My new sewing machine

I grew up around sewing machines.  My first sewing machine, which I still have and use, was a 1976 Singer.  It is built like a rock (and weighs about as much as one), and 31 years later still compares favorably against most modern home sewing machines.  I've since added a serger (a.k.a. over-locker) to my toolkit, and have been fantasizing about a cover stitcher.  But yesterday, when I went with my mother to help her pick out a new sewing machine, I was utterly charmed by a little chain stitcher.

The sewing machine shop, located in the heart of San José, Costa Rica, was the largest I've ever seen.  It eclipsed the home sewing machine shops around the suburbs of Melbourne, where I live, as well as the one in Boulder, where I used to live.  It even made the industrial sewing machine shop I once visited in Detroit  look twinky.  This place was big, and it was filled with table after table of new and used sewing machines, over-lockers, cover stitchers, and display cases filled with specialized feet and feeders for the various machines.  The entrance was dominated by industrial sewing machines (Costa Rica has a healthy textile industry) and the interior was overwhelmed by domestic machines, some of which came with tables fitted with working foot pedals for people living with limited access to power (when was the last time you saw one of those for sale in the US - did it belong to your grandmother, or was it during the  preparations for Y2K?).  Upstairs, where you could go if you were escorted by one of the sales people, were two more racks filled with used sewing machines.

Only minutes after entering the store we noticed a virtual duplicate of my 1976 Singer sewing machine in a locked case along one wall, sitting next to a variety of other machines of similar vintage.  It turns out the machine hasn't worked for a long time, but the shop agreed to fix it up and sell it to us for the very agreeable price of about $80.  We never even looked at the new machines.

What really caught my eye, though, were the rows of small black hand cranked, cast iron chain stitchers.  These machines were obviously sold by the store for ornamental purposes, but they were built like tanks, and I suspect they may be for general consumption in China, where they were probably built.  The first man we spoke to in the shop said they couldn't sew.  Though this was definitely true of some of the little machines, I wasn't convinced we couldn't make one of them work.

Not one of them was threaded, so I guessed where the thread would sit and how to get it to the needle.  I also struggled with how the bobbin worked, until I looked closely at the mechanism under the plate and realized that the machine would do a chain stitch with only one thread.  I was enchanted by the simplicity of it and determined to get one working.  With the help of one of the shop assistants, one of the mechanics, and a new needle, we got the second machine we tried to sew.  So now I am the proud owner of a little hand crank chain stitcher.  It will probably sit on display in the living room, but when the year 2028 bug hits, I'll be ready.

Elimination diet: the end

The long awaited end to our elimination and challenge diet has arrived.  After three and a half months of monitoring everything my son and I ate, we can now go to a party without bringing our own food!  During this period we challenged salicylates (twice), amines, and glutamates, and my son also challenged bread preservative.  My son finished his second salicylate challenge a few days ago, and he'll be off the diet tomorrow (I finished a little over a week ago).  I'm disappointed to report that the only thing I've learned about my son's skin condition from all of this is that my son does not have a severe reaction to any of these things.

That's not to say he didn't react, just that it wasn't obviously caused by the challenge food.  The value of this knowledge is not to be dismissed, however his reaction to each challenge was difficult to interpret.  As I've mentioned in previous posts on the topic, his skin never completely cleared.  Even with periodic use of cortisone ointment, the eczema would inevitably appear after a few days on the elimination diet without drugs.  The big question was whether the severity had reduced.  At this point I've concluded that he is not unusually sensitive to any of the chemicals we challenged.

Though I'm eager to expand our vegetable intake, we won't go back to our previous eating patterns immediately.  I expect to introduce certain foods with caution.  For instance, our diet previously relied on high intake of tomato, which is high in salicylates, amines, and natural glutamates, and often associated with eczema.  One thing I will introduce immediately is flaxseed oil, as I feel that the elimination diet is distressingly low in essential fatty acids (since everything we ate had to comply with the diet, even supplementation was restricted).  He will have flaxseed oil instead of butter on his toast (I've discovered that when drizzled over toast with a little salt it is a totally suitable substitute for butter), and whenever he would have had butter or oil that is not cooked.  We will also introduce a number of vegetables and fruits that are only moderately high in salicylates, and cut way back on meat, chicken, and sugar intake, which always felt too high to me.

