Pregnant? What Your OB is NOT Telling You

You're tired. You're hungry. You're nauseous. You're late.

You're pregnant! Congratulations! Babies are the world's greatest gift and they provide endless joy and challenges. What happens when those challenges are health related and could have been prevented or been less extensive?  Well, from experience, it sucks and you then work to restore the baby's health.

When pregnant with Jahan, I followed the advice of my OB, she was board certified and it was her fiduciary duty to guide me to optimal fetal health. She prescribed me prenatals that were rather pricey, $100 for a month supply, and didn't provide any other recommendations. I would visit her monthly until I was 36 weeks along and then I visited her weekly until my son was born.

There was no other guidance from my OB, so I opted to do my own research.  Some things I learned included:

• There is a vaginal advantage versus a c-section. A recent study from the Canadian Medical Association Journal discusses this further.
• There is a clear advantage in breastfeeding versus formula feeding. Here are 18 breastfeeding benefits and here is a more scientific article that credits breast milk with a lot of positives. The immune system boost to the baby when breastfeeding is undeniable.  A simple google search will yield endless articles, scientifically backed showing the benefits of breastfeeding.

So shoot for a vaginal delivery and breastfeed the baby - easy enough. 

Once Jahan arrived and started showing baby eczema, we learned a lot of other things that we could have done while pregnant to ensure the highest immune system possible. My OB never shared these tips. Perhaps she didn't know. Maybe a new protocol could be to see a pediatrician or immunologist at week 20 of pregnancy. There has got to be a way to ensure pregnant mothers receive all information that may impact their baby. Some things to consider while pregnant:

• Avoid antibiotics while pregnant and get Group B Strep tested closer to delivery instead of at 35-37 weeks
• While pregnant, supplement with prebiotics and probiotics
• Ensure you are getting adequate Vitamin D
• Limit sugar intake while pregnant
• If a c-section is required, inoculate the baby with mom's vaginal flora immediately following the c-section delivery 

When pregnant with my second child, Emrys, I applied all of the above and he has had no immune system issues. His microbiome is flourishing.  He has had none of the complications Jahan has had and we also expose him to germs and dirt! 

That Dreaded Call

It's been a week. A week since your  last blood draw, probing for the latest and greatest, ok maybe not the greatest.

This is pretty standard protocol for someone with food allergies. Test the patient annually for new trends in the numbers, expose new allergies and sometimes, but not all that common, drop some allergens off the list.

This call for us has only ever been bad news. Actually all results from any doctor you have seen has always been bad news. More allergens should be added to the list. Avoid more foods. Your immune system is working on overdrive all day every day.  It's exhausting and temporarily depressing.

Daddy and I are curious where your numbers are now that you are two and your immune system is more mature and has been getting massive boosts from Dr. Wong's supplement protocol.

It's now been a week and a half. Friday morning, the phone rings and I know it is Hopkins because there is no caller ID. I answer, it's the doctor's scribe. The scribe takes all the notes and makes all the calls. She is also an MD.

She starts with, "La-Tasha, there are a lot of numbers, where shall we start?"

My heart is pounding, I'm thinking, "shit, what now?"

The scribe proceeds by asking if I have been giving you seeds like they suggested. Chia seeds, flax seeds, pumpkin seeds, etc.  No, I have not because I am SCARED! I am scared to give you anything new. When we give new foods, it must be on a weekend about midday. That way if you react, we are home and awake and can manage. She tells me I have to try the seeds, today. Once you have tried all of those seeds, try sunflower because that number came back low. Woohoo, small win there since we thought sunflower could be a new allergen. Now we have homework.

Then she tells me that coconut came back very low and there is likely no allergy anymore. We have been avoiding coconut like the plague for a long time. I am beside myself with glee, just imagining the possibilities with adding a new food. Coconut milk, and water and oil and yogurt and ice cream!  She tells me to try it at home and the medical team is confident you will tolerate it with no reaction!  More homework.


Next she tells me, you will need to come in within the next year, to Hopkins to challenge peanut! Your numbers are so low and following overall decreases to most allergens and because of risk of anaphylaxis they will feed you peanuts in the hospital setting while monitored and under the doctor's care.  The good news keeps coming - This. Is. Unreal.

We chatted for a few more minutes and concluded the call with a summary. Your numbers are decreasing for many items, but he is still highly allergic. Seeing overall reductions in a two-year old is a trend that points to a high likelihood of outgrowing many of these allergens.

