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Choline Breakfast in Mom’s Kitchen 07/29/2012

Posted by thetickthatbitme in Choline Diet, Whole Person.
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I’m excited to be visiting my parents this week, especially because their kitchen is always filled with fresh fruits and vegetables. I missed the Central Coast’s superior tomatoes!

Tomato and egg sandwich on toasted sourdough.

Tomato and egg sandwich on toasted sourdough.

Choline count: 2 eggs (250 mg) + 1 tomato (12 mg) + sourdough bread (15 mg) = 277 mg of choline

Happy Sunday everybody!

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What a difference a year makes! 07/14/2012

Posted by thetickthatbitme in Patient Stories, Treatment.
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A year ago yesterday was when I started my treatment for Borrelia hermsii. I left my home, my boyfriend, and my dog to stay with my parents so I could get treated with 42 days of IV antibiotics. Looking back on this time last year, so much has changed:

1. My knowledge level. I’m embarrassed to say that when I started treatment, I couldn’t even tell you if a tick has eight legs or six. (I never saw the ticks that bit me.) I knew nothing about the habitat or biology of ticks, and I didn’t know how many different diseases they can spread. I didn’t know how to spell Borrelia. Pretty much all I knew was that I was infected with a bacterium that was like Lyme but not Lyme that causes Relapsing Fever. This was strange to me because I never remembered having a fever–cold sweats, yes, but no measurable fever. I’d had IVs in my hand before when I’d been hospitalized, but I didn’t really understand what an infusion was, or that it mattered which vein a needle goes in. I had no idea what PubMed is. I’d read maybe three medical journal articles in my lifetime. Over those six weeks, I learned a lot from my doctor and other patients, and I kept learning through support group meetings and emails. Finally, I got up the energy and courage to launch this blog, and well…you know the rest.

2. My energy level. The fall of 2011 was when I should have realized something was wrong. I was student teaching in the mornings and teaching my regular classes at night. I remember what a struggle it was to get out of bed in the morning. Getting dressed was like running a marathon. I’d had back surgery the previous June, and I was in this hard brace that everyone called my turtle shell. But it wasn’t just my back that was a problem. Even with eight to ten hours sleep, by noon, I was struggling to stay awake. My 30 minute drive home on the freeway was terrifying. The only thing that kept my eyes open most days was if I was constantly chewing something, so I tried to always have snacks with me. When I got home, I’d take a 90 minute nap–which was never enough–and then I’d get up and go to work again. When the semester ended, I thought I would catch up on rest, but even only working part-time, I was constantly fatigued. I spent any time that I wasn’t working in bed. When I had to go on a business trip in March, I freaked out. How would I handle being on someone else’s schedule? How would I go six or seven hours without lying down? By June, I was freed from back braces, and my spine had healed, but I still felt awful. And I felt guilty. How had I become this lazy, unmotivated person who spends all her time in bed? A year later, I have my life back. I work two jobs, plus freelance work. I cook dinner for Boyfriend and me several nights a week, do all the grocery shopping, and keep the house clean. I walk my dog and ride my bike. I go shopping and to the movies with friends, drive long distances, and even occasionally babysit. Before, I only had the energy to do one or two of these things per day. I was a spoonie with a very low spoon limit. If I cleaned the house, that was it for the day. If I went to the store, I probably wouldn’t have the energy to cook the food I’d bought. If I taught a 3 hour class, I would come home and sleep the rest of the day. All of this I tried to conceal from my family and friends. I tried to be fine because there was no explanation for why I wasn’t.

spoon chasing

Spoon chasing. (Image via unfocusedcreativity.blogspot.com)

Looking at how much better I am now makes me realize how sick I was. Yesterday, I had a two-hour morning conference call, after which I worked on the computer for another hour. Then I ate lunch and went to the grocery store. When I got back, I cleaned out the fridge, put the groceries away, and then did a thorough de-clutter and clean of the entire house. I read a chapter in my book, took a shower, and went out to dinner with Boyfriend. All that activity would never have fit into one day when I was sick. I was up again this morning at 8:00, feeling rested.

Weather-style pain scale.

Weather-style pain scale. (Image via fibroofoz.blogspot.com)

3. My pain level. I was on strong prescription painkillers for a year and a half, starting in June 2010 after my surgery. Clearly, I didn’t get off them when I was supposed to, 6-9 months post-surgery. That’s because I didn’t just have back pain. It was in my hips, neck, and shoulders, too. The pain didn’t completely go away right after treatment. It’s been a slow progression. In the fall, I was able to wean myself off painkillers and just use heating pads when my back or joints bothered me. We know from the research that reactive arthritis may simply be part of the package for some patients with treated Borrelia infections. This is my framework for understanding some of my continuing aches and pains. For me, low-impact exercise, comfortable shoes, heating pads, and a memory foam mattress pad help a great deal. Whereas before my daily pain level rarely dropped below a four, even with drugs, now I’m at a one or a two most days, and I’m drug-free, aside from very rarely taking Advil.

What brain fog does to reading a book.