Lessons learned
We didn't need to spend so long to learn what we did from this experience.  We had to repeat challenges to correct early mistakes in execution. Even now, there are things I should do to make up for mistakes made in the beginning, but I've lost the enthusiasm to continue.  If I ever have to go through this again, I will do a number of things differently.

What do I consider essential to success while minimizing the pain and duration of the diet?   This is written in regards to my experience with eczema, but most of it applies regardless of the condition you are trying to treat.

Do the allergy tests first.  You will have more success with the diet if you avoid all foods and other irritants to which you have a positive allergy test.  If your doctor suggests it, you can challenge those foods and then reintroduce them into your diet if you do not have a reaction.

Get your hands on one or both of the cookbooks for this diet (Friendly Food and The Failsafe Cookbook).  I use them nearly every day.  The recipes are fantastic, even if you don't end up doing the diet, and Friendly Food, in particular, is a very good source for people who need to avoid eggs, gluten or wheat, nuts, dairy, or soy.

Stock your larder, experiment with recipes, and make some of the staples (like pear jam) before you start in earnest.  Make a few things you can put in the freezer.  It will be a lot easier to stick to the diet if you already know how to make a few meals that comply with it and know where to buy the ingredients.  You will not have the option to make a last minute dash to get take away on this diet.

Rearrange your kitchen so that the food you will not be allowed to eat is separate from the food you are allowed to eat.  For instance, put all forbidden food into a cabinet separate from everything else so you do not get confused or tempted.  If you keep snacks in your bag or your car, make sure they comply with the diet as well (we used plain rice cakes and rye cruskits for this).  In the refrigerator, designate the least visible shelf for the forbidden food (things that won't go bad during the three or so months you're on the diet, like ketchup and jam, and anything your family members insist on having).

As much as possible get your entire family to follow the diet when eating in the presence of the people on the elimination diet. You may find it handy if you allow the consumption of forbidden foods out of sight of family members who are following the diet, especially right after challenges, when you will probably have left-overs that you can no longer consume but you don't want to waste (for instance, we had cherries and carrots left after our salicylate challenge, so I sent them to work in my husband's lunch).  They can also be used to slowly rid the freezer of forbidden foods.

If you have the flexibility, do the diet in the winter.  Many of the allowed vegetables are not available or of poor quality in the summer and you won't be taunted by all the beautiful summer fruits.

If you have the flexibility, don't start before the holidays or lots of birthdays.  Sticking to the diet is far more pleasant when you don't have to eat out frequently.

Take detailed notes.  Keep a description of symptoms in your food diary rather than trying to rate their severity as a number.  This will be much less subjective.  Even better: get a person who does not know whether you are doing a challenge or in the elimination phase to evaluate the symptoms; it is very easy to let your own wishes interfere with your judgment.

Prior to starting the diet, find out how the skin responds after two weeks without cortisone.  While eating your normal diet, treat the skin until it is clear, then take notes on the symptoms for two weeks.

Use the cortisone the way the doctor specifies (i.e. don't try to go
without).  Use it as directed for the first week of the diet, when withdrawal symptoms are most likely to occur and to prepare the skin for a two week elimination challenge (see next point).

After starting the elimination diet, but prior to starting challenges, find out how the skin responds to two weeks on the diet without cortisone.  A week after you start the elimination diet, do a two week elimination challenge where you do not use cortisone to determine if the elimination diet has resulted in an improvement.  If not, consider what else you might need to eliminate or consider stopping the diet altogether.

Label everything you put in the freezer with 1) the contents, 2) whether or not it follows the diet, and 3) the date it was made.  If you are avoiding amines, this will help you avoid eating meat that is too old.  It will also ensure you don't accidentally eat the zucchini risotto you made for the salicylate challenge during your amine challenge.