I hang up and just sit there.  That dreaded call wasn't. It was delightful.  A flood of emotions continue with all this amazing news.  This is the first time that I feel real hope that you will be ok. We will get thru this.

Now it's time to try our new foods! Coconut, we are coming for you! 

A Glimpse into 2020

With the boys' school closed today, we opted to make great use of our time together and explore the local area.  First up, a farm. Pony ride, check. Petting zoo, check. Goat feeding, check. Now time for lunch. Jahan plowed thru his sandwich and fruit, the sun amps up his appetite for some reason.




After lunch, we hopped into the car to pay a visit to this restaurant I have been wanting to try for sometime. It's called One Dish Cuisine. The restaurant prides itself in being very allergen friendly and free of most things that could send Jahan into an allergic tailspin.

We pulled up and went inside and were greeted by the owner. After a short intro, I learned that his wife has many food allergies and he was inspired to create an atmosphere for people like Jahan, to eat safely. Freely. And be a normal kid and eat a damn cupcake or a cookie or both.

Jahan asked for a chocolate cupcake. This was a first, not the cupcake part because I cook and bake all sorts of things at home, but the part about ordering dessert in a restaurant and eating it at a table in the restaurant. Seems basic for most, but not for Jahan.  We all sat down as I placed the chocolate cupcake in front of Jahan. I smiled, watched and waited with joy and my camera of course. Jahan still is unaware of how his allergies impact him, so this moment really was for me. Jahan removed the frosting and ate one-third of the cake - then he was done.  The freedom I felt in not having to ask one question about what was in that cupcake, what is the risk of cross-contamination, what are the "natural flavors" was indescribable  - to my surprise, that is all I really got from this moment. There was no extreme exhilaration as I thought there would be. Jahan is not a "foodie" by any means. His appetite is very small, so he did not show the excitement I was expecting even when eating the cupcake. He just doesn't really care about food or even sweets. In a big way, this makes dealing with his allergies much easier.  The joy I was expecting will only come when I see Jahan excited with glee, usually while he is playing soccer or trucks with his brother or at the beach with friends or a backyard barbecue with a slip-n-slide.  Fun>food.

Jahan removed the frosting - his least favorite part

Jahan all finished with his cake

This moment let me take a glimpse into our future and feel what that freedom will be like when Jahan is completely cured, yes I said cured of his food allergies.  

It's About the FUN not the FOOD!

With our beach vacation wrapped up, I am reflecting on this experience and how I felt throughout our beach weekend.  The trip included 22 people, 12 adults and 10 kids. The kids' ages ranged from six months to eight years old.

The kids enjoying their Maryland beach vacation

Trips like this allow Mehul and I to see how other kids eat. Freely. Wow - what a luxury that most parents take for granted.  One had a hot dog at the boardwalk. Others were allowed to eat anything from anyone without question. And of course no required label reading  The kids on this trip were far less picky than our sweet boy. Their diets seem so diverse.  A part of this is because innately the other children are simply not as picky as Jahan. They would eat foods with color also known as fruit and vegetables!  Their appetites much larger. And then of course, no food allergies, not even one.

It still is a tough pill to swallow to have to tell Jahan he cannot have what his friends are eating and it will make him sick. He cannot have the french fries on the boardwalk that daddy is eating because of the oil it is fried in. He cannot have the chicken that was made for dinner because of ambiguous ingredients.  It hurts my heart that my boy will soon know that he is very different from his friends.

With all of the "nos" and"cannot have those" this past weekend, Jahan was shown some love by one of our dear friends.  She sought out a Jahan-safe recipe separate from the others that would mimic what the others were having.  Jahan loved it!  Moments like this shows us how much Jahan is loved and we cannot express how grateful we are to have such wonderful and understanding people in our lives.

With all of the emotions that come with having a child allergic to many many foods, I have to remind myself, that the life we live is about the fun we are having, not about the food we are eating.

No horseback riding, but this was the next best thing!

Jahan won this lil monkey all on his own!

Super Foods - Part 1

As Hippocrates once said, "let food be thy medicine."  Despite Jahan's multiple food allergies, which will all be treated starting in the next 24-30 months using OIT, food is the best option for medicine. Food will address the most pertinent issues (excluding the allergies) currently plaguing his two year old body. Leaky gut, inflammation, the presence of pathogens, unacceptably low levels of of good bacteria and eczema can all begin to heal by eliminating the inflammatory foods, ingesting a diversity of fruits and vegetables and taking daily vitamins and supplements.