What brain fog does to reading a book. (Image via a-b-martin.blogspot.com)

4. My cognitive level. The ability to think, speak, and write clearly is essential to my livelihood. Having a Borrelia infection plunged me into what many people describe as a “brain fog.” For more than a year, I was sort of drifting through life, not able to think very clearly about anything. It came on gradually, and after my surgery, it got worse, which I attributed to the pain and the painkillers. Now I’ve met enough fellow patients that I see the pattern. I understand how this infection clouded my cognition. One of the reasons I didn’t start writing this blog while I was getting treated was that I couldn’t focus well enough. Even post-treatment, it took me a few months to start feeling sharp again. I really noticed the change this past semester when teaching got easier. I was able to learn the names of all my students within the first three weeks–which hadn’t happened the previous four semesters. My focus and mental endurance were so much better, as was my time management during class. I felt sort of like I’d woken up from a long sleep. The time in my life when I was very sick seems blurry. Now, not only do I have the energy to do more, but I have much better concentration. I can even go back and look at things I wrote two years ago and see the difference in sentence structure. All I can say is it’s good to be “back.”

What I’m doing to stay well, one year out:

egg

(Image via Wikipedia. Credit: Ren West)

1. Eating my eggs. You wouldn’t believe how “off” I feel if I go a day without an egg. That’s probably because my neurologically-damaged body likes choline, and eggs are full of it. I also find myself craving green vegetables. In fact, whenever friends ask me where I want to eat, I usually say, “Anywhere with good veggies.” I know there are many diets out there that are designed to help people with Borrelia infections avoid inflammation and other problems, and many of those recommend avoiding meat, dairy, gluten, and sugar. Personally, I’m not really cut out for that. I’m not the kind of person who can say, “I’m not going to eat X” when X is something that I really like, like sourdough bread, or milk, or chocolate. That’s not to knock the vegetarian, dairy-free, gluten-free, and/or sugar-free diets. I recognize that they do work for some people. However, I’m pretty sure that my body needs both meat and sugar to function normally, so I’ve always been opposed to giving up those. Other than being lactose-intolerant, I have no problems with dairy, and I don’t have more pain when I drink my Lactaid milk than on days when I don’t, so I’m not so concerned with the inflammation factor there. I seem to tolerate gluten pretty well, but I do try to limit my grains, as they’re not the best source of choline. No one gets between me and my egg sandwiches, though.

2. Staying active. I spent a large percentage of a year in bed, and going back there is very tempting at times, especially since during that time I developed a large collection of movies and TV shows, and my bed is VERY comfortable. Because I used to do most things from bed, I’m just now getting used to LIVING in my living room, WORKING in the office, and SLEEPING in my bedroom. (In fact, I’m breaking this rule now, typing the first draft of this from bed, but it’s a Saturday, and I’ve been working all week, so I don’t feel bad.) For me, staying active means not only “working out” (by walking the dog, riding my bike, and playing Dance Central on Xbox) but “getting stuff done.” I used to put off doing things and tell myself, “I’ll do it when I’m not so tired, or when I’m in less pain.” Now I don’t have those excuses, and it’s much less burdensome to get things done right away. Procrastination used to be a form of self-preservation. Now it’s a habit I have to work to break.

3. Preventing re-infection. After what I’ve been through, the last thing I want is another tick-borne infection, so I make sure that both my dog and I stay out of high risk areas for ticks. When we walk, we stay on the sidewalk. Boyfriend and I keep the yard clean–which is not too difficult since our backyard is mostly concrete. We treat Lucy monthly for fleas and ticks, and I’m always spraying that Cedarcide. I’ve decided not to do any hiking or camping for a while. When I want to enjoy the outdoors, I ride my bike or go to the beach.

4. Staying current on my tests. I get my blood drawn every 3 months so my doctor can check my antibody titer. My doctor said if I have a four-fold rise, then we’ll need to consider re-treatment. So far, I’ve been okay, but I want to be vigilant. I don’t want to get re-infected and not know about it.

Hope everyone is having a wonderful weekend!

The Choline Diet: Herbivore Style 07/01/2012

Posted by thetickthatbitme in Choline Diet, Tick-Lit, Whole Person.
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In the past, my choline diet posts have been mostly geared towards omnivores, as eating eggs and meat is an easy way to get one’s daily dose of choline. If you’re new to this blog–or just forgetful–I’ve been on a choline-rich diet since I started getting treated for Borrelia hermsii and Anaplasmosis last year. My doctor recommended this because I had some neurological involvement with my illness–brain fog, chronic fatigue, arthralgias–and there’s research that suggests that eating choline helps our bodies produce more of the neurotransmitter acetylcholine. Choline has also been linked to lower levels of inflammation. In addition, choline is particularly important for pregnant women, as higher choline intake during pregnancy is associated with a lower risk of neural tube defects in infants.

choline dude

Image via doubleeaglefitness.wordpress.com

So that’s why I’m always telling my readers to eat their eggs and meat and green veggies. However, since a study led by Scott Commins at the University of Virginia linking lone star tick bites to red meat allergies gained national media attention (ABC, CNN) a few weeks ago, I’ve been thinking about how to make my choline recipe recommendations more herbivore-friendly.