Conclusion
Since eczema runs in families (I have it, my dad has it, my son has it), there's a pretty good chance any other kids I have will get eczema, and I may find myself going through this again.  If it happens when they are only a month old, I will do the elimination diet immediately to see if it has any positive effect.  I will also continue to look for other solutions to the problem.  If nothing else, I've learned how to do this better the next time.

Getting lazy with glutamates

Well, in what feels like a never ending quest to determine what food sensitivities by son has, we challenged glutamates last week. The challenge required eating a whopping 80 ml of soy sauce (4 Australian tablespoons, or 5 ¹/₃ US tablespoons) each day for three days.  We were also encouraged to use Parmesan liberally.  Technically, those were the only two items in the challenge, but we also indulged in a few other foods that contain glutamates (and amines, which we are no longer avoiding) but no other forbidden chemicals.  We also continued to indulge in small amounts of glutamates during the three day elimination period that follows each challenge.

The most famous glutamate is Mono Sodium Glutamate, also known as MSG. It is widely associated with Chinese restaurants, but it, and a few other glutamates are often used as flavoring in packaged food.  As it turns out, glutamate also occurs naturally in a range of foods, including aged cheese, soy sauce, tomatoes, peas, mushrooms, broccoli, and grapes and their products.

After about 50ml of soy sauce on the first day I couldn't take it anymore;  I do not believe that one person could consume enough food in a day to disguise that much soy sauce.  And after a night of anxious sleeplessness and a headache, I was content to finish the challenge right then.  Was it the glutamate?  I don't know - I also had a lot to do and a son who was no keener than I to eat that much of the challenge food, but it sounds like classic Chinese restaurant syndrome.  Regardless, given that most of the foods where glutamates are found in high concentration are also high in fat I'll probably try to limit my intake anyway.

On day two of the glutamate challenge I phoned the dietitian because my two year old son had decided not to complete the challenge (he wouldn't eat anything that tasted like soy, and I can't blame him).  The dietitian recommended substituting Parmesan, so we had pizza for dinner.  That worked.  I also cheated by indulging in a little Cambazola cheese, and we both cheated by having peas, both foods that contain glutamates and no other forbidden substances that are not part of the challenge.  In the end, after eating lots of Parmesan, my son did not appear to react to the glutamates.

The day after the official end to the challenge, we went backpacking.  I do not recommend camping while on this elimination diet, nor do I recommend backpacking with a two year old child, but that's another story.  It was very difficult to find suitable foods.  All pre-packaged camping foods were out of the question.  Dried fruit was out (except for bananas, but we couldn't find those because of the recent banana shortage anyway).  Most of the vegetables that we usually take were out.  GORP was definitely out.  No pepperoni or smoked fish either (we camp in style).  We ended up taking lots of bread, chocolate and Colby cheese (which has amines, but we are eating those now), homemade cookies, oatmeal and powdered milk for breakfasts, and couscous, lentils, rice, and chickpeas for dinner.  We cheated by bringing Parmesan and freeze dried peas and adding those to the meals (technically we should have been avoiding glutamates by then).  To get vegetables we took fresh vegetables!  Leek, potato, swede (which never got eaten), and green beans.  Fortunately, we were hiking with someone who agreed to carry the food.

In theory, our three day elimination period that follows the glutamate challenge fell during our camping trip, but we cheated by eating peas and Parmesan.  The reason for the elimination period is two fold - to distinguish a delayed reaction to the glutamate challenge from a reaction to the next food challenge, and because a reaction to one food can inhibit a reaction to another food if the second food is eaten too soon after the first, thereby masking the reaction to the second food.  However, since my son requires cortisone after 10 days without, which must be followed by a further three day elimination period, it didn't seem necessary to remain strict about avoiding the challenge substance (glutamate) in this case.

