in lower abdomen, no pain, lasted 3 hours, 7/10, headache came after 1 hour. Nothing found to make it better or worse.
8/14/10 12:15 PM BM – Lt brown diarrhea, no blood/mucus present, plant fibers in my stool. Urine lightly straw colored. No complaints.

WANTED:: Creative Desktop Publisher

Need an outlet for your creativity? Consider joining our team as Newsletter Editor of The Celiac Digest. Requirements include having a working knowledge of MS Publisher and being willing to attend meetings occasionally. Please contact Cheryl Wilson at 520-298-5551 or via Email at so.az.celiacsupport@gmail.com.

GF Food Faire 2011 Showcases a New Venue

SACS board members Kim Pebley, Pat Hirsch and Cheryl Wilson met with Holiday Inn Palo Verde staff in July in order to tour the facilities and finalize an agreement to use the ballroom and the entire atrium entryway for the 2011 GFFF scheduled for Saturday, April 30, from 10am-2pm.

The Fiesta Ballroom, made up of four smaller rooms combined, will be approximately twice the size of the facilities that SACS has used for the last three years. Having the lower and upper balconies in the atrium entryway will be a huge attention-getter for anyone staying at the hotel. GFFF coordinator, Kim Pebley, hopes to offer cooking demonstrations on the upper balcony to attract even more attendees.

"The larger ballroom will certainly allow for many more vendors, as well as more space for Cel-Kids and the annual blood screening for celiac disease," states SACS president, Cheryl Wilson. "There is plenty of parking in front of the hotel and the hotel will be offering discounts for those who may want to stay there overnight, including vendors."

Many more improvements and up-grades are planned for the 2011 GFFF and we are excited to see how the new venue affects the attendance. With the location just north of I- 10 and close to the airport, attendees and vendors should have an easier time getting to/from the GFFF.

OCTOBER Lunch Bunch Fundraiser

On October 8 our main GF Lunch Bunch (GFLB) meeting will be held at Chili’s, Broadway/Rosemont. Come a little early to be ready to order by noon. Chili‘s has a “Give Back Day” program for nonprofits like SACS. They will send SACS a check for 10% of all the October 8 (only) GFLB sales. All you need to do is give the cashier your "Give Back Day" voucher when you pay for your meal. SACS will provide the vouchers at the Sept. 10 GFLB, the Sept. 22 Round Table and the Sept. 25 General Meeting or you can download it from SACS' website. Colleen will have some at the Broadway/Rosemont Chili‘s GFLB too.

All 5 Chili‘s locations will honor the vouchers on October 8th during their business hours (11am-10pm), sit-down dining AND to-go orders! So if your schedule does not permit you to be at the main GFLB on Broadway/Rosemont, you can still take part in the "Give Back Day" program for either lunch or dinner at any of their locations on October 8th. The other 4 locations in Tucson which will honor our vouchers on that day are: River/Stone; Oro Valley; Arizona Pavilions (near I-10 and Cortaro) and Valencia/I-19. All Chili‘s locations have a GF menu. All their staff are trained about safe GF handling.

If you are going to the main GF Lunch Bunch please RSVP as usual to 888-2935 preferably by Wednesday Oct. 6 so Chili‘s can be ready to serve a large group. Chili‘s managers have been very helpful in setting this opportunity up for SACS so let‘s show our appreciation by patronizing them well.

Chapter 15 Notes

  • Membership changes?
    Notify us via the website or call 219-7076 (Kim Pebley).
  • CSA/USA: 877-272-4272
    9 a.m. to 4 p.m. Central Time. Go to www.csaCeliacs.org.
  • SACS GF Mentor Program
    You can sign up online if you would like a mentor to help you navigate the sometimes confusing world of CD/DH or the GF lifestyle. We will try to match you with someone that lives on your side of town. You can also sign up to BE a mentor (diagnosed 1+yr). Go to our website and click on "Gluten- Free Mentor Program."

SACS Volunteer Needs How Can YOU help?

In addition to the Newsletter Editor mentioned on Page 2, we are also in need of the following:

  • Cel-Kids Coordinator. This person would assist us in the planning /execution of events for GF children, as well as answer questions that come to us via the web or phone calls. On-the-job training is provided!
  • Silent Auction Coordinator for the 2011 GFFF. Again, on-the-job training will be provided by the 2010 Coordinator, who will also assist in coordinating the 2011 event (which will be held at the Holiday Inn Palo Verde on April 30, 2011).
  • On going needs include clean up and/or set up for SACS general meetings or special events, as well as people to help assemble and mail the newsletter. You can volunteer to help for a specific date or any number of events. Many hands make light work for everyone else involved.

