Sunday, March 25, 2012

Bagels Every Sunday

In our family, Sunday is the ONLY day that NONE of us have work, school, activities or anything else.  It is our official family day, and we are pretty stingy with it.  Most Sundays we spend at home just enjoying not having to go anywhere.  Depending on the weather and season, sometimes we garden (while the kids play outside or help, their choice), sometimes we spend the afternoon canning stuff from the garden, sometimes we do crafty stuff, sometimes we sit around all day and don't do a darn thing. 

Regardless of what we spend the bulk of the day doing, I almost always make fresh bagels. While it is a 2 step process, they are not difficult, and they are easy to make without any of Cassidy's allergens. Since they also freeze well I've started making 2 batches so we have a couple of different flavors, although by Tuesday we have yet to have any left over to freeze!  As far as Mark and I, our current favorite is jalapeno cheddar, but we like them pretty spicy, so the only kid that will eat them is River.  I'm on the last jar of jalapenos that we canned last summer, though, so in another week or two I'll have to try something new.  As for the minions, they really like fruit bagels. Sometimes we make cinnamon raisin, and 2 weeks ago we had fresh blueberries so we used those which they loved.  But the current favorite is cherry vanilla.  Someone told me that Panera has a cherry vanilla bagel, but I have never had one so I don't know how my recipe compares.  Regardless, I'd love to know what you think if you try any of my bagel recipes!

Please note that while I really don't care for instant yeast for making bread, I do use it in my bagel recipes.  ALWAYS make sure you are using the kind of yeast that a recipe calls for, or things will usually not turn out as planned :)

Let's start with one for the kiddos, just scroll down for the jalapeno cheddar variation.

Cherry Vanilla Bagels (dairy, egg and nut free!)
yield: 8 bagels

Ingredients:

4 cups flour
2 tablespoons sugar
1 1/2 tsps salt
1 tablespoon vegetable oil
1 tablespoon vanilla extract
2 tsps instant yeast
about 1/2 cup of dried cherries, coarsely chopped
1-1/4 cups of warm water

Dump everything into a mixing bowl and combine until it all comes together to form a stiff dough.  If it is too sticky, add a little flour, or if it is so stiff that you cannot get all of the flour mixed in, add a little more water. 
Turn the dough out onto a clean counter and knead for 10 minutes or so until it is smooth and uniform in texture.
Divide dough into 8 even dough balls, and set them aside for about 20 minutes. 
Once the dough has rested, put a large pot of water on to boil.  I use a stock pot because I can fit more bagels in it at once, but you could use a saucepan and just do fewer at a time.  Some people even use a deep frying pan with just a few inches of water in it.
Preheat the oven to 425 degrees and grease a large cookie sheet generously with vegetable oil. 
Take each dough ball and use your thumbs to make a hole in the center, stretching it gently to be about an inch in diameter.  Some people prefer to hand roll bagels, but this method works just fine for me. 
Set the bagels aside on the counter for another 15-20 minutes.  By the end of this time, they should look a little puffier, and the water should be boiling. 
Carefully drop the bagels into the water one at a time, you'll have to do this in batches. Don't over crowd them! The bagels should float. 
Boil them for 2 minutes,then flip them over with tongs and boil for another minute or two. 
Take them out and set them on a plate to dry a little. 
Go ahead and add the next batch to the water, and after you turn them, move the first batch over to the prepared cookie sheet and dry the plate so the ones boiling have a place to dry.
 Continue this until all of the bagels are on the cookie sheet, then pop it in the oven for 22 minutes.  Since ovens vary, you might want to peek at the bottom of one after 20 minutes to make sure they aren't getting too dark. 
Take them out and let them cool for another 20 minutes. 
We love these with plain cream cheese, but I bet if you mixed some cherry preserves into plain cream cheese it would also be good.  For Cassidy, since she is allergic to dairy, we use Tofutti dairy free cream cheese substitute.