On the way home from the camping trip we stopped at a pub.  It was our first restaurant meal in over three months.  I was surprised at how well they were able to cater for my son's curious eating restrictions.  He had grilled chicken, boiled potato, and steamed peas and cabbage.  As for me, I had my first non-diet meal.  Now, a pub is probably not the first place you think of to break a fast, but that is where I found myself.  So I had peppercorn steak with chips and salad.  All three were disappointing and surprisingly bland.  Fortunately, the Pavlova was better.

I'm eager to put this diet behind me because, despite my efforts to eat healthfully and provide healthful food to my family, I am uncomfortable with how limited our choice of vegetables has been and how much we've relied on meat and refined sugar.  In an attempt to counteract the limitations of our diet over the past three months, I've started eating flaxseed oil on my salads, and I am keen to replace the canola oil we've been using in our cooking with olive oil.  In less than a week my son will be finished with the last challenge he will do, then we will try to return to our previous, more healthful diet.  However, after three and a half months on the this diet, I still feel compelled to write down everything I eat and I can't shake the feeling that I'm cheating every time I put a piece of fruit in my mouth.

Asynchronous challenges

We're getting to the tail end of the discovery stage of our diet to find the cause of my son's eczema.  Last week my son challenged bread preservative (three crumpets a day, whether he liked it or not; he liked it) and I challenged salicylates again.  We'll do a glutamate challenge later this week, and then we have the option of challenging additives, challenging salicylates again (this would be my son only, as I have just done this), or starting the salicylate reintroduction.

Normally you don't repeat a challenge unless you have reason to believe the results will be different.  I challenged salicylates a second time because we suspected that my mood from the first challenge may have been due to other factors, including the condition of my son's skin during the challenge and anxiety about the results.  In contrast to my first salicylate challenge, which was done at the same time as my son was challenging salicylates and was our first challenge, this last week I experienced no listlessness or irritability, nor did I have any digestive discomfort, so I have concluded that I do not have a sensitivity to salicylates.

The argument for repeating the salicylate challenge with my son is that the results the first time were inconclusive; his skin, though possibly better than it had been prior to the start of the diet, was never clear of eczema, and the dermatologist pointed out that skin irritation that is already present will change intensity without provocation.  We've also discovered recently that even when we clear all signs of eczema by applying cortisone and strictly follow the diet, it takes only three days for some irritation to reappear, so there is some background noise, making it difficult to ascertain the results of any challenge ('his skin got worse, but how much of that was due to the food versus what would have happened anyway').  We observed this pattern during the recent bread preservative challenge, when his skin slowly got worse throughout the challenge until we used cortisone at the end to clear his skin for the next challenge.  The big question is: how much worse?

Perhaps the diet isn't working at all for him.  Have I deluded myself into believing that his skin improved?  Right from the start I struggled to find a way to codify the condition of his skin.  With each new food diary (we're on our third) I have tried to clarify the meaning of the 0-5 scale that I ended up using.  In retrospect, there has been much more value in the notes I've kept describing the locations and extent of the irritation than in the numbered scale the dietitian recommended, but I didn't work that out until I was into the second notebook and starting the challenges.  Realistically, he needs to do the elimination diet for 13 days after clearing his skin with cortisone to find out what happens so we can use the results to filter the results of the longest challenge (salicylates: three days of elimination prior to starting, seven days of salicylates, and three days of elimination following).  But honestly, after three months of this I don't know how much more of it I can stand.

We can skip the second salicylate challenge, assume that my son is moderately sensitive to salicylates based on the results of the first challenge, and start the reintroduction.  To reintroduce salicylates, you eat a very small amount of a food that contains low levels of salicylates once every few days.  After two weeks, if your symptoms have not worsened, then you increase the amount or frequency.  You continue this until your symptoms worsen, then back off to the last level and maintain that (or less).  But since my son's skin will worsen on its own, without the contribution of salicylates, this process would have us conclude that he can withstand no amount of salicylates.

So my conclusion is that we will both challenge glutamates this week, which requires eating soy sauce and parmasean cheese, then my son will challenge salicylates again.  Hopefully we will either see a clearer signal or no sign at all (preferably the latter).  We'll continue to avoid additives, but following the final challenges we will not be remotely as fastidious about what we eat.

