Hangover Day.

I had a fabulous evening with friends last night. It was a perfect end to a not so perfect week. Last night I ate most everything I am not supposed to, and I thoroughly enjoyed it. It was a conscious choice and almost certainly swayed by the fact I was having a flare up anyway - what's a couple more days pain once you're in it?

I have three suspects on my flare list. Number one - gluten. Straight forward, right? You'd think so. But it was an accident. I was making pasta for the kids - they don't always eat everything I do - and I cooked the carrots in with the pasta. When I dished up, I absent-midedly ate a few of the carrots. Oh. There's gluten in the water and probably soaked all the way into my otherwise innocent carrots. What an idiot. So, instead of having a lovely piece of homemade flatbread with garlic infused olive oil and parsley, the olive oil dripping down my chin, whilst I savour the moist, hot, doughy piece of heaven....I got carrots. Idiot.

Number two: Lady's time of the month. Boo. 'Nuff said.

Number three: Walnuts. A conscious decision to have walnuts, as I had already started to flare from either Suspect One or Suspect Two. Ed made an amazing dinner of organic chicken breast, filled with pesto, with a side of sautéed cabbage and paris mushrooms. The pesto recipe came from my Well Fed cookbook and it happened to include walnuts. It was delicious. Walnuts may not have been the culprit, but as I was on a downward spiral already, who knows?

So there we go. By last night, I had already flared up pretty bad. My decision to slowly reintroduce foods was thwarted again, by an accidental ingestion of gluten, damn hormones and well, a slippery slope from there. So, last night we had this:

An appetiser of julienne cut raw carrots and radishes, with a creme fraiche and chive dip (I didn't have dip). Then I made the aforementioned flatbread, dripping with roasted garlic infused olive oil and parsley, cooked on a pizza stone ( I had a bit of this - first time I've had flour in three months).

For main we had marinated a huge rump steak in olive oil, salt and pepper in the morning and left it all day. The same with two duck breasts, skin on. We also had pork strips, just 'nature'. Just an hour or so before dinner, we squeezed the juice of a Sanguinello orange (blood orange) into the duck marinade.

These were cooked on our BBQ and seared with a salad of rocket, iceberg lettuce, thinly sliced fennel, sliced radish and diced cucumber, with a Sanguinello, lemon and oil dressing. The combination of all the meats and the salad, especially with the citrus dressing was amazing! I probably enjoyed this food the most, despite the other food indulgences. There's nothing quite like grilled meat with an amazing salad.

My other downfall. Wine and pudding. Ty had made an amazing apple crumble and once I started tucking into this, I helped myself to quite a bit! It was probably nothing compared to the portions I would have had before, but I guess there is no such thing as a 'good' sized portion of flour, butter and sugar! We drank 3 bottles of quality red wine and finished off with some organic Brie and Tommes cheese. Heaven.

I woke up at 4.30 am in a bit of stomach distress and with a headache. I had one (usually prohibited) ibuprofen, lots of water and went back to bed.

So, here it is. Hangover Day. But this morning I feel good. I had a great night. I didn't beat myself up about what I ate and today all I am craving is salad. I am not in hideous pain (yet!) I hope I stay on course and that my flares go as quickly as they came. Roll on beautiful Sunday!

We are making plans to move pretty soon and the house is a little chaotic. On the plus side, we have already packed a few boxes and I have managed to finally get motivated to put Nina in nursery. She starts properly next week. Just two mornings, but it's an ad hoc facility, which is really cool and based on our income, is only 1.10 euro an hour - fab!

Finally the HS swelling is going down - recovering from my red meat, salmon, vinegar experiences has been pretty tough. I guess like falling off any wagon, when you had been doing so well, picking yourself up again is a challenge. I have been more careful again, apart from the odd coffee and a couple of small glasses of good white wine this week. I have been taking my Serocytols medication and occasionally remembering to take my magnesium and other homeopathic remedies. I have been gorging on fresh coconut, which is probably not a good thing. Is there a recommended daily allowance for coconut?? I really should Google it up. Aside from that though, my face has cleared up and I feel good. I am going to try duck breast on the BBQ this weekend and see if it affects me. I am feeling more in control and ready to start a more structured reintroduction of foods.

I have been reading more and more posts about about people finding diet has helped them improve their HS. It's fantastic to hear it from so many. It's a tough disease and sometimes it seems all you ever read is negative comments from people. I have to remind myself that the pain can take you into a dark forest, where even the strongest of us lose sight of the light. I am grateful that my journey is mostly positive and I have the support to keep on battling this disease in the most natural way possible.

