6 Things Not to Say to a Family on a Medically Restrictive Diet

talkingBetween my daughter Sammi’s birth and her ninth birthday, she spent nearly all of her life on some kind of medically-restrictive diet. Whether it was being forbidden to eat grains as a baby, following an acid-free diet as a refluxing toddler, using the six-food-elimination diet to uncover the cause of her (incorrectly-diagnosed) eosinophilic esophagitis as a little girl, or choking down the unpleasant fat-free food that kept her safe from chylothorax after her cardiac surgery, we often had to define what our whole family ate by the things that Sammi had to avoid.

During all those years, I heard a number of unhelpful comments about what I fed my child, ranging from the well-meaning but insensitive to the downright offensive. If someone in your world is eating a diet that their doctor has prescribed, the following comments should never, ever come out of your mouth. Continue Reading…

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Gracias, Mil Veces: A Mother’s Day I’ll Never Forget

handheartThere were so many things to which we had to say “no” in the weeks after my 8 year old daughter, Sammi, had major cardiac surgery.

Soccer? Recess on the playground? Gym class? Wii games? No, far too much running and too many opportunities to get hit where her back was freshly stitched together.

Decent-tasting food? No, she had to be on a fat free diet to treat chylothorax.Birthday parties? No, too many off-limits foods and too many germs.

We said no — had to say no —  to almost everything she liked. It was heartbreaking. Still, there was one very wonderful, very life-affirming refuge for her: her third  grade teacher, Andrea Macksood. Continue Reading…

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Practicalities of the Chylothorax Diet

fatfreeThe best thing about being forced to eat a fat-free diet for chylothorax is that it is always temporary.

The worst thing about being forced to eat a fat-free diet for chylothorax is everything else.

If you are coming to this page from a web search for “chylothorax diet,” then you already know that you — or the person you’re caring for – has a leaking thoracic duct in the chest leaking a fluid called chyle, largely made up of dietary fat. If left untreated, chyle could fill the chest cavity and make it very hard to breathe. Because thoracic ducts usually heal on their own, simply waiting for that to happen is often enough treatment. While you wait, your diet has to be fat-free.

When my 8 year old daughter had to follow this diet after cardiac surgery, we were flummoxed. So many foods have a gram of fat in them — too little to be bothersome to almost any other diet, but twice as much as was allowable for her at the time. As we had before with other difficult, medically-required restrictive diets, we dug deep and did a lot of research. Here are some tips that I hope will help others manage this crummy, unpleasant, high-stakes diet. Continue Reading…

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The Sound of Water

glassofwaterMy eight-year-old daughter took a long drink of water through a straw, and I waited on the edge of a pin (on the edge of her hospital bed) to ask her a question.

As the first few drops of liquid hit her tongue, she did what she’d always done when drinking: she puffed out her cheeks like a chipmunk and held the water there. Slowly, I watched her throat as she began to swallow. Her eyes widened, and she swallowed everything in her mouth at once.

Finally, I asked. “How does swallowing feel, Sunshine?”

She set down the cup on her tray and looked at me, her hands fluttering up to her chest, trailing IVs and tubes behind her. The late afternoon light through the far window didn’t reach her bed, and so, lit by fluorescent lights above and dazed by morphine, she rested back on her pillow and answered:

“It feels so different!”

“How so?” I asked.

“When I swallow, it goes down like ssshhhhhwwwwwwww!”

“And what was it like before?”

“It was like ccchhhhk, ccchhhhk, ccchhhhk…”

With her skin still clammy and pale, only hours out of surgery, she reached again for the cup, drank another gulp, and said, “It’s so cold when it gets to my tummy.” Continue Reading…

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Terrible Conversation, Part II

conversationGiving a child bad news hurts on every level. Integrity tells us to be honest, realistic, straightforward. Nurturing tells us to soften the blow. Getting the combination right means compromising both.

When we had to tell our daughter Sammi just before her fourth birthday that she had been diagnosed with an inflammatory disorder called eosinophilic esophagitis, we did it in an age-appropriate way that, thankfully, also forced us to simplify the problem for ourselves. The new diagnosis meant a host of food restrictions that would change over time, but we focused on the first six weeks that would exclude dairy, eggs, soy, nuts, and wheat. I wrote about that conversation in a previous post:

We explained that we had good news; we now knew why Sammi’s food kept coming back into her mouth. Her esophagus was sick! We drew a body on paper, showed them where the esophagus was, drew a frown on it. We talked about allergies, about our friend’s daughter with celiac disease, about feeling crummy and then feeling better. We brought out the list of allowed foods and cheered along as favorites were listed.

At that young age, she was hardly able to comprehend it. Sammi ate what we gave her, followed the rules, and over the course of the next three-and-a-half years, endured more than a dozen endoscopies. She did everything we asked. She even participated in a barium swallow study and a strange and very uncomfortable CT scan without ever asking us why.

Sometimes, I feel horribly guilty that she never asked why. Continue Reading…

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