Allergy tests reveal error in elimination diet

We finally met with the dermatologist this month, who performed skin prick tests on my son to determine whether he has allergies to a number of common allergens.  As it turns out, he is allergic to egg whites, dust mites, and peanuts.  The good news is that he is not allergic to soy.

It is common for babies to have an allergy to egg whites, and also common for them to grow out of it by the age of two or three.  According to the doctor, my son's reaction was mild, and the allergy is probably already diminishing, so we'll avoid egg whites until a skin prick test indicates that it's okay to challenge them again.

During our elimination diet we've eaten eggs regularly, and, looking back over our food diaries, my son's skin worsened most of these times.  The presence of eggs in his diet has certainly clouded the results, and emphasizes that we should have done the allergy testing before commencing the diet.  My hope is that eliminating eggs from his diet will cause a further improvement in his skin.

I'm annoyed about the dust mite allergy, but not terribly concerned.  We will have to be more diligent about cleaning the house, and we are reconsidering replacing the carpet with wood floors rather than new carpeting.  Fortunately, we were planning on replacing the carpeting anyway, so it's not a waste of good flooring.

I'm definitely more concerned about the allergy to peanuts.  All the information I can find indicates that people rarely grow out of it and that any peanut allergy has the potential to be anaphylactic (translate: life threatening).  This means we will never be able to be carefree about eating with our son again.  Not only that, but we will probably have to give up eating peanut butter, Reece's peanut butter cups (not widely available in Australia anyway), and Thai food, due to the possibility of exposing him to peanut.  I'm very frustrated at the moment, because I was given very little information from the dermatologist and will have to wait two more months before I can get more information from an allergist.  A curious silver lining to this is that the incidence of peanut allergy is  becoming much more common than even just a few years ago, so increased demand for peanut free food may make it easier to get it.

I thought my son's skin looked pretty good when we visited the dermatologist, but when the dermatologist chastised me for not using the cortisone I realized that the eczema irritation really was pretty extensive.  He explained that if there was any irritation then the eczema could flare with no apparent reason and create confusing results during the food challenges, which of course perfectly describes what happened during the food challenges we've already completed.  Therefore we are taking a different approach now, using the cortisone to eliminate all signs of the eczema (if it's even possible), use the elimination diet to keep it clear for a few days, then do the challenge.

We also met with the dietitian this week, who tried to decipher our food logs and concluded that my son is probably not sensitive to amines or soy (she had never heard of someone having problems with soy without testing positive to a soy allergy), so we have reintroduced those into our diet.  He probably is sensitive to salicylates, and so we will slowly introduce salicylates into his diet after he finishes challenges for glutamate and bread preservative.  Now that we know about the egg allergy, I'm tempted to redo the salicylate challenge, but that will depend on whether we can get his skin clear enough to make the signal stand out from the static more clearly than last time.

We've now been on this diet for more than two months and I'm getting tired of it.  I thought we would be done with it one day, that we would be free to eat just about anything we wanted, but now I'm realizing that it was probably good practice for what lies ahead with the peanut allergy.  Food that may contain peanuts is even more common than food that contains soy.  Already I've found three things in our cupboard that may contain traces of peanuts, including the cereal my son has for breakfast every day, and it looks like we will be doing a lot of home cooking in the future.

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I found some more balanced information about peanut allergy (well, technically, my dad found it while I was lamenting about how alarmist all the information I found was).  It says that only 1/3 of the children who test positive to peanut allergy with a skin prick test will have any symptoms, and that the vast majority of people who do have symptoms will get hives, experience abdominal pain, or start vomiting.  The page states that allergies to peanuts that are severe enough to cause anaphalactic shock are extremely rare.  Reading this made me feel much better, and when I consider how often I scraped peanut butter out of the jar with my finger in the first year of my son's life, I now recognize that if my son hasn't had a severe reaction by now, then he's not going to have one.