Jalapeno Cheddar Bagels  **Please note that these DO contain DAIRY!!**
yield: 8 bagels

Ingredients:

4 cups flour
1 tablespoon sugar
1 1/2 tsps salt
1 tablespoon vegetable oil
2 tsps instant yeast
3/4 cup shredded cheddar cheese
about 1/8 cup chopped jalapeno slices, more or less to taste (use the kind that you buy in a jar, we use the ones we can from our garden)
1-1/2 cups of warm water

 Combine everything in a mixing bowl until it forms a stiff dough. Add a little more flour if it is too sticky, a little more water if you can't get all the flour worked in. 
Turn the dough out onto the counter and knead it until it is smooth and a uniform texture. Take care not to touch your face until after you have washed your hands, the hot peppers can burn your eyes.  Divide the dough into 8 equal balls and set aside for 20 minutes.
 Once the dough has rested, put a large pot of water on to boil. 
Preheat the oven to 425 degrees and grease a large cookie sheet generously with vegetable oil. 
Take each dough ball and use your thumbs to make a hole in the center, stretching it gently to be about an inch in diameter. 
Set the bagels aside on the counter for another 15-20 minutes.  By the end of this time, they should look a little puffier, and the water should be boiling. 
Carefully drop the bagels into the water one at a time, you'll have to do this in batches. Don't over crowd them! The bagels should float. 
Boil them for 2 minutes,then flip them over with tongs and boil for another minute or two.  Take them out and set them on a plate to dry a little. 
Go ahead and add the next batch to the water, and after you turn them, move the first batch over to the prepared cookie sheet and dry the plate so the ones boiling have a place to dry.  Continue this until all of the bagels are on the cookie sheet, then bake for 22 minutes. 
Since ovens vary, you might want to peek at the bottom of one after 20 minutes to make sure they aren't getting too dark. 
Take them out and let them cool for another 20 minutes.

We also like these with plain cream cheese, or jalapeno cream cheese.  They also make excellent pizza bagels!  Just slice them in half and top with pizza sauce, pepperoni and mozzerella and bake at 400 degrees for 10 minutes or so, until the cheese is melted and slightly brown on top.  Yum!

Now that I think of it, maybe my next creation will be a pizza flavored bagel, with the sauce, mozz and pepperoni baked right in...stay tuned, if it works out I'll be sure to share!

Saturday, March 17, 2012

What the heck is EoE?

I have mentioned before that I realize that we have not had much of a winter this year.  The weather was unbelievably mild.  That doesn't mean I am any less appreciative of the spring!  Spring and summer are by far my favorite times of the year.  i don't even mind the extra rainy days during the early spring.  During the worst part of the winter, we (and by "we" I mean my awesome husband) are busy planning our gardens for the year.  We double check our supply of canning jars and organize our planting charts for the season.  By late February,  we have seedlings started inside and are counting the days until we can start hardening them off.  Once St. Patrick's day rolls around, the cool weather veggies, like the peas, are in the ground and already sprouting and the apple tree is pruned.  The blueberry hedges, plum tree and fig tree have new buds growing and the forsythia is starting to bloom.  As much as it sounds like a cliche, it is a time for new growth and possibilities.

This time last year, Cassidy, at the age of 6, had just been referred to a specialist at AI DuPont Children's Hospital.  Friends and family would ask how Cassidy was doing, and we would say "Well, honestly, Cassidy isn't doing too well..." but we had no concrete answer as to why.  She had been complaining of chest pain as well as a bad sore throat for almost 3 years without anyone being able to determine the reason.  She always had circles under her eyes and she grew overly tired easily.  She had a persistent dry cough, and frequently ran low grade fevers.  By low grade, I mean right around 100 degrees, and by often I mean 3-5 times a week.  Almost every week. She had already had her huge adenoids and enormous tonsils removed.  It was a group of nondescript and fairly minor symptoms, but they never went away.  She had never been a picky eater, but we noticed her eating less.  While she has always been tall and thin (so are Mark and I), we noticed that she seemed even thinner than usual, so we took her back to the doctor, yet again.  We discovered that she had been losing weight.  Around the same time, she started having severe lower abdominal pain several times a week.  Our regular pediatrician, despite the fact that all of the tests he had run for her came back normal, agreed that something must be wrong.  He told me bluntly that no matter how long the list of normal test results was and no matter how minor and nondescript the symptoms were, that Cassidy was MY child, and if my gut instinct said that this was something bigger, then that was more than enough for him.  All pediatric physicians should be as AWESOME as our guy.

