Thursday, February 20, 2014

Day 4...

So just like every year at Passover we say "Next year in Jerusalem" and every year we are still in Virginia...yep, STILL in the hospital. But things are definitely on track (so far) for me to go home TODAY. And I mean it this time! =)

I saw the PA for my one doctor (not the pulmonologist) about 11:30 am. She was very helpful and said she would make sure all the medicines were in line for me so when the pulmonologist gave the okay, I would be able to leave with what I needed. Although, she did say that since my peak flows were still hovering around 200 (40% of my predicted) that it wasn't likely that I would be going home that day.

I didn't really like hearing that, but honestly, when I took a step back to evaluate how I was feeling, I don't think I was quite ready. I was still coughing pretty regularly and my chest was still feeling tight. When my mom and I were talking, she asked if I felt ready to leave and I told her that I really just wasn't sure. I think that in itself was enough of an indication that I needed to stay.

I saw the pulmonologist again about 3:45 in the afternoon. He again said it was my call if I wanted to go home, but suggested another day or 2 (really did not like hearing that 2...) to get another couple rounds IV steroid, stay on the IV fluids, and get my peak flows up. I decided that we would give it one more day and assuming I wasn't any worse today I would go home even if things hadn't changed too much. I want to get as much benefit as I can from the treatments they can give me here in the hospital, but I also know that the longer I stay the more exposure I get to other germs and potential triggers.

Shortly after the doctor left, my nurse came in and said that I would be moving to a different floor. Apparently I had been on an observation floor since I had been admitted and there was a time limit on how long you could stay there. So I was moved down a floor. Initially I was sharing with an older lady, but when the nurses realized my mom wanted to stay, they moved me to a private because overnight guests are not allowed in semi-private rooms.

As always, I was nervous about switching floors and nurses. My nurses on the observation floor had been great and my mom and I had trained them well with all my issues =) Haha, so I was a bit nervous having to change nursing staff. But just like everyone I've seen here, they have been great. The first nurse I had on the new floor asked a lot of questions and want to learn more about my various issues and ways that we treat them and how she could be help me keep improving. We probably spent a good 30 minutes or so just talking with her about POTS, MCAS, GP, food allergies, asthma, etc. It was really cool to have a nurse who wanted to learn more, and it gave me a way to help pave the way for future patients who may come through this hospital with similar issues. Like I've said before, as much as I don't want to always be going on and on about all my health issues, it's times like that where I can help educate someone else that may be beneficial to other patients that makes me grateful that I can be a part of raising awareness and helping others get better treatment in the future.

It was actually pretty funny later that evening when the nursing staff changed from the day nurses to the night shift. My nurse that we had talked with spent a good 10 minutes probably talking with the nurse who was coming on for the night shift just debriefing him on my case and what was going on. My mom and I could hear every word because my room is right next to the nurses station. We were impressed with how much the day nurse remembered from what my mom and I had told her and how thorough she was communicating that to the new nurse. He was great too and when he was leaving this morning said he enjoyed having me as a patient because I was low key and not high maintenance.

Last night was a good night =) I was able to go 4 hours between treatments consistently and even had to be woken up for the midnight treatment. I had minimal coughing and actually slept pretty well! My peak flows were still around 200, but the respiratory therapist doing my treatments said it's typical for peak flows to be lower at night because sleeping suppresses breathing. This morning I had a treatment about 8 am, I was able to get my peak flows up to about 250! That was higher than it had been so far, and based on how I was feeling and breathing, the respiratory therapist said he would give the okay if the doctor asked. That was definitely good to hear!

So now we are just waiting to see the doctor. My nurse paged him and hopefully he will be by soon and we can start the discharge paperwork. I am SO ready to get home. Yesterday morning as much as I wanted to leave, I still felt like I wasn't quite ready physically. Today, I'm definitely ready! I'm not back to 100% yet, but moving that direction and at the point where I should be able to manage things on my own at home. The nurses and doctors have been great, but I'm ready to GET OUT OF HERE!!!!! Haha, so for real this time - "Next post from my apartment!!!"

Wednesday, February 19, 2014

Jail Break Time...

I wish I was writing this post from my apartment or school or anywhere else really, but I'm still (wait for it...) in the hospital! =\

I needed to be here last night, so I'm not really complaining but just ready to go home. After writing the post yesterday morning, I had an up and down day. At the time I was going about 3-3 1/2 hours in between breathing treatments. They are scheduled every 4 hours but I can get them as needed every 2. I guess it was good that I was going longer than 2 hours but still couldn't quite get past that 3-3 1/2 hour mark without having major issues.