Defeated by amines

It's been 62 days since we started our elimination diet to identify the causes of my son's eczema and I'm starting to feel defeated.  We've finally completed our amine challenge and now my son's eczema is the worst it's been in nearly two months.  During this period we've also faced two birthday parties, a Christmas party, Christmas dinner, and a week away with friends.  All of these occasions were poignant reminders of how little "normal" food we can eat.

It took three weeks to complete the amine challenge.  First we had to wait for his skin to clear from the previous challenge.  Then we delayed the start of the challenge so it would not interfere with his birthday party.  Next we had a false start when we found him chowing down on salicylate laden watermelon at a neighbor's Christmas party, and then we had to wait several more days for his skin to clear again before starting the challenge in earnest.

Amines result from the breakdown of proteins, and are found in chocolate, cheeses, old meat, fish,  and poultry (including "fresh" meat that has been stored in cryovac packaging, meat that has been frozen for a long time, and ocean fish that is caught a long time before it reaches the market), the skin of poultry (and probably of cows, pigs, and sheep as well, but we don't usually eat these), a number of fruits and vegetables and products derived from them, and most alcohol products.  For the challenge, we were required to consume bananas and chocolate in quantity for a week.  We were also allowed to eat papaya, tuna, and Colby cheese.  My son, who had never tasted chocolate before, was in heaven despite being restricted to very dark chocolate.  The first night of the challenge we had tuna carpaccio and banana splits, and the rest of the week we indulged in toasted cheese sandwiches and chocolate chip cookies.

His skin actually looked quite good during the challenge, which was belied only by the curious red circles that appeared in his armpit on the first day.  We were optimistic that we would soon be able to permanently reintroduce some foods into our diet, but three days after the end of the challenge we were faced with itchy eczema on his tummy, lower back and bum, his upper chest, the back of his neck, on his thighs, and behind his knees, with no alternative explanation to the recent amines.

The literature explains that there's little point in doing the remaining challenges (MSG/glutamate, Propionates, Sorbates, Benzoates, Antioxidants, Colors, Nitrites, and Sulphites) if you respond to both salicylates and amines because you will probably respond to everything else, which means we are now faced with an indefinite period on the elimination diet.

I now realize that I commenced this project expecting it to end after a month or so.  Two months into it we still haven't even finished the first round of challenges (we still need to challenge soy, which would normally be done prior to salicylates and amines) and are likely to have to follow it for many more months before we can enjoy only a few more of the foods we ate before we started the diet without having adverse reactions. 

At times like these it's tempting to say, stuff it, it's too hard.  The food we eat is quite good, but the constraints of the diet are antisocial. We cannot eat out at all, and I've had to provide virtually all our food when we've gone to parties (except at one birthday party, where the host gets a gold star for making sure there was a meat, a vegetable, and an hors d'oeuvre that we could eat).  When trying to plan a recent Christmas dinner with friends it became clear that it was too complicated to ask anyone to cook according to the
constraints of the diet, and it is now obvious that nothing ever satisfies the constraints of the diet just by chance.

So what's keeping me going?  Quite simply, it's the prospect of eliminating my son's eczema, reducing the likelihood of him developing asthma and hay fever, and saving him from the fate of his grandfather, whose childhood was shaped by asthma attacks, endless trips to the allergist for injections, and his mother wrapping his cracked hands each night to soothe them.

Salicylates challenge more than expected

After 31 days of a strict elimination diet, we've finally entered the discovery phase.  Our first challenge, salicylates, was harder than I thought it would be.  For the previous 31 days I had looked forward to indulging in strawberries, mangoes, cherries, pumpkin, and apples, and once again enjoying the flavor provided by curry and cinnamon.  I thought my son would too; he was absolutely fixated on pictures of strawberries.  But the food didn't taste as good as I expected, and I was surprised to discover that I didn't feel very well either.

