NJ/PA Elemental Formula Legislation

There is a new Facebook community to support elemental formula legislation in NJ & PA.  There will be a new bill introduced to the NJ legislature in March, 2012.  Information will be posted at https://www.facebook.com/pages/NJPA-Support-for-Formula-Legislation/215841811847087

Assemblymen John Amodeo (R) and Chris Brown (R) will reintroduce A-3830, which, if passed, would mandate health insurance coverage for certain amino acid-based elemental formulas that are used to treat eosinophilic disorders.  Both welcome other assembly members to join them in sponsoring the bill.  Assemblyman Dan Benson (D) has already expressed a desire to do so.

If you reside in NJ, please meet with your local assembly representatives to educate them on this issue and request that they sign onto the bill. Assembly members' staff may contact Tom Suthard at Assemblymen Amodeo and Brown's office to indicate their interest in becoming a sponsor.  Their phone # is 609-677-8266.

Please share this information with others, especially those in the eosinophilic and food allergy communities, as well as those who are dealing with any other medical condition that necessitates treatment with elemental formula, whether delivered enterally or orally.

Feeding Tube Awareness Week

This is the 2nd annual Feeding Tube Awareness Week (February 5 - 11, 2012). There are NG (Naso Gastric) tubes, NJ (Naso Jejunal), ND (Naso Duodenal), G (Gastric), GJ (Gastric Jejunal), J (Jejunal) and TPN (Total Parenteral Nutrition). No one wants them and no one wants their children to have them, but when they are necessary, they can be a Godsend!

The feeding tubes, along with liquid medical "food", such as elemental formulas, can provide the proper nutrition when a child is allergic to many foods (typical allergy or eosinophilic disorder), can't swallow, has a gastrointestinal (GI) disorder, or isn't getting enough oral nutrition for various possible reasons. They can allow a person to receive the nutrition necessary for proper nourishment to gain weight, grow, and thrive, which they were otherwise unable to do on their own. There are many reasons why someone may need a feeding tube, but a person does not get one unless they REALLY need one. Please don't judge.

If you see someone with a feeding tube, please don't make a face, stare, or ask "What's WRONG with YOU?" They don't have "cooties".  It is an alternative, yet necessary way for them to "eat".  Please give that person (especially a child) a smile and know that whatever the reason, that feeding tube IS a medical necessity and it is providing medical benefit to them.  If your own child knows someone with a feeding tube, please reiterate your lessons of tolerance and understanding, just as you would with all other differences.  They likely feel left out enough as it is, and we can never have too many friends who care.

You can learn more about feeding tubes at the following organizations' websites:
APFED (Americal Partnership For Eosinophilic Disorders)
Feeding Tube Awareness
The Oley Foundation

To learn more about our personal journey and how the use of feeding tubes have affected our lives and improved the health of both of my children, please feel free to read my prior blog posts, especially the first one "First Post - Our Journey".

Recipe for Gluten-Free Beef Stew with Red Wine

Since my son has been trialing beef, I have been trying to come up with a beef stew recipe that everyone in my family would enjoy.  After scouring through various recipes for stew in general, I experimented with the ingredients to suit our needs and came up with this recipe.  It has been a hit!  This one is free of wheat, gluten grains, dairy, soy, egg and any of the most common food allergens.

I previously only had stew with larger chunks of meat, but I noticed that cutting the stew meat into smaller pieces helped make it very tender and easier for the kids to eat.  While I used beef, I am assuming this would work with lamb as well, and I will likely try that in the future.

You can chop or dice the onions and other vegetables to the size of your choice.  I dice the onions (very small but not quite minced) because my son won't eat them if he can see them or recognizes them.

While I recognize that I'm not using chicken, I experimented with the Hol*Grain G/F Chicken Coating Mix and it worked well.  It contains rice flour, brown rice bread crumbs (medium grain brown rice), red pepper, black pepper, garlic powder, chili pepper, salt and xanthan gum.

If you can't have rice in your diet, you could omit the Hol*Grain G/F Chicken Coating Mix or rice flour mixture altogether.  You could also use another safe flour in lieu of rice.  The beef can just be browned with a little salt and pepper.  It will not be quite as tender, and the stew will be a bit more "soupy", but it will still be good.

Gluten-Free Beef Stew With Red Wine 


Ingredients:

• 1 1/2 - 2 lbs beef stew meat, cut into small (1-2") pieces.
• 2-3 tablespoons Hol*Grain G/F Chicken Coating Mix ~ or ~ a mixture of rice flour and the following seasonings to taste:  garlic powder, paprika, salt and pepper (see preparation instructions below).
• salt and pepper to taste
• 2 tablespoons olive oil
• 1 cup dry red wine
• 1 box (32 oz) Pacific Brand Organic Beef Broth or other safe beef broth
• 1/2 tsp dried thyme
• 1 bay leaf
• 1 onion, chopped or diced to the size of your choice
• 1 medium to large parsnip, peeled and chopped into small pieces
• 1 small turnip, peeled and chopped into 1" pieces (1/2 of a rutabaga can also be substituted)
• 3-4 carrots, peeled and chopped into small pieces.