I finally saw the doctors about 2 or 2:30 yesterday afternoon. Since being admitted my experiences with my nurses have been fantastic. They have all been very helpful and caring without constantly hovering. But I still hadn't seen a doctor, so I was a bit nervous (if you want to know why, read my post from yesterday...see VISIT #3). Thankfully I had good experiences with both doctors!

I saw the pulmonologist first who was great! He listened to what was going on and wanted to hear what I had to say about how I was feeling and what was going on. He agreed that it sounded like this could have been triggered by a MCAS reaction on Friday/Saturday that caused my asthma symptoms. He also said that my asthma in general is likely to be atypical, meaning that I don't present with normal symptoms. Why am I not surprised?? The best part of talking with him was finding out that there was another medication I could try in my nebulizer. Maybe 7-8 years ago I was on an inhaler for my asthma that was cromolyn sodium (yep, same thing I'm not taking for my GP). It was the best medication I had ever been on and controlled my asthma symptoms so well. I had to stop taking it because it was taken off the market because one of the ingredients was apparently damaging the ozone layer...who cares about all the patients who require that medicine to breathe, right?!?! Anyway, the doctor I saw yesterday said that cromolyn sodium is back on the market for nebulizers as a generic! So he went ahead and prescribed that for me to start later yesterday evening. He originally said he would allow me to make the call when I felt ready to go home, and that if I felt comfortable leaving with prescriptions to manage things at home that would be fine. Before he left, though, he decided to have me do my peak flows to see how my breathing was doing. And those 3 breaths are why I'm still in the hospital today...LAME!! That's exactly how I performed on my peak flows...I was not even 40% of my predicted normal values. The doctor said that research and experience has shown that if they send someone home with peak flows less than 60% of the patients predicted values, there is typically a relapse within 48 hours. So my fate was sealed and I settled in for another night in the hospital...

Like I said earlier, I had been going about 3-3 1/2 hours between treatments, and in between I was doing okay. Still coughing, still kinda sore, but definitely improved from when I was admitted. My mom had been with me the whole time and decided to run over to the YMCA to workout for a bit and to get a shower. She left around 3 or so and I figured I would be fine because I had been doing better and we had just finished talking with the doctor who had been so good. Unfortunately, about 3:30 I started struggling A LOT. It was right about 3 1/2 hours since my last treatment... I wasn't able to get my nurse because I couldn't talk so when she walked by she couldn't hear me. There was also a lot going on around the floor so pushing my call button didn't do anything either. Finally, about 5pm I was able to get my next treatment which was now 5 hours after my previous one. I was seriously not doing well...BUT it was good because I started the cromolyn sodium that the doctor had prescribed.

I saw the second doctor later that night about 8pm. He was good also! After my experiences the day before I thought it was too much to hope for having just one good doctor, but both of my doctors have been great. I saw his PA earlier in the day but she didn't really seem to give us much info. She was very nice, but I didn't feel like she really had an idea of what was going on...this doctor was good, though. He listened liked the other doctor and asked me some questions. He actually said I sounded pretty bad to him with all my coughing, but since he hadn't heard what I was like when I was admitted, would let me and my mom make the call when I felt comfortable leaving. He did say the pulmonologist would have the final say based on my peak flows and breathing, though. One of the biggest things I appreciated about both these doctors was that they treated me like an individual and not just a number. They were willing to listen to me and realized that I am not a typical patient with asthma and wanted to work with me to get me better. They didn't give me a checklist of what we would do to fix things before hearing from me what was going on. I have a lot of issues, I know that, and both these doctors were willing to see that and work with me to treat ME and not the stereotypical asthma flare. Yay for positive doctor experiences! It gives me hope that I will be able to find doctors that are willing to help me where I am instead of trying to shove me into a neat little box that I don't fit into.

Anyway, I would say that I definitely started to see a pretty big improvement after starting the cromolyn sodium, especially after the 2nd dose around 8:30pm. I was able to go 4 hours between the last cromolyn treatment at 8:30 and my next one! The over night treatments were only albuterol so by this morning I was struggling a bit again and back to about 3-3 1/2 hours before needing the next treatment. I got more cromolyn sodium this morning and I'm feeling pretty good right now. So here's to hoping I get to go home today! We will see what my peak flows look like later probably, but for now I'm definitely coughing less and feeling more comfortable breathing than I have since I was admitted.