After my last choline-related post, I stumbled upon the USDA Database for the Choline Content of Common Foods, which is a fairly good resource (and handy since it comes in a searchable PDF), although it doesn’t include everything I like to eat. (For example, the desserts section is severely lacking.) The other issue with it is that the choline values are reported in mg per 100 grams of food, and the average person may not eat 100 grams of some of those food items in one sitting–particularly the spices. (100 grams of chili powder, anyone?) So keep in mind that the choline numbers below are based on that ratio, and don’t think you’re getting 120 mg of choline in a pinch of mustard seed. This week, I decided to go through the database and find the foods with the most choline. For my herbivore/vegetarian readers out there, whatever your reason for avoiding meat (moral, dietary, tick-bite-induced allergy…), here are the top choline sources from several non-meat categories:

Top 10 Veggies:

  1. edamame—56 mg*
  2. broccoli (boiled) —40 mg
  3. cauliflower (boiled) —39 mg
  4. tomato paste—39 mg
  5. artichokes (boiled)—34 mg
  6. peas (boiled)—28 mg
  7. spinach (cooked) —28 mg
  8. asparagus (boiled) —28 mg
  9. sweet corn (boiled) —22 mg
  10. red potatoes (baked) —19 mg

Top 10 Fruits:

  1. dried figs—16 mg
  2. clementines—14 mg
  3. avocados—14 mg
  4. dried apricots—14 mg
  5. raspberries—12 mg
  6. raisins—11 mg
  7. prunes—10 mg
  8. mandarin oranges—10 mg
  9. medjool dates—9.9 mg
  10. bananas—9.8 mg

Top 10 Nuts and Seeds:

  1. flaxseed—79 mg
  2. dry roasted pistachios—71 mg
  3. roasted pumpkin seed kernels—63 mg
  4. roasted cashews—61 mg
  5. dried pine nuts—56 mg
  6. sunflower seed kernels—55 mg
  7. almonds—52 mg
  8. hazelnuts—46 mg
  9. dry roasted macadamia nuts—45 mg
  10. pecans—41 mg

Top 5 Legumes:

  1. creamy peanutbutter—66 mg
  2. boiled navy beans—45 mg
  3. baked beans—28 mg
  4. firm tofu—28 mg
  5. soft tofu—27 mg

Top 10 Spices:

  1. mustard seed—120 mg
  2. dried parsley—97 mg
  3. garlic powder—68 mg
  4. chili powder—67 mg
  5. curry powder—64 mg
  6. dried basil—55 mg
  7. paprika—52 mg
  8. ground turmeric—49 mg
  9. ground ginger—41 mg
  10. onion powder—39 mg

*All measurements are given in mg/100 g of food

I hope these lists get you on your way to a diet more rich in choline, whether it includes meat or not.

This concludes the herbivore section of this post. If you don’t want to be tempted with any meat, try clicking over to some of my other posts.

***

If you’re here in search of choline diet inspiration of the omnivore variety, I haven’t completely forgotten you. Here’s a glimpse of what I had for lunch.

steak sandwich tomato avocado

Steak sandwich on pumpernickel with avocado and tomato.

Happy Sunday, everybody! And watch out for ticks!

06/10/2012

Posted by thetickthatbitme in Choline Diet, Reblogs.
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Great post about the importance of choline intake during pregnacy.

Valerie's Voice: For the Health of It

Choline (a nutrient found in  beef liver, chicken liver, eggs, bacon and pork) status in pregnant moms has been found to affect cortisol levels in newborns. According to a study published by Jiang X, Yan et al., http://lib.bioinfo.pl/paper:22418088, these pregnant women were given either 930 or 480 mg/day of choline in their third trimester for 12 weeks. The more choline consumed the more was found in moms blood the lower the levels of stress hormone cortisol was found in baby. As you can see from the chart below, current recommendations need to be updated and increased to help promote healthy gene expression and reduce the risk of unwanted health issues.

The Linus Pauling Institute, http://lpi.oregonstate.edu/infocenter/othernuts/choline/ posted the chart on the Adequate Intake level for choline, however this is not based on the methylation information we now have.

Adequate Intake (AI)               for Choline

Life stage Age Males (mg/day) Females (mg/day)
Infants 0-6…

View original post 426 more words

This week’s choline diet highlights 05/20/2012

Posted by thetickthatbitme in Uncategorized.
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I tried to be good and cook simple, choline-rich meals at home this week. Here are some highlights:

McBreakfast Sandwich

I love making my own version of a fast food breakfast sandwich for several reasons. One, it’s healthier because I can use better ingredients. Two, it’s relatively inexpensive. Three, I don’t have to drive anywhere to get it.

eggs and canadian bacon

Start with an egg and a slice of Canadian bacon.

Sometimes I use an English muffin or a bagel, but this week I didn’t have those, so I used sourdough, which I actually like better. I also subbed out boring old American cheese for some spicy pepperjack.

sourdough pepperjack

Pepperjack on toasted sourdough. They’re big slices, so I just used one and folded it in half.