If you would like to know more or want to sign up right now, please contact our Volunteer Coordinator, Celeste Harvey, at lily_celeste@yahoo.com or call her at 721-6767.

SACS in the Community

By Pat Hirsch

Tucson Tamale Company Simpligy, sustain, Celebrate. Gourmet Tamales Everything we sell is 100% Gluten Free! See our entire menu online www.tucsontamalecompany.com.  2545 E. Broadway Tucson, AZ 85716 520-305-476-

Educating all sectors about CD/GF is essential for the health of our nation. We go to health fairs, provide in-service talks to medical providers such as school district nurses and hospital dieticians. Monthly GF Lunch Bunch and Fourth Friday Dining Out groups provide education one meal at a time to restaurant workers and we hold our annual Gluten Free Food Faire. These successful programs make it necessary to expand education to the general public. In doing so we must:

  • Keep the message as pure as the food so people won‘t "mis-learn" that the GF diet is a "weight loss" scheme or fad diet.
  • Impress that it is medically necessary (not optional) for increasing numbers of Americans.
  • inform beyond the medical/health arena, without sounding preachy.
  • be present at non-health-related events to keep CD/GF in the public eye.

How?

  • We began this summer at a fund-raiser for the food bank of Interfaith Community Services which was sponsored by Southern Arizona Women’s Chorus (a long-time in-kind supporter of SACS). Admission to the first-ever "For Summer Only" mixed voices concert was non-perishable packaged food or cash. Generous SACS members taped blue SACS brochures onto the GF packages they donated. In return, SACS members enjoyed one of the best summer choral concerts ever held in Tucson. It was a great way for 350 concert-goers to see tangible CD/GF awareness in action. SACS provided ICS‘ executive director with a letter saying SACS is here to help them understand how best to serve their GF clients.
  • We will be at the 37th annual Tucson Meet Yourself folk arts, food, traditions and cultural identity festival which draws about 100,000 people to downtown Tucson. It is so all about food that it is often called, "Tucson EAT Yourself"! Planners are receptive to SACS‘ CD/GF input and have even welcomed us in planning with them their brand new Traditions of Health and Wellness section. They will let us tell vendors about CD/GF during pre-event food vendor orientation. We are grateful to the event organizers for welcoming us so heartily. Mark your calendar for October 8, 9, and 10. For more about the festival please visit www.tucsonmeetyourself.org.
  • Jerry Heintze, SACS‘ Fourth Friday Dining Out organizer, has arranged an exciting new type of in-service opportunity. It will be for the longtime original restaurant owners‘ association in Tucson known as Tucson Originals. This talk introduces local restaurant industry leaders to all facets of the medically necessary reasons (including the positive business aspects) to get GF food service right the first time and all the time for every customer who asks for GF food. The restaurant inservice model should blossom into on-going education to keep the concepts of healthy GF food service "fresh" in the industry.

Please contact any SACS board member if you think of some way to enhance our outreach programs.

Boston's the Gourmet Pizza, home of the gluten-free pizzas!  Meet Me@Boston's Come walk or run with us every Wednesday at 6pm  It's a Marana thing 5825 W Arizona Pavillions Dr, Tucson 520-572-1555  We also have Redbridge gluten-free beer $2.50

SACS Adds GF Cooking Classes to the Calendar

Southern Arizona Celiac Support is proud to announce the start of our gluten free cooking classes. Classes will be held the first Saturday of each month from 10 a.m. to 12:30 p.m. Each class will take on a different theme, with emphasis on healthy, easy, everyday, gluten free meals.

The first class will be held October 2, 2010, near Sunrise and Swan. The number of participates will be limited to ten students, so everyone can enjoy "hands-on cooking." A $20.00 fee will be charged for supplies.

October‘s menu is eggplant parmesan (see recipe), spaghetti, fresh vegetables, gluten free garlic bread, and dessert. For November and December‘s class menu, please see our Calendar on the Website.

For more information call Corene Johnson at (520) 577-6930. Join us for a fun way to spend a Saturday morning with new friends while exploring cooking methods and recipes.