Just like at seder every year we end with "Next year in Jerusalem," I'm going to end this with "Next blog post from my apartment!"

Tuesday, February 18, 2014

Not 1, Not 2, Not 3, but 4...4 what?? Read on to find out...

Brace yourself, this is going to be a long one...

So my weekend started on Gastroparesis Awareness Day just like everyone else (even though most people probably thought they were celebrating Valentine's Day, silly them...). Later in the afternoon I got back to my apartment after working on campus all day and noticed a very distinct cleaning chemical smell...asthma (or not, I'll explain that later) + cleaning fumes = NOT GOOD. I was actually okay Friday night, went rock climbing with my boyfriend which was super fun and felt decent. Then along comes Saturday...

I woke up Saturday morning feeling pretty good, actually. My peak flows were slightly lower than usual but still green, not having any issues that I knew of...I went running at the Rec Center on campus and went back to my apartment to get some work done. About mid-afternoon my roommate was getting ready to go out somewhere and decided to wear perfume which she doesn't typically wear...you probably see where this is going...I started coughing pretty bad and wheezing a bit. I went over to my boyfriend's apartment to eat dinner and watch the Olympics around 5ish. By 6:30 I was really struggling...couldn't stop coughing, wheezing, chest was tight, etc. I had started using my nebulizer (called neb/nebbing from here on out) after my symptoms started at my apartment, but I was struggling to get 2 hours between treatments...not a good sign. By 8pm I couldn't talk, couldn't stop coughing, my neb treatments weren't working, rescue inhaler wasn't working...I was out of options. So my boyfriend took me to the ER.

VISIT #1: ER (yep, that's what I'm counting =P)
For someone who hates doctors, I will push things until the very last moment to avoid having to go in, but I had hit that point. Thankfully, this was a very good experience (unlike another I will detail shortly). I was triaged immediately...guess that's what not breathing, coughing, and wheezing will get you...who knew they were at least good for something! The nurses were very nice and efficient, the doctors listened and gave me different treatment options to work around my allergies and sensitivities, I was in and out in 2 hours. 2 HOURS FOR AN ER!!! They gave me 4 breathing treatments, some cough medicine, pain medicine for the chest pain from coughing (which I later threw up), but were very helpful and listened to my issues (of which there are many) and worked WITH me to figure out a treatment plan.

I spent the night at a friend's house to make sure I was okay for the night which ended up being a good decision. I had a very severe flare about 3am and was grateful to have someone with me. After leaving the ER I kept nebbing about every 2-3 hours just to maintain breathing. I still couldn't control my coughing though. They gave me a prescription in the ER but 10:30 on a Saturday night, nothing is open to get them filled.

Sunday morning I went back to my apartment and hung out most of the day. I just wanted to stay low key and try to recover since I had to teach and had class on Monday. Mostly that went according to plan...again, about 3-4pm I started having the coughing get worse (even on the medication the ER had given me) and shortness of breath. I had community group that evening and I went even though I wasn't feeling great because I didn't really want to be alone. I couldn't stop coughing and was getting even more short of breath. I was really trying to hold out until Monday because I knew I could at least go to the health center on campus (as much as I dislike going there) which wouldn't cost me anything instead of going back to the ER and paying an arm and a leg and possibly my future first born.

VISIT #2: HEALTH CENTER
I made it to Monday (yay!). Still nebbing every 2-3 hours even through the night and knew that I needed to get seen again. I went to the health center and actually had a good experience. I was able to get an additional breathing treatment and have a doctor see me which confirmed that I was definitely not doing well. She wanted to start me on prednisone which is a steroid that I have reacted very badly to in the past. I asked what other options there were at the point I was at. She was very honest and said not much. I ended up getting a steroid injection at the health center which I was hoping would not have the effects of the oral steroids (it didn't, yay!). But even after the injection and a neb treatment, I was still coughing. She decided to send me to the local hospital to be admitted and monitored while they worked to stop the coughing/bronchospasm. So I called (actually texted because I had not had a voice since Saturday) a friend and she took me to the hospital.