While none of us are doctors, my husband and I have consulted with multiple functional doctors, functional/holistic dietitians, allergists and dermatologists and we have compiled a list of some of the best foods to help obtain optimal gut health based on their recommendations and our personal results.

Getting your two year old to actually consciously eat these foods or any foods other than juice, pasta and milk is an entirely separate and equally challenging endeavor.  Consider yourselves extremely blessed if your toddler is eager to eat and try new and different foods.

Here is part 1 in the Super Foods Series

1. Jicama - If an apple and a potato had a baby, Jicama would be the result.  This starchy tuber is packed with vitamins and minerals, especially vitamin C. Vitamin C is great for boosting the immune system of which a whooping two-thirds is located in the gut.  Jicama contains a prebiotic called inulin. Probiotics seem to get all the love these days, but prebiotics are ultra important too because they are food for the good bacteria.  If you don't feed the probiotics, they go away. Prebiotics promote the growth of the good bacteria in the gut. Jicama is refreshing raw sliced in a salad, added to a smoothie or cooked like any style potato you may fancy.  
2. Sweet potato - This starchy tuber is the gift that keeps on giving. Sweet potatoes provide high amounts of sustained energy without causing the body to spike.  Sweet potatoes are a also a prebiotic, so the good bacteria feeds off of these. Sweet potatoes are delicious baked, steamed or fried. 
3. Turmeric - This spice is used daily in our house. Turmeric is very commonly used in Indian cuisine, but word is spreading about this 8th wonder of the world. Turmeric is known for it's anti-inflammatory properties and can be used to treat a wide variety of digestive inflammatory diseases including Crohn's disease, irritable bowel syndrome (IBS) and indigestion.  Turmeric can be added to smoothies or sprinkled on potatoes.  We simply add to our toddler's milk at each serving and he gladly downs it. 
4. Salmon (wild caught) - All salmon are NOT created equal.  Farmed and wild salmon may look similar, but farmed salmon are loaded with antibiotics, which are extremely harmful to the gut flora's environment.  In addition to that, wild salmon has more protein and less fat per serving, less toxic compounds and lacks the artificial coloring that farmed salmon contains.  Oh and the taste, there is no comparison.                      
5. Plantain - A resistant starch. What does this mean?  Without getting too scientific, plantains resist being absorbed as sugar, instead, these starches travel to the small intestine where they are turned into a short-chain fatty acids, which provide energy to the cells in the colon.  Inflammation reduction also occurs.  Green plantains are delicious fried. This Puerto Rican version is similar to how I cook them at home. 

Stay tuned for more posts in the Super Foods Series. 

The Squeaky Wheel Gets the Grease

It's the last weekend of the summer of 2016, well according to the schools anyway.  The Patel's last hurrah and we are super excited to be doing it with five other families, one which we have never met. Vacations used to be the source of a lot stress and anxiety.

• What food will we pack for Jahan? 
• Will we have a kitchen?
• Have we considered all the precautions at the airport and on the airplane?
• What will he be able to eat at the restaurants? 
• Will the restaurants be able to accommodate his multiple allergies?
• Did I research all the restaurants and call ahead to speak with the chef and manager(s)? 
• How and when do we break it to the others in our group that they are important players in the game of keeping Jahan safe and reaction free? 
• Will they have stores nearby to restock should we need more Jahan safe food? 
• How close are the nearest fire stations, hospitals, etc. should he have a reaction?

And the list could go on and on - the squeaky wheel gets all the damn grease! What I mean by this is Jahan usually gets most of my attention in planning for a trip that often I forget something for Emrys - never fails me. 

There is zero margin for error. I, we, none of us can make a mistake.  This is a lot of pressure for people to carry. We are all much more comfortable with this process now because we do it all the time.  We includes not just Mehul and I. Our friends, our family, the school teachers, all are nothing short of amazing.  I am quite vocal, maybe to the point of being annoying, but everyone we associate with knows Jahan has allergies and while he is still young, it's everyone's duty to help keep him safe.  

My mantra for Jahan is that he may have a restricted diet, but he will not have a restricted life. We will actively participate in everything - Jahan goes to a group setting school, has a better social life than most 30-somethings, has stamps in his passport and will be going on his sixth vacation this summer.  Isolation does not work for us. Here is to an amazing reaction free weekend with wonderful people and not forgetting any of Emrys's things! Let the memory making begin! 

