Tag Archives: Gluten Free

Ask Me Anything on Reddit

23 Jul

Recently, I did two AMAs on Reddit.

Click the links below to read the Ask Me Anything (AMA) segments on Reddit:

  1. Hi, I’m a Family Medicine Doctor. I find that patients that DON’T LIE to me make the best patients.
  2. Hi Reddit, I’m a Family Medicine Doctor. AMA about Celiac Disease and Gluten Intolerance.



1 Feb


Our enemy is so pretty!

Mushrooms NOT ALWAYS Gluten Free

17 Jan

So, I came across this from About.com:

Question: Are mushrooms gluten-free?

Papa Smurf?

Answer: Plain mushrooms ought to be gluten-free — after all, they’re a fresh vegetable, right? But unfortunately, that’s not the end of the story for mushrooms if you’re particularly sensitive to trace gluten.

You see, mushroom spores are grown on gluten grains — most commonly on rye, but also on wheat and occasionally on a combination of the two grains. And this cultivation method leads to some gluten cross-contamination on the finished fungi…

The author goes on and informs us that washing and treating the mushrooms would likely reduce the 20 PPM (Parts Per Million) threshold required by US Labeling Laws to be “gluten free.”

As a patient and sure as hell as a doctor, I don’t like the statement: “washing my veggies will LIKELY result in reducing the ppm below 20.” I deserve to know if it does or does not.  The nutritional facts of what goes into my body need to be Black or White. I don’t care if I’m buying that from my local farmer’s market or from a national chain. I demand this as a consumer, a patient, and a doctor.

It’s imperative that federal food labeling laws regarding Gluten Free Foods become uniform and strongly supported by the varied patient symptoms, science, and medicine. And not be muddied by being in the Gray Zone.

Gluten Free Meals at College Campuses

11 Jan

Nothing too dramatic to add to this story from the Boston Globe:

The US Department of Justice has reached an agreement with Lesley University that ­requires the school to “continually provide” gluten-­free dining options to students, to ­ensure compliance with a federal law that protects people with disabilities, authorities said.

Among the settlement’s terms, Lesley has ­also agreed to provide a space in its main dining hall to prepare and store gluten- and allergen-free foods and to pay a combined $50,000 in damages to a group of students who have celiac disease or other conditions, the Justice Department said….

Though I welcome these directives, I think a couple of things need to be kept in mind:

  1. An institution may provide gluten free meals under threat of lawsuits–but this does not mitigate risk.
  2. Offering gluten free foods without experts on hand can lead to cross contamination.

Both of the problems above–will lead to MORE lawsuits! I think the problem can be tackled with unified and consistent Gluten Free labeling and more education.


Happy Holidays

25 Dec


Happy Holidays

So, I pulled up to the Starbucks drive through on Christmas Eve and Nick asked, “What would you like for Christmas?” I said “a medium black coffee, double cupped.” For those of you that don’t personally know Nick, you are missing out. Though, most of you probably know him from one of my first entries on my blog.

Nick for the last 16 months has asked me on an almost daily basis as to why I choose to have my cofee black. No, he’s never said “Once you go black, you dont…” Pay attention!

I explain the details of my AM coffee to him, Everyday. In the drive-through lane. Our latest conversation has been about non celiac gluten sensitivity and why a young man chooses to wear skinny jeans. I teach him about the former, he the latter.

“So, you just want a black cup of coffee for Christmas?” I smile at him, and say: “Yes, just that.”

This time, he simply smiled at me and said “Happy Holidays.” This was my first interaction with Nick in which I did not need to bust out my “super celiac educator cape” for the 1 in 133 people out there. There indeed was a lot of smiling going on.

I consider it to be my responsibility as a physician to educate people about Celiac disease, on a daily basis. I smile alot, nod my head to show that I am actively engaged in conversation, and BHAAMMM!! They end up learning something.