And so, because the pain was in the chest (along with fatigue, coughing and weight loss) and in the tummy (along with sore throat, fevers and again, weight loss) he referred us on to the cardiology team and the gastroenterology team at the children's hospital.  We saw cardiology first, and they quickly cleared Cassidy, which was a relief. Then we saw the gastroenterologist.  At first, he was also stumped.  He tried a few things, but nothing offered relief.  Eventually, as symptoms escalated and we had no answers, he felt that he had no choice but to look inside.  Cassidy was scheduled for an upper endoscopy and colonoscopy with tissue biopsies in June 2011.  Even the doctor was not sure what he was looking for, but in his own words, a child living with daily pain and no known cause and therefore relief was, in his practice, unacceptable.  Things looked fairly normal during the scope, so we initially felt relieved but also frustrated.  If everything looked normal, what was the problem?  Still, loved ones were asking, and we still answered "Well, honestly, Cassidy isn't doing too well..."

Then the labs came back.

That phone call, with the lab results, was the first time I had ever heard the term Eosinophilic Esophagitis.  Quite a mouthful, although at this point even my 3 year old can pronounce it. While still considered a rare disease, as are all eosinophilic diseases, it is being diagnosed more often.  This is what it means, in a nutshell.  Eosionophilic Esophagitis, or EoE for short, is one of a group of diseases called Eosinophilic Gastro Intestinal Diseases (EGIDs), and is, in some ways, an auto-immune disease because it causes the body to attack itself.  One distinct characteristic is that is triggered, usually, by food allergies, so in that sense it is an allergic disease.  It is not characterized by traditional food allergies or allergic responses.  When my daughter eats foods that she is allergic to, rather that a rash or wheezing, her digestive system, specifically her esophagus, attacks itself.  The reaction can develop and intensify over weeks after a single or several days worth of exposure to a food.  Her body releases a specific type of white blood cell (eosinophils) which then build up and infiltrate the tissues of her esophagus, causing damage.  This causes inflammation, pain, scarring and in some people difficulty swallowing or episodes of dysphagia and impaction, or food getting stuck in the esophagus.  It causes chest, throat and abdominal pain and can make food taste different and make swallowing very painful.  In addition, sometimes the child feels full too early which, along the pain of swallowing, causes them to not eat enough.  This can lead to weight loss, malnutrition, fatigue and stunted growth.  Some children vomit frequently.  These problems then lead to classic symptoms of lack of nourishment, including joint pain, headaches and bloating.  All of this combined usually means trouble sleeping and mood changes (you'd be pissed all the time too, if you were exhausted, hungry and in pain).

To quote, APFED, a patient advocacy and awareness group for eosinophilic diseases,

"Since none of these symptoms are specific for EGID, and many occur at times in healthy children or adults, the diagnosis is generally sought only after the symptoms have failed to resolve. Eosinophilic disorders can mimic the symptoms of other diseases like inflammatory bowel disease, food allergies, irritable bowel syndrome and reflux, among others."

While not generally a life threatening disease on it's own, it is certainly life altering.  Once we had a diagnosis, we had to determine the allergens.  We kept a food diary for 2 weeks to help determine which foods we should test for, then we went though 3 different kinds of allergy testing.  Scratch testing, which is histamine based, turned up peanuts and cauliflower.  Blood testing, which looks for antibodies in the blood, also showed peanuts and added dairy and eggs.  then we went for patch testing.  This looks for a  different type of reaction, one that is delayed and happens on a cellular level.  Samples of actual foods are placed in small cups and taped to the child's back for 2 full days. Then they are removed and rinsed off.  24 hours later, the results are read.  Sounds like nothing much would turn up with that type of waiting, but we were stunned.  When we removed the samples, her back looked like this:


The next afternoon, when we went to see the allergist, one small area looked like the picture to the left.  That big angry blister that would break open later and leave a scar for months?  That was zucchini.  To the left of it, with smaller but still distinct and painful reactions, were apples and bananas.  The full list from the patch testing?  Apples, bananas, cucumbers, cantaloupe, zucchini and corn.  This is in addition to the dairy, eggs, peanuts and cauliflower.  We have since determined that she can tolerate corn after all, but so far that is the only addition.  Some foods, like zucchini and dairy, we can't even test for tolerance. 
We had spent the summer growing our own organic vegetables, which she loves, and feeding them to Cassidy.  Cauliflower soup, zucchini bread, cucumbers, you name it. Now we know that it was making her sick.  Very sick.

