Friday, April 24, 2015

Allergies, Atopic Syndrome, & Sports Nutrition

Generally I steer away from squawking about my health on the internet because it's not like we really need MORE of that. This rule kind of goes double re: talking too much about food and what I do and don't eat. But, I make exceptions from time to time for things that feel somewhat relevant to running (at least for me), so here I go DOUBLY breaking my own personal blogging rules.

I've had exercise- and allergy-induced asthma basically my whole life, and when I lived in Texas (where I grew up), I also had really bad dust and plant allergies at certain times of year. (Also to animals, though after a few days around a particular set, I seemed to acclimate & be fine.) All of this got a lot better when I moved to Ohio for college, to the point that after a couple of years, I went from taking ALLLL the asthma/allergy drugs/pills/steroids/inhalers to taking essentially none. Some of it's come back *just* a touch since I've been in California these past 10 years, but for the most part as long as I use my inhaler before I run and take a Zyrtec if I know I'm going to be out in nature or around animals, it's basically been fine.

My body likes to keep things interesting, though, and in 2008, I started having throat/upper GI problems, which ranged from mild heartburn to sometimes being unable to swallow food or even water. I saw a doctor for this, who put me on some medicine which helped a lot, and he was all like, "YYYYeah, you should probably have an upper endoscopy & a biopsy to figure out what's up with that." So we tried, and the anesthesiologist couldn't knock me out, and everyone gave up, and I got really busy & moved on with my life.

A year and a half later, I developed an absolutely hideous rash. On my face. Like, nightmarishly, cringe-inducingly bad. All the skin around my eyes became itchy, then red, then turned scaly and started flaking off. Also during this time I had to go out in public sometimes and be around other people, particularly my job teaching public high school to teenagers which was AWESOME. It was disgusting and humiliating and also quite uncomfortable, and the worst part was not knowing when (if?) it was ever going to end.

After going to the doctor like three times only to have her be like, "HM, THAT'S REALLY WEIRD, IT'LL PROBABLY JUST GO AWAY." "OH IT DIDN'T GO AWAY? HERE HAVE SOME BENEDRYL." "WHAT THE BENEDRYL DIDN'T WORK?? THAT IS SO WEIRD." I finally went to an allergist, who, after one phone conversation was like, "I'm pretty sure I know what's wrong with you. Come in & I'll fix it." Dude was like, "You have asthma, bad allergies, eczema [the scaly skin thing], and from the sound of it, eosinophilic esophagitis [the throat thing]. That there's what we call Atopic Syndrome, which basically means every part of you is allergic to everything between here & eternity."

The doc gave me a giant steroid shot which, I kid you not, was so big that it took nearly a full minute to inject. A few days later, the eczema was completely gone. The next week they did two blood allergy panels (one for plants and one for foods), for which the official results just read, "Sweet holy fucksticks."

No but really, the doctor was like, "This test is not conclusive but it looks like you have allergic antibodies to egg white, wheat, corn, soybean, peanut, hazelnut, cashew, walnut, almond, macadamia nut, cat and dog hair, mites, bermuda and johnson grass, timothy, penicillium notatum, cladosporium herharu, aspergillus, alternaria tenuis, white oak, elm, cottonwood tree, white mulberry, smooth alder, mugwort, and pigweed. So maybe avoid those things?"

But to be honest I kind of blew it off because it said I was allergic to all these foods that I've been eating my whole life without having any reaction, and besides my immediate problem was solved which is obviously the only really important thing in life.

Fast forward to a few months ago when I called to get my throat prescription refilled and the doctor's office was like "YOU HAVEN'T BEEN HERE IN FIVE YEARS, WHAT IS THE MATTER WITH YOU?" So I slunk back in, and finally agreed to get another endoscopy/biopsy, which confirmed the eosinophilic esophagitis/Atopic Syndrome. The treatment, typically, is to stop eating eggs, wheat, dairy, soy, nuts/seeds, and seafood. Forever.