This time, I smiled back at Nick, and just needed to say “Happy Holidays.” No teaching, no educating needed today. For the first time, I felt like all the other people in the line: I simply felt like an anonymous overpaying Starbucks’ customer. I felt normal. And then Nick, in his deep Tom Brokaw– voice said, “The driver in front of you paid for your coffee.” I was touched by their random act of kindness, especially since I was guilty of tailgating them too closely and totally violated their personal space in the drive-through lane.

And then, I became even happier when I heard what Nick said next: “ They asked why you wanted a black coffee, and I told them “it’s because are you are allergic to soy, gluten, and dairy.”


To learn more about Nick:


Poop Cycle of Celiac Disease

21 Nov

Here is an interesting chart that shows the amount of time patients with Celiac Disease spend in the restroom.

A Graph about Poop

**Note: It’s Funny. 🙂

Some Facts about Autism

18 Nov

Autism Awarenss

So, here are some facts about Autism.

→ Vaccines do not cause autism.

→ Autism is a deficit in a kiddos language skills.   Specifically, autism manifests as a deficit in receptive language or expressive language. The term Autism Spectrum Disorder has replaced the term Autism.

→Autism spectrum disorder is defined by defects in impairment in socialization, restricted/repetitive behavior, and impairment in communication.

→Intervening  early and intensively is key to treatment. It should be done by trained applied behavioral analysts affiliated with a medical group. It should NOT be done by isolation, changing foods, and other fad diets.

→ A child with autism starts showing signs  around 12 months of age by showing impairment in communication.

→It is hard for parents and doctors to judge impairment in communication. Let’s be honest, we communicate better some days than others. Just remember the last time one of our spouses were exiled to “the couch.”

→A child’s brain develops by pruning. Similar to how we prune a hedge. It’s argued that “autistic” kids don’t prune early in life.

→The  inability to show “joint attention” is the core symptom of autism and is a more concrete way to identify  “communication” impairments.

→Joint attention is best explained by this analogy:  a kiddo points to a cloud. He really digs that cloud. He then, looks at you or dad–he signals,  makes a noise, or says a word to get your interest. AND, then, the child wants you to see that groovy cloud. That is joint attention is a nutshell.

→The inability to see, express interest, and share that interest is very telling of autism spectrum disorder.

→In the near future, head circumference might be one of the first screening tools for the  indication of autism.

→Autism’s incidence is growing because we now have screening tools to recognize and diagnose it.

→The Academy of Pediatrics now recommends autism screening for ALL children from between 18 and 24 months of age.

If  your doctor doesn’t screen your child, ask them nicely.  If your doctor still doesn’t, get another doctor.

→Kiddos should be screened earlier than 18 months if they have a sibling with autism, aren’t talking by age 1, have a family history of any auto-immune diseases, or, if, they have a family history of any psychiatric disease.

→Autism is a diagnosis that now forces Commercial and Medicaid Insurance to pay for treatment by specialists. It was recently passed and is rightfully called the “autism insurance bill.”

→Most Commercial insurances and Medicaid now reimburse doctors for this screening test, MCHAT. It is politically correct to educate your doctor from reputed academic sources, not necessarily from what ya may have  heard on da street.

→By, that I mean: Jenny McCarthy.

→If, Mr Rodgers were still around, he’d surely not like Jenny McCarthy. But, I’m sure, he’d have a classy way of describing his opinion of her. I have yet to gain that skill.

Please note: the above does not replace medical advice, diagnosis, and treatment of your doctor.

Some Facts about Hernias

11 Nov

Man, that hurts!

Here are some random facts about hernias:

-Men AND Women can and do develop hernias.

-Most men will describe a history of lifting a heavy object, turning/twisting abnormanlly; and, then, a sensation of having felt a “pop” and seeing a “bulge.”

-You may see a mass extrude through the hernia, which resembles a pouch.

-No, you’re not a kangaroo.