VISIT #3: ER (different ER than visit #1)
This visit was one of the worse experiences I have ever had in an ER in my life. I was triaged quickly but once I got to a room, it went downhill quickly. I still could not talk, was coughing so much I could barely catch my breath, had chest tightness, and was shaking from all the stress on my body. The first nurse came in, listened to my chest, took my o2 sats and said I was fine. The second nurse did the same. I told them I knew my o2 was fine and my chest was mostly clear, but the doctor on campus had sent me to be admitted because I had been coughing for 2 days and was still short of breath. They begrudgingly gave me a breathing treatment which was less than what I had been doing on my own at home. When I finally saw the doctor after coughing for almost 2 hours and seeing no one, he said they were going to give me some oral prednisone and send me home since there was nothing wrong. This was AFTER the nurse had already charted my sensitivity to prednisone and that I wanted to try another option. Because I could barely talk from all the coughing and shortness of breath, he just talked over me and refused to listen when I tried to advocate for myself. They finally gave me some cough medicine and another steroid injection (even after I told them the one from the health center hadn't helped) and said "peace out." I made a point to ask the doctor when I should come back because I had not gotten any help and felt worse then when I had walked in. If I hadn't already been in an ER, I would have gone in...and they were sending me home. The doctor said to come back if things got worse...I told him (AGAIN) I had been in a different ER 2 days ago and things were worse, that's why I had come in...plus the doctor on campus had sent me. He told me to take the cough medicine and I would be fine.

So I left. My friend who had taken me said I sounded worse then when we had gone in...I agreed. Now I not only couldn't stop coughing and was seriously short of breath, but I was reacting to whatever the 2nd steroid injection had been. My HR was more than double my resting HR and my BP was also significantly elevated. The only problem was that my resting HR and BP are normally so low that when things are elevated, they are still within a "normal" range so no one thinks there is a problem (even though I had told them when I got there that I run low). It was one of the worst experiences I have had with doctors.

My mom had decided to drive out that morning when I told her things were not going well, so I had my friend take me back to my apartment. By the time my mom got there (about 15 minutes later) I was even worse. We spent a bit of time trying to decide whether I needed to go get seen AGAIN (4th time in 2 days), but eventually made the decision to head back to the first ER. What I was doing at home wasn't working, and after talking to the doctor at the health center again (who was upset with the situation at the 2nd ER also) figured I needed something more. So off we went to pay out my future first born.

VISIT #4: ER (again)
Back to the same ER I had started at. I think the check-in people recognized me (or at least my cough) and I was triaged immediately again. After intake finished their stuff which didn't take long since it had been less than 48 hours since I had been there, I ended up back in the same room I was in Saturday night. This time they did breathing treatments (again), more cough medicine, and a chest x-ray. The x-ray was clear, but after being there for 2+ hours and no change in my coughing, they decided to admit me. Here's where things got a bit frustrating/weird. The ER is kind of a satellite campus for a major regional hospital system. So to admit me, they had to transport me to another location. Unfortunately, this had to take place by ambulance ($$$) and we had to wait about 30-45 minutes for them to get there. On top of everything, there was a major snowstorm so the 20 minute drive to the hospital took way longer because we were driving about 25 mph on the highway.

I guess this could technically be visit #5 since it was a whole different facility, but since it was the same hospital network I'm counting these together. We got to the hospital about 10pm and check-in took forever. I had my last neb treatment at the ER about 8:30 and didn't get another treatment at the hospital until midnight. That was the longest I had gone without a treatment and I really felt it...the nurses were good, but it seemed to take FOREVER to get orders from the doctor. That's how it has been this whole time (yep, still here...hopefully not for too much longer...). Everyone we talk to is very helpful but things just seem to take a long time to get done. When I finally got the treatment at midnight, I also got some IV steroids. I have been doing treatments every 2-4 hours as needed since being admitted and have had 2 rounds of the IV steroids so far.

I'm finally starting to feel a bit better (at least I think...). I'm not coughing as much (yay!), going whole MINUTES in between coughing fits rather than seconds! My chest pain is a bit better since I'm not coughing as much, and my throat is calming down thanks to some wonderful lemon ices the nurses were able to find for me. I'm still definitely coughing and hurting and I know it's going to be a while before I'm back to normal, but I'm hoping to get out of the hospital soon (i.e. TODAY). I think the IV steroids have been one of the biggest things that has helped me. I started to feel better after the second dose about 6am. My guess is that it takes a little while to build up in my system, especially considering it's me we are talking about. I still haven't seen a doctor although they have been involved with my care, but I'm told I can't be discharged until I see both the regular doctor and the pulmonologist assigned to me...I have another round of breathing treatments at 12pm and another dose of IV steroids at 2pm, so I'm hoping that the doctors will come by at some point so I can go home.