To drink, I had Treetop orange-pinapple juice, which I water down.

orange pineapple juice

Choline count: fried egg (125 mg) + Canadian bacon (19 mg) + sourdough bread (15 mg) = 159 mg

breakfast sandwich juice

Rainbow Coleslaw

I grew up on traditional southern-style coleslaw, and when the weather gets hot, I start craving it. I love putting it on pulled-pork BBQ sandwiches. Being that eating cabbage covered in mayonaise (or in my case, Miracle Whip) is not the healthiest way to get one’s veggies, when I make coleslaw at home, I try to make it a little healthier (and more rich in choline). One of the ways to do this is to use broccoli slaw. You can make it yourself in a food processor, or if you’re lazy like me, you can buy it already shredded up in a bag.

rainbow slaw

In a small bowl, I mix the dressing, which consists of Miracle Whip, sweet pickle juice (I didn’t have any, so I skimmed some out of the pickle relish jar), and horseradish sauce (for a kick). Some people also like to add vinegar (in place of pickle juice) and dijon mustard.

condiments

The condiment lineup.

Then I dump the shredded veggies into a big bowl, add a diced tomato, and mix in the dressing. It’s best to refrigerate slaw for a few hours before eating, but I always sneak a few spoonfulls to make sure it tastes right.

Choline count: broccoli, cauliflower, carrot, cabbage, tomato

coleslaw

Ready to refrigerate.

California Sandwich

I’ve been eating a lot of sandwiches lately. Boyfriend brought back several loaves of bread from Eric Schat’s Bakery, including some delicious rye bread, so I used some of it to make this sandwich.

tomato avocado egg sandwich

I topped that slice of delicious rye bread with Miracle Whip, horseradish sauce, tomato slices, a fried egg, and half an avocado.

milk and sandwich

Choline count:  fried egg (125 mg) + tomato (12 mg) + 1/2 avocado (9 mg) + rye bread (5 mg) + milk (39 mg) = 190 mg

Chorizo Scramble

Toward the end of the week, I started feeling guilty about eating so much bread, so I cooked up some Mexican chorizo with eggs and topped it with diced avocado and tomato. Cooking for two, I use five eggs and one package (a long link) of chorizo.

chorizo eggs avocado tomato

Choline count: 2 eggs (250 mg) + chorizo (58 mg) + tomato (12 mg) + 1/2 avocado (9 mg) = 329 mg

Eating out {in the name of choline} 05/13/2012

Posted by thetickthatbitme in Choline Diet, Whole Person.
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One of my dear friends is a new mommy who’s been going a little stir-crazy for the past two months waiting for her son to get his first shots and be allowed to leave the house more regularly. Yesterday, she got a few baby-free hours, which presented a perfect opportunity for some fine dining (or at least what we frugal ladies consider fine dining), and that’s how we found ourselves at a little place called Cafe Mundial in Monrovia.

Now, I must confess, I wasn’t thinking about my choline diet at all as I was scanning drooling over the menu, but it turned out that both my friend and I did fairly well on the choline count without really trying. Here’s what we had:

To Start

This restaurant serves their complimentary bread with a side of hummus (which is really not to be confused with humus). Much to my delight, when I looked up hummus today, I discovered it has 4 mg per tablespoon. (Side note: if you look up “humus,” which is how WordPress spellcheck thinks “hummus” should be spelled, you’ll find it has no choline. So if anyone ever commands you to “Eat dirt!” tell them, “I can’t. I’m on a choline diet.”) We also each ordered the soup du jour, which was tomato basil. (I have no picture of this, and couldn’t find one from Cafe Mundial.) Not much choline in the soup, but it was delicious!

cafe mundial hummus

Yummy hummus with bread for dipping. (Image via Yelp)

The Main Course

I had the duck conflit, which was accompanied by a small scoop of mashed potatoes and generous helpings of carrots and zucchini. You can see it pictured below with beans instead. Choline count for roast duck: 43 mg for half a pound. Cooked carrots and zucchini add 7 mg and 8.5 mg choline, respectively, for half a cup each.

Duck Conflit

Duck Conflit with veggies. (Image via Yelp)

The Finale

Though I admire the philosophy of “Life is short; eat dessert first,” this isn’t really possible with soufflé, owing to the long prep time. It was more like, “Life is short; order dessert first, or else it won’t be ready.” This one was accompanied by fresh strawberry slices and a vanilla bean sauce. We were a few bites into it when I said, “Hold on, I should take a picture of this.”  It was just as delicious as it looks. I couldn’t find any nutritional data for chocolate soufflé, but boring old grocery-store-bakery chocolate cake has about 20 mg per slice. With all the eggs and chocolate in soufflé, I’m guessing this little treat comes it at around 30 mg.

chocolate soufflé

Chocolate soufflé, a.k.a. Heaven.

So how well did I fare in the choline department? According to my (rough) estimate, I had about 100 mg of choline. My friend, who ordered the filet mignon (77 mg choline in 3 oz), out-cholined me by about 40 mg.