Baked GF Eggplant Parmesan

  • 2 cups gluten free bread crumbs
  • 1 ½ cups grated Parmesan cheese
  • 2 eggplants (peeled and cut into ¼ inch round slices)
  • 4 eggs, beaten with 3 T. water
  • 1 jar of gluten free Pasta Sauce
  • 1 ½ cups Shredded mozzarella cheese

Preheat oven to 350°. In a medium bowl, combine bread crumbs and ½ cup Parmesan cheese. Dip eggplant slices in egg mixture, then bread crumb mixture. On lightly oiled baking sheets, arrange eggplant slices in single layer; bake 25 minutes or until golden.

In 13 X 9-inch baking dish, evenly spread 1 cup pasta sauce. Layer ½ of the baked eggplant slices, then 1 cup sauce and ½ cup parmesan cheese; repeat. Cover with aluminum foil and bake 45 minutes. Remove foil and sprinkle with mozzarella cheese. Bake , uncovered, an additional 10 minutes, or until cheese is melted.

G F Cooking

WHAT:

A gluten free cooking class, meeting once a month with a different cooking theme and guest chefs/cooks

WHY:

To learn how to cook easy, healthy, GF meals

WHEN:

The first Saturday of every month

The Lotus Garden  Fine Cantonese & Szechuan Cuisine  Gluten-Free by request  5975 E Speedway  Ph: 520.298.3351

WHERE:

4662 E. Don Jose Drive Tucson, AZ 85718 Corene Johnson, Hostess

WHO:

Anyone over age 14 (limit of 10 per class)

COST:

$20.00 per person

HOW:

Call Corene Johnson (577-6930) to reserve your space for the fun!

First GF Cooking Class:
Saturday October 2, 2010
10:00am to 12:30pm

WAIT! Don’t Throw that Away...

By Virginia Morgan

What do you do when the expensive gluten-free breads and treats become inedible? I have found there are several options to throwing them away. Only moldy baked goods cannot be used and must be thrown away.

  1. Steam it on the stove in a steamer or similar pan. This works well for the dry bread slices and rolls.
  2. Steam it in the microwave. Place wet paper towels above and below the item such as a slice of bread and microwave it for about 30 seconds.
  3. Toast it in a GF toaster or in a pan on the stove.
  4. Make French toast with it.
  5. Make bread pudding with it. This is one way to use the sweet bakery items as well as breads.
  6. Make meat loaf with the dried out bread.
  7. Make croutons. Cut the bread into squares. Place in a baking pan in a thin layer and bake 250 degrees for 20 min. or more, stirring to make sure all sides are dry and crispy. Optionally, before the bread is baked, add a TBSP of garlic or Italian spices to it and /or pour melted butter over it, up to 2TBSP for each cup of croutons. Once it is fully dried, it can be stored in baggie or container in the cupboard.
  8. Make bread crumbs. Dry out bread in the oven as for croutons. After it is fully dry, place bread pieces in a blender or food processor and pulse till all crumbs are small in size. These can be used for breading in cooking and can be stored in the pantry. I save some for turkey stuffing. Bread crumbs for stuffing taste great with some sage and rosemary added before the bread is dried.
  9. Dried out sweet cake squares can be added to a jelled dessert with fruit and whipped cream.
  10. Cakes and cookies can be stirred into homemade ice cream
  11. .

Save the Date: Shop-a-Thon

Saturday December 4th
Holiday Inn @ Palo Verde
10am — 2pm
SACS Fundraiser

You are invited to join us on December 4th for shopping and fun! This is a fabulous chance to do your last minute holiday shopping. We will have many vendors on hand such as Homemade Gourmet, Tupperware, Gold Canyon and more. We need your support to make this fundraiser successful for SACS. Hope to see you there.

Mark Your Calendar

Fall 2010

  • September 17 — 1pm: Bd Meeting, @ Ward 6 City Hall, 3202 E. 1st St
  • September 24 — 4th Friday Dining @ Feast (new location)
  • September 25 — 9am: General Mtg @ Pima College District Campus
  • September 22 — 1pm: Roundtable @ Ward 6 City Hall, 3202 E. 1st St
  • October 2 — 10am-12:30pm, GF Cooking Class @ Corene Johnson’s
  • October 8 — GFLB @ Chili’s!
  • October 9 — 8-11am: SACS booth @ Tucson Meet Yourself!
  • October 22 — 4th Friday Dining @ The Loop, Taste of Chicago
  • October 27 — 1pm: Roundtable @ Ward 6 City Hall, 3202 E. 1st St
  • October 28-31 — CSA/USA Annual Celiac Conference in Kansas City
  • November 6 — Cooking Class
  • November 12 — GFLB
  • November 13 — 9am; General Mtg @ Pima College District Campus

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