The Scratch that Itches and the Itch that Scratches

Jahan's eczema at seven months old

The correlation between eczema and food allergies although undeniable, is often not common knowledge to all.  Jahan's food allergy journey began shortly after birth with full body eczema covering his tiny body by five months old. Weeping, bleeding, itching, repeat. It's the scratch that itches and the itch that scratches.  We have had ups and downs, learning a lot along the way, but around the age of 14 months old, Jahan's baby skin was finally just that, soft and supple, like it's supposed to be.

This lasted for six short months and then a chest to knee flare began. Wet-wraps, diet revisions, elimination diets, creams and ultimately steroids. Ugh, that feels like the ultimate fail, having to resort to god awful steroids on my toddler's young and still thin skin.  All to end up back with an unwavering flare.  We opted to see our functional doctor, think east meets west, a holistic, natural MD.  The marriage of the two had produced some amazing results in the past, so I thought, lets get in to see Dr. Wong.

As we meet with Dr. Wong, Jahan is fearful, he must be thinking what will this doctor do to me. He has seen more doctors in his short two years of life than I have in my 32 years.

Right away Dr. Wong takes a look at the eczema and then scans Jahan's tongue and suggests eliminating cow diary. That's all milk, cheese, yogurt, mac n' cheese, string cheese, pirates booty, milk chocolate and the list goes on. We will switch to goat dairy, no problem since we live in an area where we have access to these foods and Amazon basically delivers same day now.  Dr. Wong also reminds us that Jahan's eczema is his body's way of showing the internal inflammation and suggests we complete a stool sample to see inside of his gut, where two-thirds of his immune system lives.  We agree.  Then Wong as Jahan calls him tells me that I have to prepare the samples at home, FedEx them overnight to the lab and wait.

Eczema flare at 22 months old before dairy elimination

So off we go.  Waiting for Jahan to have a bowel movement was our next step, which thankfully was only the next day (Saturday).  Jahan does his business and quickly I start in on this home scientific lab.  This was not fun.  Spooning fecal matter into various tubes, mixing and smoothing, repeat. They should really consider sending a mask home with this sample kit.  Not one of my finer mothering moments, but someone had to do it.

I package it up and off the stool goes to the lab for testing.

The results are in and right away from them I can see there are issues that need to be addressed. Inflammation. Leaky gut. Dysbiosis. Minimal bacterial diversity. And worst of all, two pathogens. Shit, how did this happen to my little guy? He was born vaginally, solely breastfed for 6 months, no antibiotics for the first year of life, probiotics from birth. He's only two!

Jahan's eczema and gut resolution regimen 

We circle back with Dr. Wong and he confirms everything from above.  Mehul and I are not interested in putting a "band-aid" on Jahan's symptoms, we want to solve the problems at the root. Wong knows this. He works to find "safe" supplements for Jahan's issues. This is quite the task given all of his food allergies, but ultimately we go home with our list of supplements and prescription to remove all dairy, even goat. So now Jahan is dairy free and ingesting 11 vitamins, supplements and herbs multiple times daily in hopes to improve the gut.

With this routine, the eczema has dissipated entirely with the exception of one stubborn patch.

And now we will continue the routine for eight weeks and then I get to spoon, smooth and smell the fecal matter of my adorable two-year old....again all while hoping we can stabilize Jahan's gut and entirely eradicate the scratch that itches and the itch that scratches.

Sometimes You Feel Like a Nut

Sometimes you feel like a nut...so you eat it. Not my sweet Jahan, no nuts for him, at least not yet.

Jahan is allergic to tree nuts and peanuts among many other foods. Today Dr. Wood, yes the renowned Dr. Wood, provided a glimmer of hope in the allergic world in which we live and have lived for almost all of Jahan's two years of life. "Coconut and almond appear to be false positives, but we will need to confirm with a blood sample."  I know what you're thinking, "who is allergic to coconut, it's hypoallergenic?!"  Jahan is or wait maybe he was...allergies are complicated!

And off we go to get labs done. This never gets easy. Jahan does not appreciate being dealt the allergy card thus resulting in recurring pokes and prods. Jahan has had many many blood draws, more than me through both of my routine pregnancies.  Today was good, it was a successful draw which included only a few tears coupled with tortuous shrieks.  I know soon those wretched screams, welled-up eyes and that flailing toddler body will become more subdued during these all too common procedures.

The aftermath, REM covered with banana bread crumbs