Snacking in the name of choline 05/06/2012

Posted by thetickthatbitme in Choline Diet, Humor.
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Since I spend a lot of time working from home, it’s difficult to resist a lot of snacking. Now I believe that eating small meals throughout the day is healthy; however, when you factor in my mighty sweet tooth and the fact that my better half keeps visiting the Entemann’s bakery outlet on his way home from work (he can’t resist the deals), well…you see the predicament. So I decided this week that if I’m going to be ‘bad’ and indulge in a few fattening or sugary or salty snacks, I had better make sure I was getting my choline. Here are some of the choline-rich snacks that my research turned up.

Savory Choline Snacks

Peanut Butter (21 mg in 2 tbsp) and Carrots (6 mg in 1 large carrot)

This is an established favorite for both me and my dad. I used to feel guilty about putting peanut butter on something that is otherwise pretty healthy, but with about 10 mg of choline per tablespoon, I don’t feel that bad. I do, by the way, buy the reduced fat peanut butter. If you prefer almond butter, it has about 8 mg of choline per tablespoon.

carrot peanut butter

Carrot ♥ Jif in my kitchen.

Pistachios (20 mg in 1 oz)

I’m a girl who likes to play with her food, so these are one of my favorite snacks. Sometimes I like to eat them with a few chocolate chips and some dried cranberries. If you’re wondering how many dry roasted pistachios are in an ounce, it’s about 49.

pistachios

(Image via Wikimedia Commons)

Edamame (56 mg in 100 g—about 2/3 cup)

I usually order edamame (boiled soybean pods) as an appetizer when I go out for sushi with friends. Some grocery stores also have it in the freezer section.

(Image via Wikimedia Commons. Credit: habitatgirl)

Sweet Choline Snacks

Peanut Butter (21 mg in 2 tbsp) and Banana (11 mg)

Yes, you can see I have a propensity to put peanut butter on a lot of things. This is a third-generation snack in my family that originated with my grandma. I find a glass of chocolate milk goes well with it. (One cup of chocolate milk also adds 42 mg of choline!)

banana peanut butter

Banana and Jif hanging out on my counter. If Carrot finds out, you are sooo busted, Jif!

Baked Sweet Potato (23 mg for a large one)

Sweet potatoes are so underrated. I try to substitute them for boring old russet potatoes whenever I can, including when I make home-made french fries. The easiest (and laziest) way to prepare a sweet potato, though, it to stab it with a fork a few times and then pop it in the microwave. I like mine with a little butter and brown sugar, but season salt or garlic powder is also good.

sweet potato

(Image via Wikimedia Commons)

Ready for the finale? My most exciting discovery in my choline research is that chocolate is a great source of choline. (Which means, all those times when I was craving chocolate, it wasn’t just me, it was also my neurotransmitters.) I could list about 100 chocolatey snacks here, but I’m going to have some self-restraint and just do one.

Chocolate éclair (79 mg)

This one takes me way back to when I was too short to even see over a bakery counter. (Thanks, Mom, for getting me addicted to these at such a young age.) When I discovered this dessert, I considered changing my name to Claire, just so I could be “Chocolatey Claire.” Is an éclair the same as a doughnut? Of course not, silly! It’s far, far better. I recommend a tall glass of milk with this one.

chocolate eclairs

(Image via Wikimedia Commons. Credit: georgie_grd)

If you want to try making some éclairs from scratch, here’s a yummy recipe over at Moo’s Pantry.

That’s all I’ve got for today. What high-choline treats would you add to this list?

Omelet you in on these yummy high-choline recipes 04/29/2012

Posted by thetickthatbitme in Choline Diet, Whole Person.
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In my family, omelets are somewhat of a sacred tradition. My dad was the omelet-master when I was growing up, and whenever we had weekend company, he’d make each guest and family member his or her own made-to-order omelet. By the time I was in high school, I’d picked up his technique and was making omelets for all my friends after school. Little did I know back then what a great source of the B vitamin choline omelets can be! (For more on choline, see the Choline Diet page.)The best thing about omelets besides the choline factor is the infinite possibilities–there are no rules about what cannot go in an omelet. Here are some of my favorites.

Smoked Salmon, Spinach, and Avocado Omelet

salmon omelet avocado

Image via cuisineaustralia.com.

I love smoked salmon, and I’m always looking for new ways to cook with it (aside from just eating it on a bagel with cream cheese–yum). Check out this salmon omelet recipe from cuisineaustralia.com.

Choline Count: eggs (2) 200 mg + salmon (3 oz) 80 mg + spinach (2 oz) 11 mg + avocado (1) 19 mg = 300 mg of choline!

Mushroom, Spinach, and Feta Omelet

mushroom spinach feta omelet

Image via closetcooking.com

What do I like almost as much as smoked salmon? Crumbly cheeses! Feta and spinach are always delicious together, why not put them in an omelet? Add shiitake mushrooms for a bonus 66 mg of choline! Check out this recipe on closetcooking.com.

http://www.closetcooking.com/2008/03/mushroom-spinach-and-feta-omelet.html

Choline count: eggs (3) 300 mg + shiitake mushrooms (4 oz) 66 mg + spinach (2 oz) 11 mg + feta cheese (1 oz) 4 mg = 381 mg choline!

