A letter to our "normal diet" friends and family.

You may have noticed that I haven't posted any new recipes lately. I have found as I approach the last weeks of my pregnancy I am frankly just too tired to make any extra effort when it comes to meal preparation; in fact, more and more often, I make no effort at all and my wonderful husband and/or kids end up taking care of dinner for me. I am so blessed to have them in my life!

This does not, however, mean that I have forgotten this blog or my (few and far between) blog followers. I have been considering what to write about in the absence of a recipe, and feeling very discouraged about it. Then, Lo and Behold, a couple of days ago I was chatting with a friend about gluten-free dining, and she was asking if I knew anything about a grain called "Faro" or "Farro" (I don't -- please, if anybody out there has any knowledge of this grain, let me know!). Then she made a side comment to me that she had been talking to another mutual acquaintance, who told her something to the effect of, "Yes, I know Elizabeth; she won't eat anything I cook because she doesn't trust me to understand how to cook gluten-free." (facepalm)

I should mention here, in case you were the person who made this comment, I have no idea who you are. The person who related this comment to me did not tell me who said it, and I did not ask. If you are that person, I must apologize for any perception I might have caused that I do not trust your competence in food preparation; nothing could be further from the truth, and I will try to explain myself better forthwith. But this is a concept I (and other people with severe food allergies and intolerances) run into all the time: "Oh, that so-and-so... so paranoid about food that s/he won't eat anything." I try so hard to tactfully explain my reasons for my caution, but food-sharing is such an ingrained part of human society (cutting across all cultures that I'm familiar with) there simply doesn't seem to be a polite way to decline food that is offered. In fact, I recently heard of a psychological disorder that essentially describes my life: Orthorexia Nervosa. According to Wikipedia, "Sufferers of orthorexia often display symptoms consistent with obsessive-compulsive disorder and have an exaggerated concern with healthy eating patterns." Initial diagnostic criteria may include the following questions: "Do you care more about the virtue of what you eat than the pleasure you receive from eating it?... Does your diet socially isolate you?"

Um. The answers to those two questions are unequivocally "Yes," and "Yes." But please allow me explain why I do not feel my concern for what I ingest is "exaggerated."

I am debating whether to actually go into detail on this blog about the signs and symptoms of gluten contamination in my diet. On the one hand, I feel that if my friends and acquaintances understood exactly what I feel and experience when I accidentally ingest food containing even minute amounts of gluten, they would not make comments that would make me feel even more isolated and embarrassed about my condition than I already am. On the other hand, this blog is publicly viewable to everyone and I really don't want to shock anybody with the "TMI" of what I actually experience. I wish people who knew me would just accept that I have very very good reason for my eating habits and it has nothing to do with an "exaggerated concern" with what is in my food and what my food may have inadvertently come into contact with.

So instead of going into details about my own personal symptoms, please allow me to make some generalizations about the types of symptoms that are typical for the severely gluten-intolerant:

One of the immediate possible combination of symptoms may include:

• Nausea
• Vomiting
• Diarrhea
• Abdominal Pain
• Lethargy
• Weakness
• Muscle aches
• Headache

Coincidentally, these symptoms are nearly identical to symptoms of Norovirus. They also closely resemble the symptoms of an E. Coli infection. Symptoms can sometimes be immediate (felt before the meal is even finished) or they may take a day or two to manifest, or anything in between. In my case, if the contaminated meal does not include dairy, I probably won't notice a problem until next time I have a glass of milk (and by then I may not know which of the meals I've eaten in the last day or so were the culprit); if the meal includes dairy I will usually feel the onset of symptoms immediately.

With repeated, long-term exposure, the auto immune system breaks down, and this can lead to more serious problems over the years. Just a few of the possible long-term complications of a Celiac or other gluten-intolerant person who continues to ingest gluten include:

• Chronic pain such as fibromyalgia
• Diabetes
• Extreme weight problems (either underweight/anorexia or overweight/obesity)
• Multiple organ failure
• "Idiopathic" neuropathy
• Vitamin and mineral deficiency of all kinds
• Cancer (most commonly colon cancer)
• Infertility (men and women), miscarriage, and stillbirth (women)
• Death

So... once a person becomes aware that he or she suffers symptoms out of the first list whenever gluten is ingested, that person must also be wary of the second list. (This is true whether the person has ever been diagnosed with Celiac disease or not; Celiac is just one of many manifestations of an auto-immune reaction to gluten). I wish someone would explain to me what an "exaggerated concern" would actually look like in the face of such consequences.

"But I understand all that and I promise what I just made for the pot-luck is gluten-free! Why won't you eat it? Don't you trust me?"

This is where things get sticky. As you can see from the symptoms, ingestion of gluten by a gluten-intolerant individual actually is almost indistinguishable from Norovirus and E. Coli infections. So imagine yourself for just a moment in the shoes of a Celiac or other individual who is unable to eat gluten. In order to do so, let's just pretend that all gluten-containing items (crackers, flour, barley, bread) are actually items that are (or contain) fecal matter from people known to be infected with Norovirus and/or E. Coli.

If I walk into your kitchen and I see bread on the counter, a bin of flour on the shelf, and a box of Wheaties on top of your refrigerator, I do not see a "dirty kitchen." However, I do see a kitchen that is full of items that are just as dangerous to my health as if you walked into my kitchen and saw a bag of feces on the counter, a bin of used toilet paper on the shelf, and a box of dried fecal flakes on top of the fridge. Even if I have never seen your kitchen, I have to assume that there is gluten in your household. If you knew that everyone in my home had an active E. Coli infection, you probably wouldn't eat anything I brought to a pot-luck, either.

Now let's imagine, for the sake of argument, that you actually took the time to move all the gluten out of your kitchen, and wash all your pans and utensils, and you washed down all your counters before you prepared the meal. Then you brought your dish and set it on the table next to all the other gluten-containing foods at the pot-luck and proudly proclaimed that you'd taken extra-special care to bring something I could eat.

If the roles were reversed, you would be looking at a lovely, tempting, and delicious-looking meal sitting in the middle of a table full of food you know to be contaminated with E.Coli. And all the other people have just lined up and dripped sauces and crumbs from the contaminated food into your beautiful and tempting dish, and taken a spoon out of one dish and put it into another, and you have to make a choice between hurting my feelings and taking the risk of becoming violently ill... all while watching fifty other people laugh and chatter and safely enjoy all the food on the table, because somehow all of them are immune to this devastating and sometimes deadly disease. Except you.

And sometimes you might even take the risk anyway, because you don't want to hurt my feelings. And, sometimes it would work out okay and you'd get lucky and not get sick. But sometimes you lose. And the more times you lose, and spend the rest of the day sitting on (or bent over) the toilet, and the rest of the week laying in bed unable to move, you miss work, you get behind in your chores (and your blog), and you kick yourself for taking the chance... the less frequently you succumb to the peer pressure and the "etiquette" that says you must try your friend's dish that your friend specially made especially for you in order to make you feel more "included."

And then your friends take it personally.

Please don't take it personally. It's not about you. We have to be like this with everyone. It's not about your culinary competence, your ability to read and understand food labels, or even the cleanliness of your kitchen. We are all sure that you make wonderful food that is not only delicious but is safe for most people to eat and is prepared with love. But if you really want to share a meal, it would be better if you would allow us to pick the restaurant. Or, if you would be willing to, come to our house and let us prepare food for you instead. And you can smile and lie and say "Oh, it tastes just like the real thing" even if it doesn't, because at least it's not going to make you sick later. Better yet, why don't we go for a walk or visit the mall or see a movie instead. Anything that doesn't involve food.