By August, we had the full list of foods that she had to avoid, and we were very strict about it.  She is not a picky eater, but in addition to the difficult symptoms associated with the disease, we had to remove dairy.  Soy and rice substitutes were fine with Cassidy, but lack the fat content of dairy.  By September, the nutritionist told us that if she lost any more weight, literally one more pound, we would have to seriously discuss placing a feeding tube. We barely avoided that, but while she reported an improvement in the chest and throat pain, her bouts of lower abdominal pain were becoming more frequent and severe.  I'll cut to the chase.  Her repeat upper endoscopy in November showed normal biopsies of her esophagus.  The dietary restrictions and medications worked, and as long as she sticks to it she should be OK.  She could develop new allergies later, but that can be dealt with when the time comes. Her colonoscopy, however, showed mild to  moderate microscopic inflammation throughout her entire colon.  In the first set of scopes, there was inflammation but it was patchy.  The fact that it is now covering the entire colon means that it has gotten worse. By now she was already on anti-spasmodic medication (to control painful muscle spasms) as needed for pain, and she was needing it 3-5 days a week.  As a result of the test results, she has since been diagnosed with microscopic colitis, and is now on additional medication, commonly used to treat more pronounced Inflamatory Bowel Diseaeses like Crohn's Disease, for that.  It seems to be working, and she is needing the anti-spasmodic meds less often.  She also reports to us that while she still always has lower abdominal pain, it is less severe than it was.  She has gained 7 lbs since September and is feeling better in general.

Compared to many children with EoE, Cassidy's presentation was not terrible.  Some children are allergic to almost all foods, and get all of their nutrition through feeding tubes. Some get sick at a much younger age and some do not respond as well to the treatments.  As far as the colitis, it is also considered by some doctors to be an auto-immune disease, meaning that the body's own immune system attacks itself. Earlier in this post, I quoted APFED as saying that eosinophilic disorders can mimic the symptoms of other diseases like inflammatory bowel disease, food allergies, irritable bowel syndrome and reflux, among others.  They can also happen IN ADDITION TO these other diseases, which is important to remember since the treatments for the different diseases vary.  The dietary restrictions and medication for Cassidy's EoE carry no side effects, however her Crohn's meds do, and Cassidy does experience some of these including headaches, dizziness and mild nausea.  She says, however, that the relief that she gains from the medications is worth the side effects.  Neither disease is one that will be outgrown. Microscopic colitis, like Crohn's disease, has remissions and flares, but is commonly life long.  EoE is not typically outgrown, although allergens and triggers can change over time.

This year, we planned the garden without zucchini and cauliflower, at least for now.  We don't all avoid all of her allergens, but we do try to avoid flaunting her absolute favorites right in front of her.  She has done a great job as far as adapting to her situation, and is very responsible about following her dietary restrictions.  She reads labels herself and if she is unsure of ingredients she just eats something else.  She has told us that at one point before she was diagnosed with EoE, she felt so sick and was in enough pain that she thought that first scope would end up diagnosing her with cancer, so when she does get frustrated, she remembers that and her the current situation is actually a relief. This is her own perspective, and she is now 7 years old.  It reminds me to be to be thankful that while her diseases are life altering, they are not generally life threatening, and that as many times as we have gone to the hospital and O.R. for tests and procedures, we have all come home together.

Many times, people have asked me exactly what the situation is with Cassidy and her illness(es) and food allergies, so I thought the simplest way to explain to many would be to lay it out here.  This is definitely an abbreviated version of our story, so I absolutely welcome any questions or comments that any readers or friends may have.  In the mean time, putting all of this into writing, especially Cassidy's own perspective, reminds me of one thing that I believe strongly in, which is that gratitude makes what we have enough. Also, perhaps it will help my readers to understand why I'm only posting once every week to 10 days.  You see, In addition to Cassidy, I have 3 other children.  The twins, Quinn and Chloe, will be 5 in several weeks.  How are they, you ask?  Well, honestly, just like Cassidy at this age, now it's Chloe that isn't doing too well.