-Your surgeon may have to perform emergency surgery if your intestines get strangulated or incarcerated as they move through the abdominal defect.

-Most hernias can be surgically corrected via a laparoscopic approach–this is of value because you’re left with three tiny suture sites.

-The surgery to repair the defect is VERY routine and is done to strengthen your abdominal wall. Think of a tire patch on a flat tire.

-Blood in stools, bloating, numbness in the inner thighs, and intense pain, are, sometimes, symptoms that your hernia isn’t just an accessory of the year. It’s NOT something to show to your friends at parties–it might be time to have that pouch examined by your doctor.

Please note: the above does not replace medical advice, diagnosis, and treatment of your doctor.

Gluten Free Brown Jasmine Rice and Veggies

7 Oct

So, today, I cooked, a very nice gluten free dinner. I think you’ll like it–it’s easy to make and requires virtually NO prep time.


  1. 1 Cup Jasmine Brown Rice

    Yummy Dinner

    Looking Good

  2. 2 Small Onions — Chopped Fine
  3. 1 Large Tomato
  4. 1/4 Cup Peas
  5. 1/4 Cup of Cut Broccoli Heads
  6. 1 Carrot Thinly Cut
  7. 1-2 American Cheese or Swiss Cheese Slices
  8. 1/2 Table Spoon Salt
  9. 2 Pinches Black Pepper
  10. 2 Cups Water 🙂
  11. 1/2 Spoon of Butter
  12. 1 Small Lemon/Lime


So, let’s get you cookin’

First, take 1 cup of Jasmine Brown Rice and soak it in water for 20 minutes.

As the rice is being soaked, get a glass of wine (or scotch) and get to the prep station.

We’ll finely chop the two onions, thinly slice the carrot (I like to slice along the length of the carrot); get the 1/4 cup of precut broccoli heads, 1/2 cup of peas, chop the tomato (i keep the tomato pit); and add the salt and pepper.

Saute, on medium heat, ’till the mixture begins to sweat. Then add the butter and let all rest.

Now, let’s get back to the rice:

Drain the soaked rice a couple of times and then once you’re satisfied that the rice looks clean–add (2) two cups of water to the rice and bring it to a quick boil by heating on high heat.

Once, the rice has been brought to a roaring boil–add a 1/2 a tablespoon of salt, 1 tablespoon of olive oil, add the tomato pit, and a thinly cut lemon/lime slice to the mix. Bring the heat now DOWN TO SIMMER & cover the with a lid.

The rice now need patience, and you need to down the drink.

Check on them occasionally but do not keep lifting the lid and letting all that good steam escape. After about 30 minutes, stir the rice, check for consistency–they should be chewy and still a little grainy to taste. If they are, cover the pan again and let cook for a few more minutes.

It’s now time to add your sauteed mixture and the two slices of cheese (Yes you can use shredded cheddar) but the slices were handy and quicker.

Bring it all to a nice mix–take out the lemon slice and squeeze the other half in the mixture. Let it all sit for 2-5 minutes.

Serve with Red wine and enjoy this awesome gluten free meal.

Ready to be Eaten.

Need Some Beer…

20 Sep Only 3 PPM of Gluten!

Often times, the hardest thing for the gluten free person is finding a good beer. A Gluten Free, good beer! I’ve knocked down a bottle or two before; but, I’ve yet to stick to one brand. Some are too salty, some too bitter, and some taste too frothy. Just yesterday, I was pleasantly surprised with Estrella Damm’s Daura. I googled them after I got home, and was surprised to see how serious they’re about their beer.

Only 3 PPM of Gluten!The beer contains only 3 parts per million of gluten and is surprisingly light without the heavy after taste that comes from Amber Ales.

From their site:

Estrella Damm Daura has won a Gold Medal at the World Beer Championships, a Gold Medal at the International Beer Challenge and the World’s Best Gluten-free Lager Award at the World Beer Awards.

So, for now Daura gets my beer nod of the day.