We embarked on this diet to discover the cause of my son's eczema, which has been present since he was a month old.  It could be anything he has contact with, including the pervasive dust mite, but since food proteins and chemicals can be passed through breast milk, and are one of the few things we have much control over, we decided to do an exhaustive test of foods to determine if any of them were the cause.  Many food allergies can be diagnosed through skin prick tests or blood tests, but foods can also cause irritation without triggering an allergic reaction, and these sensitivities to food can only be determined by altering your diet.  To find a food sensitivity or allergy, you first eliminate all likely causes of irritation from your diet for a period of time.  This is the elimination phase of the diet.  The next stage is to challenge your body with possible irritants.  This is the discovery phase of the diet.  For some irritants, the reaction may be reduced by avoiding exposure to the irritant for a while, so there is a period of developing tolerance following the completion of the discovery phase, and then you should follow a maintenance diet that minimizes consumption of foods that cause a reaction for you.

It is worth noting, since many people I've spoken with about this whole process do not seem to understand this at first, that you are not meant to stay on the highly restricted elimination diet indefinitely.  Nor is it the theory of the diet developers that salicylates are inherently bad for everyone.  Once you have determined which classes of food do not cause a reaction for you through the challenge phase then those foods can be reintroduced into your diet.

The first challenge
Our first challenge was salicylates.  You may be asking yourself "What are salicylates?"  It's a fair question; it's not an everyday word.  Salicylates are a class of chemicals that occur naturally in fruits, vegetables, and nuts and are thought to function as natural pesticides.  According to the research of the Royal Prince Alfred Hospital Allergy Unit, a surprising number of people respond to salicylates, meaning that they will have some sort of reaction if they eat a large quantity.  Responses to salicylates vary dramatically, but can include migraines, rashes, irritability, restlessness, gastrointestinal problems, and asthma.  Salicylates occur in almost all fruits, many vegetables, and virtually anything derived from them, including artificial and natural flavors, most types of alcoholic drinks, and aspirin.

What was the salicylate challenge?
The challenge required eating six serves of salicylate laden foods a day for a week (or until we reacted, which ever happened first).  My own participation in the elimination diet was mandated by the fact that I was still breastfeeding my son, and anything I ate could be passed to him through the breast milk, so I anticipated participating in the challenge as long as my son did.  The foods we were required to eat comprised:

• mangoes
• Granny Smith apples
• cherries
• nectarines
• peaches
• apricots
• watermelon
• cantaloupe
• strawberries
• pumpkin
• sweet potato
• asparagus
• bell pepper
• carrots
• cucumber
• zucchini
• honey
• cinnamon
• curry powder
• tea

There was no shortage of choice, especially since it is stone fruit season.  On the first day, we ate strawberries on our breakfast, watermelon for morning tea, zucchini with lunch, mango and yogurt for afternoon tea, cherries before dinner, and a colorful stir fry for dinner.

Though we continued to stuff ourselves with red and orange fruits, both my son and I lost our appetite for the challenge foods pretty quickly.  On day one, I had a mild stomach ache most of the day, and by the afternoon I didn't feel like doing much of anything.  By day three, I was longing for cabbage, and my son wouldn't eat anything containing salicylates after lunch.  Over six days of the challenge (I didn't last all seven) I had a stomach ache of some sort nearly the entire time.  I was also irritable, emotional, and unmotivated.

Clearly I was responding to the salicylates, however, since my motivation for doing the diet was not to assess the cause of my own moods but to determine the cause of my son's skin problems, it took me five days before I finally clued in to the correlation between my mood and my diet.  Even then, I couldn't stand the thought of missing out on two more days of red and orange fruits and persisted eating them for almost another day before I realized that I was not only torturing myself, but increasing the likelihood of suffering withdrawal symptoms, and stopped the challenge.

It has taken six days for my son's skin to get back to what it was before the challenge and it is now clear that he also reacted to salicylates.

What next?
After the challenge we went back on to the elimination diet.  The first three days following a challenge are considered part of the challenge, as it is possible for reactions to be delayed, and also required to ensure there are no residual effects from the salicylates before the next challenge.  My mood improved almost immediately but both of us continued to show signs of reactions to salicylates over that period.  Since his skin has only just returned to its pre-challenge condition, we will wait a few more days before we go onto the next challenge, which for us will be amines.  Tune in next week for the results.