Leftover Stir-fry Omelet

This was my go-to omelet when I was a college student and rarely went grocery shopping or planned meals. I always seemed to have leftover Chinese food in my fridge, so I devised this omelet to make leftovers into breakfast. I usually use two eggs per person with a little milk. If you’ve got the jumbo eggs, you can get away with using one and use a little more milk (1 oz of skim milk has 5 mg of choline!). I whisk up the eggs and the milk in a bowl, then pour them into my omelet pan (yes, they make a size of frying pan that’s just for omelets). Meanwhile, I heat up the leftover stir-fry in a separate pan. Once that’s heated through and the egg mixture has set in the pan, I spoon some stir-fry onto one side. After a few minutes, the other side will be ready to fold over.

orang ginger beef stir fry

Image via mccormick.com

If you want to make a healthy stir-fry at home to use for your leftovers, you can try this recipe for Orange Ginger Beef Stir-fry from mccormick.com.

Choline count: eggs (2) 200 mg + beef sirloin (1/4 lb) 96 mg + broccoli (1/2 cup) 31 mg = 327 mg choline!

Hope you enjoyed this week’s high-choline recipes. Eggspect (sorry, I promise I’ll try to stop) to see more next Sunday!

Have a high-choline recipe (and mouth-watering photos) you’d like to showcase on this blog? E-mail thetickthatbitme AT gmail DOT com.

Eat Your Eggs, Benedict! 04/22/2012

Posted by thetickthatbitme in Choline Diet, Whole Person.
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If you know my story, you know that when I was diagnosed with B. hermsii and Anaplasmosis, my doctor put me on a high-choline diet. Why choline, you ask? Choline is a B vitamin that aids in the transmission of nerve impulses from the brain through the central nervous system–this process is essential to functions like memory and muscle control. Since Borrelia like to attack the central nervous system, choline is especially important for people with (past and present) B. hermsii and B. burgdorferi infections. People who eat diets high in choline have also been shown to have lower levels of inflammation (like inflammation of the joints in Arthritis) than people who don’t. You can read more about choline here.

Enter the Benedict. It is by far my favorite egg-based dish, and I enjoy making it at home just as much as I do eating it for brunch in a fancy restaurant.

"Eggs" Benedict Talley (Mehcad Brooks) from HBO's True Blood. Photo via hbo.com.

One large poached egg has 100 mg of choline, so if you eat two, you get about half of your recommended daily amount (425 mg for women, 550 mg for men). Add to that other high-choline foods like smoked salmon (129 mg), Canadian bacon (39 mg), portabella mushrooms (39 mg), spinach (35 mg), asparagus (23 mg), avocado (21 mg), and tomato (6 mg) to get your choline fix!

Here are my top five Benedicts:

1. Old Fashioned but Fried

for those mornings (or afternoons, or evenings!) when I’m feeling traditional, yet lazy

I learned this simple recipe from my mother, and it

Benedict Asparagus

Image via firsttimerscookbook.com

brings back all kinds of fond childhood memories. A toasted whole-wheat English muffin, topped with pan-fried Canadian bacon and over-easy eggs (make sure they’re still a little runny, because that’s the best part). The hollandaise sauce I usually make with one of those sauce packets you can find in the grocery store (next to the gravy packets). It’s easy–you only need to add milk and butter–and, in my opinion, it tastes better than the from-scratch hollandaise recipes I’ve tried. Because of the butter and bacon, this is a slightly fattening meal, so I balance it with a side of boiled asparagus, which tastes delicious with the hollandaise sauce and adds 23 mg of choline to this meal!

Choline count: eggs 200 mg + Canadian bacon 39 mg + asparagus 23 mg = 262 mg of choline

2. Crab Benedict

for when I’m feeling crabby or rooting for the Terps

I’ve never made this one at home, but I’ve had it at Toasties Cafe, and it is delicious!

Toasties Crab Benedict

Image via Yelp.com.

Choline count: eggs 200 mg

3. Portabello Mushroom Benedict

for the fungus-lovers amongus

If you’re looking for a meatless meal or just craving these yummy mushrooms, this is the Benedict for you. Check out Jackie Dodd’s recipe at TastyKitchen.com, which also includes spinach, tomatoes, and Sriracha for a kick!

Portobello Mushroom Benedict

Image via TastyKitchen.com

Choline count: eggs 200 mg + portabello mushrooms 39 mg + spinach 35 mg = 274 mg of choline

4. Tomato Avocado Benedict

because I’m a California girl

My mouth was watering as I scrolled through SoupBelly.com’s deliciously illustrated recipe for this west-coast Benedict. If you want to make it even more California, use sourdough English muffins.

Avocado Tomato Benedict

Image via soupbelly.com.

Choline count: eggs 200 mg + avocado 21 mg + tomato 6 mg = 227 mg of choline

5. Eggs Hemingway

for when I’m feeling literary

This one may seem a bit fishy, but I assure you it’s delicious and packed with choline. It’s also called Norwegian Benedict. Here’s a recipe at food.com that includes not only salmon but spinach, too!