Wednesday, March 7, 2012

Chocolate Chip Cookies, allergy safe!

My, oh my it has been a busy couple of weeks!  We have had so much going on, and after this week the rest of March is already pretty tightly booked.  My Etsy shop needs serious attention as does my laundry and house, but so have my kids and they always come first.  After a rough weekend (Friday night trip to the emergency room with River when she bit through the sides of her tongue, which was every bit as awful as it sounds, followed by a 24 hour stomach virus for me), I started the week 2 days behind in my projects with deadlines. Despite this, on Monday I made a "executive decision" to have coffee with a friend instead if catching up on my projects during the hours that I normally work while the youngest kids are in preschool .  After the weekend we had, I deserved it, and it was well worth it.  I left feeling refreshed and reconnected with the world just from the simple act of casual conversation.  Thanks Cristin!  I also have a new sewing tutorial in the works, inspired by that conversation and my attempts to scribble a sewing lesson on a paper napkin.  It's really for Cristin, but maybe some of you will enjoy it as well. Stay tuned for that, hopefully this weekend! So Monday afternoon, I did get white bread baked for the week as well as banana bread, but between ballet lessons, homework and bedtime, not much else.

I planned on getting caught up on Tuesday, since Mark was home all day too, but we ended up having company most of the day.  First my mom and a fantastic friend recently home from a military deployment.  Nothing that I had to do held priority over that visit.  Then my in-laws, who always understand when I need to work while they are visiting, but I ended up hanging out instead. By evening, Chloe was running a fever.  Never a dull moment.

As for me, I think the down time was a wise choice, because today not only did I get almost completely caught up (and by now I was 4 days behind!), but also played outside with the kids a bit, straightened the bedrooms, helped with homework, made dinner, cleaned the kitchen and did 4 loads of laundry.  I never would have gotten caught up on work if Mark had not entertained the little ones today (and he got the garden tilled to boot!), and if work had been hanging over my head I never would have had the (semi) focus and drive to get everything else done.  Especially since, other than the laundry which I had running while I was downstairs working, I did everything else that I listed after he went to work for the night.  The kids were all  completely not whiny or argumentative, either, which is always a bonus.

I decided that we all deserved a treat, and since It was an hour too early for a martini for me (vodka, dirty and slightly dry, 2 olives, please!) and Chloe, who has been eating next to nothing for weeks, has been asking for chocolate chip cookies, that seemed like a great idea.  The only problem was that my old standby recipe that used to be allergy safe for Cassidy contains applesauce (important since it is egg and dairy free) and she now clearly has a pronounced reaction to apples.  So I poked around in the kitchen for a bit and tried out a new allergy safe version.  Lucky for us, they turned out really well, and made plenty.  Luck for you, I'm going to share the recipe with you all now!

Allergy Safe Chocolate Chip Cookies
yield: about 30 cookies

3/4 cup non-dairy margarine (I use Earth Balance), softened
1 1/4 cups brown sugar, firmly packed
3 Tbsp. soy milk (if avoiding soy, use coconut milk)
1 1/2 Tbsp. vanilla
2 Tbsp non-dairy cream cheese (or vegetable shortening, in a pinch)
2 1/4 cups flour
1 tsp. baking soda
1 tsp. baking powder
1 tsp. salt
1 1/4 cup allergy safe mini chocolate chips (I use Enjoy Life brand)

Preheat the oven to 375 degrees.

Cream together the first 5 ingredients (margarine, brown sugar, soy or coconut milk, vanilla and cream cheese/shortening) until smooth.
Mix everything else except the chocolate chips (flour, baking soda, baking flour and salt) with a whisk and gradually add to the sugar mixture, beating well.
Stir in the chocolate chips.
Drop by  teaspoonfuls onto an ungreased cookie sheet and bake for 13 minutes.
Let cool slightly on the sheet, then move to a wire cooling rack.

I'd love to know what you think of this recipe, so feel free to leave me a comment!

Now, since the kids are in bed, I must get back to my martini...