(Did I mention I already can't eat cruciferous vegetables because of my thyroid problem? GUESS IT'S STEAK AND FRUIT FROM NOW ON.)

(Oh, wait. We can't shouldn't eat beef because of the drought, so chicken, I guess. Chicken and fruit.)

So yeah. That business is like a real, legit, medical-treatment diet, not something Gwenyth Paltrow made up because paleo-vego-gluten free was too rich.

My reaction, predictably: Eff. That.

And the doctor was like, "No but really. This is a food allergy & it's really bad for you, & if you're not going to do the diet, you really have to get the skin tests & then stop eating whatever it says you're allergic to."

Cue the allergist. I explained my situation and then they did a round of skin testing, which involves drawing a giant grid on your back & then pricking each little square with one of the allergens they're testing you for. (I think they did 40-50 on me.) It was less uncomfortable than I was afraid it would be, and the good news is that it only takes about 15 minutes before you can see the reactions. Sure enough, my back started to itch in several different places, and I kind of resigned myself to being told it was chicken and fruit from here on out.

But, interestingly enough, the only foods I reacted to were the nuts, particularly peanut and hazelnut. I was elated!

The downside: I eat a peanut butter & jelly sandwich every morning when I get to work, and of course, just refilled my stash last week.

Anyone want any peanut butter?

When I was thinking I might have to retool my entire diet, I made an appointment with a sports nutritionist at the Sports Medicine Institute in Palo Alto (the same place where I go for massages). He's apparently worked with a lot of Stanford athletes and other local recreational and professional endurance athletes, so it seems like he's the right kind of guy to talk to. I'm feeling a lot less panicky about nutrition (now that I know I'm not allergic to every food on earth), but to be honest, as I start to really, actually train for Santa Rosa, I kind of do want an expert set of eyes looking at what and how I eat & see if there are things I can tweak a bit for better results. By & large I feel that my eating habits are pretty decent, but they're certainly not perfect, and I feel like I'm not quite up to doing it on my own (even with the help of Matt Fitzgerald).

So, I'm seeing him next Tuesday. It will be interesting to hear his thoughts (especially about what I should start eating when I get to work now that PB&J is out)!


  1. Oof. That's rough (re: allergies) but at least it's only certain nuts that are officially, 100% out? Because my reaction to not eating dairy, wheat, eggs, or seafood would definitely be yours: eff that.

    I personally find the nutrition side of running -- especially when seeking peak performance -- to be really interesting and always welcome a bit more insight on how others balance life/work with the nutrition element.

  2. First and foremost, I love that you didn't jump to full-blown conclusions until you'd gone through the testing, and that you're still not being preach-y. (After all, if everyone ate the same exact thing that was supposedly the healthiest/best/whateverest, we'd run out of it.)

    Moving along to breakfast options, have you tried sunflower seed butter? If that's blah, how about half an avocado mashed up and spread on toast? I tried that this week (with some salt because I am a salt fiend sometimes) and it kept me full for quite a while.

  3. Well. Shiznit. Immune systems are so weird (saying that is one thing, living with your immune system is quite another). Good luck with your nutritionist. (I would also bring in all your medical evidence so they don't think you're a fad-diet crackpot.)

  4. Atopic syndrome can be so odd. Some people show wildly high antibody levels to a particular food, yet when they eat it, they're just fine. Or their mouth feels a little puffy and weird, but it goes away. And other people sit on the grass and want to claw their skin off in two minutes, but they don't appear to be highly allergic to it.
    I have an under-active thyroid myself (well - only a small part of it remains now!) but I take levothyroxine, so I kind of eat whatever I want in regards to cruciferous vegetables. That's good, because they're my favorites!

  5. That sounds hideous. Having to change your diet is like trying to reinvent the wheel. I hope your nutritionist has some great ideas for you which are easy to incorporate.