I have never been what I class a 'sporty' person. As far back as I can remember, I admired those with a lean physique. No 'bulging hips' or pot belly, the ability to run and run for ever, to push themselves no matter what. Even when I was a kid, I quit ballet at age 5. My reason was that I thought I couldn't point my toes properly. Everybody else's feet looked beautifully arched, whilst my flat-footed 'point' just didn't look the same. I never told my Mum why I didn't want to go anymore and later in life, she told me the ballet teacher was sad to see me go, because I had been one of the best in the class! I guess like most things in life, being 'sporty' is all about perception.

Since then I've been a rower, I've attended boxing training, I've been a gym member and even took a GCSE in PE. I still never truly felt sporty. Then in 2007, I started running. It was a revelation to start running at my own pace and find that I could run and run for many miles, so long as I kept a reasonable pace. Later, when I worked in a prison, we would work out and run up to 4 days a week in our lunch hour - perfect! No need to get up super early, nor go to the gym after work. Plus, it was a good break from our desks in the middle of the day. I kept it up until I was 24 weeks pregnant (not all of it, just the occasional run by the end) and since then, my activity levels have plummeted!

Today I am feeling good pain for the first time in an age. Not the usual soreness of open wounds or swollen skin, but good, healthy, 'it hurts to get on and off the toilet' kind of pain! My legs ache, as does my torso and I am physically worn out. And it feels great!

I ran a fairly short distance - about 4 km/2.6 miles - but it feels great to have finally got out there again. My average time was about as quick as it used to be when I was fit - I was pretty shocked. However, it's not because I am miraculously athletic after such a long time out of the saddle, it's just because I'm carrying an average of about 34 pounds/15.4 kgs less than before. I shouldn't be surprised by this basic science, but I am easily awed by so many things in life! My HS didn't flare up, nor did it cause me any pain during the run. The area was a little more swollen in the evening, but no more than when I have been walking a lot.

Anyway, one swallow doesn't a summer make; so, I need to stop being so happy about doing one run and get motivated to start doing more and more to tone up this newly thin body!

I'm five days back into my diet and seem to have made another little faux pas. Today I have swelling and pain again - boo! I think it's either the apple cider vinegar, or the organic smoked salmon.

Organic, but from my research, still toxic??

Before I made a dressing for my beautifully pressure-cooker steamed artichoke, I need to find a substitute for balsamic vinegar after my last experience left me a little inflamed. I had read quite a few different sites yesterday on the effects of apple cider vinegar and they all seemed very pro this type of vinegar on the autoimmune protocol (now I'm wondering if I had been reading 'Doc' sites or just blogs...hmmm?). Now I am having another little look, there appears to be a huge debate over the quality of apple cider vinegar and what effect it can have on you.

I had had a bit of a flare last time I ate organic farmed salmon, but I had forgotten about it. So now I am trying to do a little bit of research, so that it stays in my brain. I must remember not to be lured in by the organic-ness and I remember why I should not be eating farmed fish.

It's all about keeping the Omegas 3 and 6 in balance apparently. Now, there is so much sciencey stuff attached to this and I would love to spend my days immersed in the ever elusive search for the perfect balance of fatty acids in my system, however, I have 'home' stuff to do (and a life that doesn't revolve round me!).

I did do a little research, and as with most things food related, I wish I had never opened the flood gates! I found so many articles on how farmed salmon is ridiculously dangerous for the ecosystem and how the labels for organic fish have much lower restrictions than those on farmed animals. There is quite a comprehensive article on the The World's Healthiest Foods site, explaining all the science behind the imbalance of Omega 3 and 6.

This article about Canadian salmon is interesting, 'Demystifying "organic" farmed salmon: Is there such a thing?' and obviously a little Googling it up produces a plethora of the 'whys', 'whats' and 'wherefores' of eating salmon. An article here gives a bit more background into what we should be eating and steers the topic away from the eco/ethical debate, focussing on the health issue more.

Back to my search for the 'perfect salmon to meet my Omega ratio requirements', I found another little article on "Balancing Omega-3 and Omega-6". It doesn't talk about farmed salmon, but does give an insight into how the imbalance affects people's health.


After trying not to get too sucked in by the whole salmon debate online (and limiting my exposure as to why eating anything that has a pulse makes me a bad person), I have managed to skim the surface of farmed vs wild salmon and the many reasons I shouldn't eat it farmed.

I found a little fact sheet that summed it up with this:

"Don’t eat wild Atlantic salmon and farmed salmon. The Monterey Bay Aquarium in California recommends wild Alaskan salmon as an alternative, while the UK-based Marine Conservation Society suggests organically farmed Atlantic salmon."

With the apple cider vinegar debate still looming, I think a little more eating experimentation will have to occur, before I can make any confirmed conclusions between the salmon and my HS. In the interests of health and general eco-equilibrium of world balance, my conclusion is that I should probably just eat wild alaskan salmon once or twice a year (preferably when I'm near Alaska to minimise my carbon footprint). Perhaps this is my cue to start looking for a wild, line-caught fish oil supplement....