Salmon Benedict

Image via Wikipedia.

Choline count: eggs 200 mg + smoked salmon 129 mg + spinach 35 mg = 364 mg of choline

Now that I’ve made myself really hungry, I’m going to go make my own Benedict. Hope you enjoy these eggcellent (sorry, I couldn’t resist) high-choline meals!

My Story 04/18/2012

Posted by thetickthatbitme in Diagnosis, meta-blog, Treatment.
Tags: , , , , , , , , , , , ,
5 comments

Like many people who have suffered from tick-borne illnesses, I struggled with my symptoms for a long time before I got a diagnosis and effective treatment. At the time when I hypothesize I was infected—I say ‘hypothesize’ because I never discovered a tick or a tick bite, I never had a rash, and I never had a fever—I was already dealing with a number of medical problems that had begun in my early twenties. I’ll save all the gory details for another time, but my laundry list included irritable bowel syndrome (later diagnosed as an Entamoeba histolytica infection and treated with Metronidazole), a dysfunctional bladder (still unresolved), a spinal deformity (for which I underwent major surgery in 2010), and a ptosis in my right eye.

In the summer of 2009 I had finished graduate school and started my first professional teaching job. I’d been suffering from bladder and bowel issues for several years and had begun seeing an urologist and a neurologist who were trying to figure out if my problems were neurological, and if so, what to do about them. I spent the Fourth of July weekend in Yosemite National Park on a girls’ retreat with some friends from high school. We stayed in a yurt—with bunk beds—and hiked two or three trails a day for several days. I remember having a head cold that I picked up on the plane ride from Long Beach to Oakland and blowing my nose all night. I remember being eaten alive by mosquitoes one morning, despite having worn bug spray. I don’t remember any ticks, but I’m not much of an outdoor girl, and at the time, my tick-awareness was nonexistent. The kind of tick that bit me was likely a soft-bodied tick, the kind that fall off when they’re done, so it’s understandable that I never saw it. If there was a fever or a rash, I didn’t notice them because I was already sick and swollen with mosquito bites.

This is when I believe I was bitten, but there is really no way to know. According to CDC reports, the area of Southern California in which I live is known to be infested with ticks that carry Borrelia hermsii. I could have been bitten while walking my dog or sitting at a picnic table in the park.

After my Yosemite trip, I returned to LA and the neurologist, who referred me to a neurosurgeon. The surgeon, after ordering MRIs, concluded that I was cursed with a spinal column that was too long for my spinal cord, which was causing the cord to stretch like a rubber band and causing nerve damage that might account for the bladder and bowel problems. After much convincing (and much freaking out), I decided to undergo surgery to shorten my spine the following summer. At the time, I was under a lot of stress, trying to balance work, my teaching credential program, my relationship with my boyfriend, and routine doctor visits. If I was exhausted, I attributed it to this balancing act, not to the infection that was, unbeknownst to me, festering in my bloodstream.

The spine surgery was traumatic–nine hours face-down on the table, nine days in the hospital–but successful. My mobility was impaired for the first six months. I wore a hard brace until December and a corset until February. I was able to drive (and teach again) by September, and my life got back into full swing with student teaching, paid teaching, and two other part-time jobs. When I wasn’t working, I spent most of my time lying on my back in bed. I got an iPhone so I could be more productive in that position, and most of the time, friends who wanted to hang out came to me. After the first six months, when my surgeon said–according to imaging–that the bone had completely healed, I wondered why I was still so tired and achey all the time. I was having trouble getting up in the mornings, and I wasn’t making expected progress in cutting back on my pain medication. Maybe it was just stress, I reasoned. Maybe I was depressed. After all, at 25, my life hadn’t exactly panned out the way I’d planned it. Maybe it was part laziness. That was the conclusion of one of my mentor teachers. I had no real framework for understanding what was happening to me, so I just tried to push through it.

A little more than a year following my surgery, I went up to my parents’ house for a summer visit. I’d had the second of two eye surgeries in May to correct the ptosis, which so far has stuck–no more ptosis. (The surgeon attributed my ptosis to having worn hard contact lenses as a teenager.) School was out, and my back was doing all right, but I felt perpetually exhausted. I helped out at my dad’s medical practice for a week, and he ordered some blood tests for me. I didn’t find out the results until I got home to LA. Three little surprises: 1) Entamoeba histolytica, my parasitic souvenir from my time studying abroad in China; 2) Borrelia hermsii, from a tick I’d never seen evidence of; and 3) Anaplasma phagocytophilum, another tick-borne infection.

We treated the Entamoeba histolytica with a course of Metronidazole, an oral antibiotic and the Anaplasma phagocytophilum with three weeks of Doxycycline. The treatment for Borrelia hermsii was 42 days of intravenous Ceftriaxone therapy.

The treatment of tick-borne infections with IV antibiotics is controversial because research, professional guidelines, and doctors’ practices based on their experiences treating these diseases often contradict each other.