A couple things I've learned from this experience:
  • I DEFINITELY need someone with me when I go to the ER/hospital/etc., especially with my asthma when I wasn't able to talk for myself. I carry wallet cards with me that have all my medical information on them but it's no replacement for having someone there to advocate for me when I can't 
  • I'm getting better at knowing when I need to go and when I can treat things at home. I really resisted going to the first ER, but once I was there, the nurses and doctors reaffirmed that I had needed to be there that night. Same for being in the hospital now. As much as I don't want to be in this germ factory any longer than I need to be, I could not have gotten the IV steroids at home or the IV saline, both of which I think are seriously contributing to me recovering.
  • I can't let 1 (or more) doctors tell me I'm okay when I'm not. This is definitely an ongoing lesson, but reinforced yet again this go round. If I had listened to the doctor in the 2nd ER, I would have taken medication that I knew would not work and would make me incredibly sick. I could have ended up in an even worse state because I wouldn't be getting the treatment I needed. It was extremely difficult for me to make the decision to go back to the ER after that horrible experience, but I knew that I needed something that I could not do on my own. Had I allowed that experience to dictate my treatment plan, who knows where I might be now because I was not in a good place when I was admitted.
  • Going back to something I mentioned earlier (WAY earlier, like first paragraph earlier), I think there is more going on than I tend to think of. I was reading some articles while I've been sitting in the hospital and one was about histamine-induced brochospasms. Histamine is the major trigger of mast cells which is the basis of my MCAS. If the cleaning chemicals or perfume set off a release of histamine in my bronchials and lungs, that would explain the incessant coughing and why it didn't respond to normal treatment. It also explains why my o2 sats have been okay and my lungs sound mostly clear. It was a bit of asthma, but more a MCAS episode. Maybe next time something like this happens, my first response should be benadryl instead of the typical asthma meds...something to think about/investigate further.
So that's been my last few days! I'm still sitting in the hospital writing this, but like I said earlier, hoping to be discharged later today...who knows...I'd REALLY rather not spend another night in the hospital...but oh well. I definitely moving in the right direction now (yay!) and hopefully will remember to blog again when I'm out and better...but no promises.

Friday, February 14, 2014

Gastroparesis Awareness Day

Happy GP Day!! Yes, it's Valentine's Day, but I'm not really a mushy person, I don't like pink, and the color for GP is green, so all around it seems like a better idea to celebrate Gastroparesis Awareness Day...and I happen to have GP...so let's celebrate!!

This time last year I was really sick and unable to eat much anything at all, so I'm really celebrating today. I am so grateful to have found a treatment plan that is working, and that I'm in a place where I am able to eat pretty much what I want (within reason, haha, no cheese casseroles for me!).

One thing that I've struggled with/wondered about is how I fit into these "awareness" days. This year has been the first time I've really tried to do anything for Dysautonomia Awareness Month or Invisible Illness Week or Gastroparesis Awareness Day. And when I say doing anything I mean making a post of facebook or this blog...does that even count? I want to do my part to raise awareness, but what does that look like?

Recently I just found out that there is a genetic research trial looking at MCAS and other similar conditions and the genetic background of patients with a diagnosis or suspected diagnosis. Being a part of that is way for my experiences and medical challenges to contribute to the research community and hopefully work toward finding a better way to diagnose and eventually treat these rare conditions.

Something else that has made me think about my contribution to raising awareness for these conditions has been my research that I am doing in my PhD program. One of the grad students who is a year ahead of me is starting a study on Lower Body Negative Pressure (LBNP) and blood flow changes. His purpose is looking at therapies for Parkinson's Disease and other neurodegenerative diseases that may cause some form of orthostatic intolerance. I still have about 6 months or so before I start my research, but what better way for me to contribute to the Dysautonomia community then to use my resources to do LBNP studies to simulate orthostatic stress and study the sympathetic and parasympathetic response of the body.

Maybe I'm not ready to be all out there with everything that is going on to my entire facebook network, but I do want to be a part of raising awareness and contributing what I can to the research community. Whether it's participating in a research study or doing the research myself, I want to do what I can to increase the awareness of these rare conditions so others are able to have quicker diagnoses and better treatments.

So wear GREEN for Gastroparesis Awareness Day!!!

Monday, February 3, 2014

I can eat THAT???

With all my food sensitivities, sometimes it feels like I can't eat anything but a short list of foods...white rice, turkey, black beans, carrots...and THAT'S IT!