This time last year and hadn't even considered giving up any of these foods. A couple of month's down the line, I had started a "Paleo" diet, having read a little about how Hidradenitis Suppurativa could be an autoimmune disease and therefore influenced by diet. At that early stage, I knew then that I'd never be able to cut out eggs if I was hoping to get enough protein in my diet without bankrupting us. I definitely could never have envisaged living without tomatoes, spices and chilli - my staple foods for cooking up tagines, curries and most of my evening meals. Six month's down the line, and many hours of research on the internet, my diet is almost virginal (slight exaggeration, but that's how it feels sometimes!). I am a fully fledged autoimmune protocol diet fan!

What I should be drinking right now.....

As with any times of restrictions in life, I found that it helps to have some kind of boundary or end date in sight. Without this, my motivation to abstain wouldn't have lasted past my initial pain-motivated, stubborn determination. I set my timeframe as 60 days of a complete elimination diet, before starting to reintroduce foods one at a time. Somedays, I would comfort myself with the fact that I may only need to do 30 days and other times, I would face the (sometimes depressing) reality that this diet may become my way of life. Forever. However, for the sake of sanity and positivity, it is good to keep in mind that there are definitely worse realities in life than this!

....what I'm actually drinking right now
(NOT recommended for AI elimination diet!)

Just snacking on a piece of fresh coconut with a lovely cup of freshly brewed cup of Fairtrade organic Ethiopian coffee (which should read 'a lovely cup of organic mint, nettle and gunpowder green tea', but no-one's perfect!)  and thinking that I'd share a little of what I have read and researched in terms of things to avoid whilst on the autoimmune diet. Despite it being a little negative to start with what I can't eat, it is a known fact that bad news is far more exciting/interesting than good news...so we'll start with what we can't eat....

Foods to avoid

• Eggs
• Dairy, including all dairy (yes, even fermented dairy, goat's milk and any thing else that comes from an animal's udders)
• Cereal grains (rice, oats, wheat etc)
• Seeds of any variety.
• Seed and vegetable oils (all except coconut oil and olive oil, which I have in abundance - see Foods to Eat')
• Spices derived from seeds (cumin, coriander, mustard - anything which I used to eat that made my food taste good)
• All nuts, including nut butters.
• Legumes, including all types of beans, chick peas (garbanzas), lentils, soy, peanuts etc.
• Any soy derivatives (soy milk, yoghurts, tofu, soy sauce)
• Refined sugar in any form.
• Honey in any form.
• Processed foods - bread, pasta, any gluten-free 'health' alternatives, cured meat, ham, bacon.
• Alcohol (boooo)
• Grain-fed red meat (after my bad experience of an intense flare up after homemade burgers, this is off the menu!)
• Nightshades. This includes tomatoes, all types of peppers, including bell peppers, pimento, chilli pepper (excluding black peppercorns), egg plant, tobacco (not many people still eat this, but you probably shouldn't smoke it either!) and common old potatoes.
• Coffee - especially if you are a caffeine addict! (I am not a coffee drinker per se, but I have started to have a cup here and there, in the name of rebellion and inner freedom. Also, I haven't noticed a reaction from it..yet)
• Fruit juices (too much concentrated sugar, not enough fibre).
• Any food that contains an ingredient that you cannot pronounce, like stock cubes and sweeteners and anything containing sweeteners, like sugar-free gum.
• Many vinegars  - I even avoid organic balsamic vinegar; I think the 'concentrated grape must' contains too much sugar.

So it's not a long list, but the combinations of processed foods out there are endless. Dark chocolate, carrot cake, "paleo" muffins, cereal bars, smoothies, V8, gluten-free crackers - so many things that look innocent (ooh, Innocent Smoothies - yum yum...No. Stop it. Illegal), but are now off limits. Melissa Joulwan, author of Well Fed, a beautiful paleo recipe book, tried the autoimmune diet for 30 days and as she puts it, there is zero "food fun" during that period.

Anyway, enough of what can't be had and onwards and upwards to what can and should be delightfully savoured in the name of self-healing....

Foods to Eat

• Fresh vegetables - anything in season, although when your diet is so limited, I've found it's better not to fully restrict yourself to keep some variety and sanity in your life.
• Beautiful squash and versatile sweet potatoes (I know these are vegetables, but they become your "pasta/rice replacements", so I think they deserve a line on their own
• Fresh fruit - I have read so much about limiting fruits, eating one piece per meal, eating them before dinner not after - oh so many pieces of advice, but I just tend to eat as much as I want. It may have a negative affect, but it's got to be better than eating a handful of Haribo Tangfastic jelly sweets.
• Fish - preferably wild and line caught. 
• Grass fed beef and pastured meat of any variety and game.
• Poultry, again organic and not battery farmed would be best.
• Coconuts, coconut oil and coconut milk (preferably with no guar gum and BPA free- although hard to find unless you have dedicated organic shops).
• Olive oil and olives (organic as non-organic contain various preservatives).
• Herbal teas (I'm bang into Jasmine green tea- amazing!)
• Naturally dried fruit (although I'd avoid this as a staple ingredient as it's too high in sugar).