The CDC does not have specific guidelines for the treatment of Tick-borne Relapsing Fever (TBRF), the name of the illness caused by a Borrelia hermsii infection. Here’s what the CDC has to say about treatment procedures: “Experts generally recommend tetracycline 500 mg every 6 hours for 10 days as the preferred oral regimen for adults. Erythromycin, 500 mg (or 12.5 mg/kg) every 6 hours for 10 days is an effective alternative when tetracyclines are contraindicated. Parenteral therapy with ceftriaxone 2 grams per day for 10-14 days is preferred for patients with central nervous system involvement.”

You’ll notice that they only recommend one to two weeks of antibiotic therapy, in contrast to the six weeks of therapy that I received.

The Infectious Disease Society of America doesn’t have treatment guidelines for Borrelia hermsii, but they have guidelines for its Lyme Disease-causing cousin, Borrelia burgdorferi. They recommend treating what they term “Lyme arthritis” with Doxycycline, an oral antibiotic, for 28 days. Treatment suggested for “Late neurologic Lyme disease” is intravenous Ceftriaxone for 2-4 weeks.

Many of the patients that I met in clinic had tried oral antibiotics—sometimes for months at a time—with less than stellar results. Others had been given intravenous antibiotics on an inconsistent basis (for example, Monday through Friday, but not on the weekends). The patients I met who got better were ones who had had a minimum of 28 days of IV antibiotic therapy.

I can’t prove anyone wrong or right, and I am most certainly biased as a patient and a doctor’s daughter, but I can point you to facts and information that may help you in your own journey to health. So here is an abbreviated description of my experience being treated for Borrelia hermsii by an experienced infectious disease specialist:

I came to the clinic every day for 42 consecutive days, except for the day that I had gallbladder surgery. I know you must be thinking the Ceftriaxone caused my gall stones, but the stones were revealed to me by an ultrasound that was done in LA two weeks before I started treatment; they were probably brought on by a combination of heredity–my mother had hers out–and my weight loss following back surgery.

The doctor prepared the drug in a sterile hood. He used a butterfly needle (which is very small as needles go) in the top of my hand. It wasn’t very painful for me, and I’m not squeamish, so the process was not traumatic. Each day, the drug infused over about 45 minutes. The doctor said this method was better than an injection because it lowered the risk of adverse reaction. If I’d had any problems, they could have switched me to saline quickly.

The first two weeks were the most difficult. I was still extremely fatigued, and I began getting more arthralgias (aches and pains) in my wrists, hips, knees, and ankles. It was explained to me that Borrelia like to “hide” in joints, and my pain probably meant that the bacteria were dying. Knowing this, I could reluctantly accept the pain as a good sign.

In week three, I had my gallbladder out. My surgeon was very talented and did the laproscopic procedure, so it only took a few days for me to get back to normal. They gave me Ceftriaxone through IV in recovery, so I didn’t technically skip my infusion that day.

At the end of week four, I started to notice that I had more energy. I was working during the day, helping my dad, then coming home at night and doing my own work (I do freelance editing when I’m not teaching.). It was the first time in more than a year that I felt truly alert and productive.

Weeks five and six went by more quickly. I found myself laughing more, and even singing in the clinic. It helped that there was a piano there. For the first time, my back felt almost as good as it had before my surgery. And my mind…well, I’m sure you can tell how sharp I am based on my excellent writing skills.

For those who believe in more holistic treatment methods, I’ll note that a few other components played a role in my recovery:

1. Exercise: I joined the small pool where my mom takes arthritis water aerobics classes and went with her two to three times per week. The warm water made my joints feel better, and the exercises strengthened my muscles and improved my balance. Because the class is zero impact, I didn’t get sore like I would from walking the dog or playing a sport. The class I took was designed by the Arthritis Foundation and is offered at hundreds of facilities around the country. Though you could say I had a reactive arthritis, you don’t have to have arthritis to take the class. You do, however, need a doctor’s approval.

2. Diet: My doctor recommended a diet high in choline. Choline is an essential nutrient that is classified as the newest member of the B Vitamin family. It’s important because it is required for the proper transmission of nerve impulses from the brain through the central nervous system. You can find information about high-choline diets here.

3. Fun: During the six weeks of my treatment, I tried to find ways to relax and fun things to do. I attended a musical and several movies with friends. I read some “guilty pleasure” novels (you know, the kind with romance, vampires, etc.). I took walks on the beach with my family. I also benefited from the relaxed atmosphere of the infusion center. The doctor invited a piano player to entertain patients, and a few patients, including myself and a former opera singer, often sang along. There were a handful of regulars, like me, “doing time” for 28 days or more, and they became my friends. We swapped stories about doctors, work, and life. We gave each other nicknames and told each other jokes. My six weeks of treatment were filled with song and laughter. Could that have affected my prognosis? If I were a betting kind of woman, I’d bet on it.

I am still a work in progress. I’m back home in LA and feeling better than I’ve felt in a long time, but I’m not done with doctors. I’m determined to stay on top of everything from now on. Never again will I let one discouraging doctor visit interfere with my care.

I invite you to stay tuned and learn with me as I gather articles, resources, and stories from others.

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