I go to restaurants and the serves probably think I'm OCD or have "issues" because I order something super plain and emphasize that my food can't touch anything else...actually had an incident at a restaurant this past week where the server didn't quite understand what I was saying. He thought I just didn't want my food touching so he asked if I wanted the chicken and vegetables on separate plates...that made me a bit nervous, but no worries, it ended up being a great meal!

Anyway, the point of this post was not to lament the lack of food I can eat or the fact that I appear to have weird eating habits (note I said APPEAR...haha). Instead, I wanted to celebrate how much I CAN actually eat!

I've had about 2 weeks now of feeling good! The Gastrocrom has been really good, and my stomach has calmed down quite a bit. Overall, I've had the best couple weeks that I've had in a long time! As a result, I've been actually enjoying cooking and trying new food combinations (within reason of course...no crazy obscure ingredients here).

One dish that I made recently was a Black Bean Sweet Potato Turkey Chili. Now I've had chili many times, I eat black beans and turkey often, and I've recently added back sweet potatoes as being an approved food. BUT, I've never had them all together. Plus, the recipe that I used had a lot of ingredients.

Typically I'm a 5 ingredient or fewer recipe person - TRANSLATION: if there is a long list of ingredients, I'm not even going to try it. But my boyfriend had gotten a new slow cooker for Christmas and it sounded so good, so we decided to try it.

Black Bean Sweet Potato Turkey Chili


Ingredients:

  • 3 tsp olive oil, divided
  • 4 tsp garlic powder 
  • 2 bell peppers, diced 
  • 1-2 jalapenos, minced
  • 1lb ground turkey breast 
  • 2 teaspoons cumin 
  • 2 teaspoons kosher salt 
  • ½ teaspoons pepper 
  • 1 teaspoon oregano 
  • 1 teaspoon chili powder 
  • 1 1/2 teaspoons smoked paprika 
  • 1 1/2 lbs sweet potatoes, peeled and diced into 1/2 inch cubes 
  • 1 28 ounce can tomatoes (not drained) 
  • 2 15 ounce can black beans, drained and rinsed 
  • 28 ounces chicken broth 
  • 1 15 ounce can pumpkin puree (make sure you’re not using pumpkin pie filling :) 
  • 1/2 tsp cinnamon
  • 1 tablespoons unsweetened cocoa powder
 Directions:

  • Heat a large skillet to medium-high heat. Add 1 1/2 teaspoons olive oil and add garlic, bell peppers, and jalapenos. Saute for about 5 minutes, until veggies are tender and fragrant. Add to slow cookerIn same skillet, heat remaining 1 1/2 teaspoons olive oil. 
  • Add turkey and cumin, salt, pepper, oregano, chili powder and smoked paprika. (note: the meat will taste very seasoned when done. Keep in mind these seasonings are not to flavor just the meat, they will season the entire pot of chili, so they are intentionally strong!) Cook turkey until no longer pink.   
  • Add to slow cooker. Add sweet potatoes, tomatoes, beans, broth, pumpkin, cinnamon, and cocoa powder to slow cooker and stir to combine. Place lid on pot and cook for 4-6 hours on high, or 8-10 on low. Slow-cookers vary greatly in temperature and cooking times, but really, the important thing to note is if the sweet potatoes are tender.
  • When done, turn off heat and let chili sit with lid off for 10-15 minutes to thicken. Season with additional salt to taste before serving. 
Some points to notice...First, this recipe is gluten free, dairy free, onion free, low fructose, low fat, kosher, cardboard, oh wait...JUST KIDDING, there's not really any cardboard taste or otherwise in here. Second, and the point I'm trying to make, there are 18 ingredients in this recipe...EIGHTEEN!!! That's more ingredients than I think I've used some WEEKS...in one dish! That's an accomplishment in and of itself!!!! And it even tasted great! I liked it more than my boyfriend did...it was a bit sweeter than a typical chili which threw us both for a loop. I'm not usually someone who likes sweet dishes, but I enjoyed this a lot. We made this one evening before we went snowboarding and it was the perfect dinner before heading out into the cold.

As I said earlier, the point of this post was to focus on what I CAN eat rather than what I can't. This dish isn't the only thing in the past couple weeks that I've made that I can eat that is outside my comfort zone of rice, black beans, turkey, and PB2 sandwiches. I might have to be a bit more creative than someone who can eat anything, but that's okay....CHALLENGE ACCEPTED!