Ok, so the 'Foods to Eat' list looks shorter, but when you consider all the amazing varieties of fruit and veg in the world, it is an endless list of variety and choice. I know that to back this all up I should include all the yummy recipes that we try every week, here at home. One day I will, but until then, I'll leave it to the experts, like Michelle Tam from nomnompaleo.com and Sarah Fragoso from Everyday Paleo.

Until then, I am back on my autoimmune 'wagon', and hoping to start reintroducing foods in the coming months. For all those who are embarking on this journey, it is baby steps all the way and a constant reminder to "be kind to yourself. Bon courage!

I'd love to hear people's experiences of how they have survived the elimination diet and things that have or haven't worked.....

I am not a physician, licensed dietician, nor nutritional specialist. The dietary information provided is not intended to diagnose, treat, or cure any illness or to provide medical advice. it is advised that you make your health care decisions based on your own research and the advice of a qualified health care professional. Good luck!

So much for avoiding inflammatory foods. By the end of the day of 'pain', I decided that whilst I'm having a flare up, I may as well indulge....I never said my resolve was endless! Ed has a garage full of good wine and, well sometimes it's hard to say no to a 90 euro bottle of wine! We are celebrating and not just my 8 weeks of strict eating. We have made an offer on a piece of land and it has been accepted! Woohooo!

Whilst off the wagon, I have had a couple of days of indulgence. Another rump steak on the BBQ - lush! And also, Ed managed to get free tickets to a wine exhibition (think free wine tasting on a grand scale) at the Parc des Expositions at Bordeaux Lac. We picked up our free glass at the entrance and voila! The selection was enormous, so we narrowed it down by trying the organic wines first. We stuck to Burgundy, Bordeaux and Champagne. Then as we went along we narrowed it down by the look of the vendors! We bought six bottles and headed off. It was a great experience and a really good way to find lots of lovely new wines to fill up our wine fridge. Next year, hopefully we will be following suit with the French and bringing a trolly to fill up the car with a few boxes, not just a few bottles!

In the evening we cooked up a rump steak on the BBQ that had been marinating all day in olive oil, salt and pepper. We had it with a mushroom mix of oyster, paris and closed cup mushrooms, sautéed in coconut oil with onion and garlic - lush!

By the evening, the pain had stepped up a notch, as it always does after I've been walking around a lot. I was struggling to sit down and when I went to bed, sleep evaded me. I resorted to taking an ibuprofen - something I have avoided since trying to heal my gut. The relief was amazing and at about 2.30, I finally drifted off to sleep. 

Today, the pain continues and the inflammation around my spots is back. I am sitting down like an old woman and I know I will have to apply all my dressings properly if I want any kind of comfort today.
I am day 2 back into my diet and despite the pain, I feel good.

Far from being a hideous experience, I can say (in hindsight!) that this has been educational and motivating. At least I know for sure that my diet does have an effect on HS and the past two months have not been a waste of time. Nothing like a good flare up to remind us how lucky we are when are days are pain free. 

Wow. I am in pain today. It was the red meat - I am sure of it. I woke up and the pain was back in my butt - like it used to be everyday before I started this autoimmune protocol diet. The area is inflamed and it hurts to sit down. I can't believe I had almost forgotten how that constant severe pain feels!

I was getting so used to just a little mild discomfort and enjoying being able to sit down without wincing. I was also catching myself crouching down super slow, thinking I might put pressure on my spots and realising that I didn't need to.

But today it's back. 

The shooting pains up the side of my butt cheeks. Perching on the seat cushion, so I don't put any added pressure on the spots and strapping up the area, to avoid any friction pain on top of the swelling pain. The grumpy mood I'm in because of the pain. All back after one meal of red meat.

I had discussed it with Ed before and we had guessed that red meat might have affected it, but that was back when I was eating a whole load of inflammatory foods and the constant pain meant it was hard to distinguish which foods were doing what. Now I am sure. No more red meat. Well, at least no more regular, supermarket beef. Grass-fed beef? It might be an option, but I am still trying to source it here in Bordeaux. We had always said when the meat had run out in the freezer, we would be looking to buy grass-fed (and even better, organic) beef. Now, if anything, it is the only option for me.

So after nearly 8 weeks on the autoimmune diet the great news is that I am definitely healing. I  inadvertently reintroduced an inflammatory food and to my surprise, the results are super clear. I thought I was ready to reintroduce other foods back into my diet, but after this experience, I think I'll wait a little longer!