Preparation:

1. Chop/dice the vegetables and set aside.
2. Cut beef into 1-2" pieces; pat with paper towels to absorb excess moisture.  In a bowl, combine 2-3 Tbsp. Hol*Grain G/F Chicken Coating Mix or 2-3 Tbsp. rice flour, 1 tsp of salt (or less if preferred) and then add garlic powder, paprika and pepper to taste.  Add beef and toss to coat.  In a pinch, Lawry's Seasoned Salt can be substituted in the flour mixture.  
3. Heat olive oil in a Dutch oven over medium-high heat.  Add beef to the hot oil and cook, stirring often for approximately 4-6 minutes, or until brown.  Add a little extra fresh-ground pepper while cooking if desired.  When browned, remove beef from the Dutch oven and set aside.  
4. Leave the particles of beef and flour at the bottom of the Dutch oven.  Add a little bit of the red wine and stir to loosen the particles.  Add the onion, carrots, turnip and parsnip, and cook for 2-4 minutes, stirring often to keep them from burning on the bottom.  Return the beef to the pan and add the remaining red wine, beef broth, thyme, bay leaf and a little salt to taste (if still needed).  Bring to a boil.  You can also add a little extra thyme to taste if preferred.
5. Cover, reduce heat to low, and cook, stirring occasionally, 1 to 1 1/2 hours, or until meat is fork-tender. 
6. Serve and enjoy! 

Serves 4-6 people.

Dairy-Free "Greek Yogurt"

If you are looking for a dairy-free "Greek Yogurt", So Delicious has come out with one!  I made a yummy shake for my "non-eos" daughter last night, using that yogurt, a banana, frozen blueberries, rice milk and MLO Brown Rice Protein Powder.  She only has to avoid dairy, but if I omit the bananas, it is safe for my son ("Eos Boy"), too!

On occasion, my daughter has a hard time eating solid foods, even soft foods.  That was the case yesterday, so I made the smoothie to give her something substantial and filling.  It was a hit!

The yogurt may contain only 2 grams of protein, but it DOES have 9 grams of dietary fiber (36% of the recommended daily intake) in each 6 oz container.  So, if you have So Delicious products in your local store, keep an eye out for this new yogurt.  I paid $1.99 for a small, 6 oz container, which is rather steep, but on the bright side, I was able to make something special, delicious, and nutritious for my daughter, which was also easy to ingest.

If you would like to check the ingredients in advance to see if it's safe for you to use, please click here for the product link.  

I'm looking forward to trying other combinations for both of my kids!

Back to Food Trials & Hoping To Blenderize Food

My son has stopped taking swallowed Flovent and is back to food trials.  He is currently trialing beef, which he has to have every day for 3 months before having another endoscopy with biopsies to determine if it is safe for him to eat, or if he has eosinophilic infiltration in his esophagus.  So far, he doesn't have any definitive symptoms that would indicate he is reacting, so I'm crossing my fingers.  He still has 2 more months to go before his scope.

The problem we've been experiencing is with his weight.  He lost a lot of weight when he stopped getting his enteral formula (an elemental liquid medical food that goes though his feeding tube) but his intake has improved and he is growing.  He looks VERY skinny now, and his pants will literally fall off without drawstrings or belts to hold them up, but his current growth spurt may be playing a part.  It's difficult not to be concerned when I see how skinny he has become, but I have to try not to overreact.  I'm trying to keep tabs on it to make sure he isn't dropping any more weight.

We would love to have him discontinue his enteral formula and get rid of his feeding tube, but thus far we haven't been able to get enough nutrients in him to do so.  He still supplements what he is eating with formula and if he isn't feeling well, that's all he will take.  So, I have been trying to figure out how to get enough nutrients and calories into him with the safe foods that he has.  His nutritionist recommended making shakes/smoothies with a safe protein powder (understanding that he can't have soy, dairy, wheat, etc.).  I have found a very good brown rice protein powder which can be used to make protein packed shakes.  He can have rice milk, coconut yogurt, berries, peaches, pineapple, pears, grapes, etc.  However, he can't have bananas.  He failed (reacted to) a combination of bananas and oats and will need to retrial bananas by themselves in the near future to determine if they are safe or not.  I suspect it was the oats, but there is no way to be sure without trialing them separately.  He also can't have melons or citrus fruits, which he definitely failed (they caused an eosinophilic reaction in his esophagus).

Since he does not like most vegetables, I would really like to put them into a smoothie.  However, my blender can't properly handle raw vegetables.  It doesn't make them smooth (it leaves chunks) so it isn't sufficient and you really can't make a good smoothie with cooked fruits and vegetables.  I'm trying to find a blender that CAN handle raw fruits and vegetables, so that I can make him smoothies that will provide him with the natural nutrients that he is otherwise lacking.

I am trying to find out if there are any potential medically-related tax deductions or if medical flex spending accounts can be used for the better blenders (with proper documentation and letters of medical need or Rxs from physicians).  There is one in particular, the Vitamix Blender, that I think would be perfect.  I have seen them demonstrated locally and I could make so many things that he could eat or drink, which would greatly benefit him.  If is not tax deductible or eligible for flex spending reimbursement, I won't be able to afford it.

If I do find that it's possible to purchase one, I will gladly post recipes (and videos if I can figure out how) that are free of the most common allergens, as well as others that are common triggers for Eosinophilic Esophagitis.  I truly feel that it would be beneficial to many parents of kids with Eosinophilic Gastrointestinal Disorders as well as adults with EoE / EGID.  It may greatly reduce the stress of trying to provide proper nutrition on a severely limited diet.

In the meantime, I will continue to struggle with getting enough nutrients and calories into my teenager who desperately needs them.