Divvies Egg-free Banana Muffins

It was a bleak and pitiable day a few years ago when Roo received his initial eosinophilic esophagitis diagnosis (EoE). Our GI team assumed that dairy was largely to blame and we eliminated it cold turkey. Just like that, one half hour doctors appointment and no more pizza, ice cream, Goldfish crackers, Parmesan on pasta, you get the idea. Shortly afterward, a skin prick test revealed Roo was also IgE allergic to peanuts and eggs. That's the scary anaphylaxis-causing kind of allergic, as opposed to IgG mediated allergies which cause his EoE. Then he lost all the tree nuts. Then peaches. Beef. And apples.

Suddenly very alone and flailing in a sea of Earth Balance, Veganaise, and Enfagrow Soy Formula with Christmas approaching, I was pulling out all the stops to come up with something remotely palatable to bake that we could all enjoy. It was not going well.

Just as I was about to call off the reindeer and torch the stockings, I discovered Divvies, nut-, dairy-, and egg-free cookies, popcorn, and candy. Thanks to Lori Sandler, Christmas came after all.

Even with dairy and apples back in play for Roo, Divvies is still without a doubt one of my favorite sources for baked goods. The cookies are top notch, not top-notch for allergy-free cookies, but rather, someone please take these things away from me before I eat the whole plate good. The Sandler family's attitude is proactive, inclusive, and upbeat. And though she might not know it, I credit Lori Sandler with single handedly pulling me out of the little pity party I was having for myself when Roo was diagnosed.

So, when Divvies came out with a cookbook, can you guess who was first in line? The Warm Apple-Apricot Cake on page 19 is ridiculous even though we modify it a bit. Apples are ok for Roo now but apricots are still a little too close for comfort to peaches, so I use orange marmalade instead of apricot preserves. The chocolate cupcakes are the best I've ever tasted from a home kitchen. The fudge is decadent and well, super fudgy, but the recipe we end up making more than any other in the book, is the banana bread.

My girls adore quick breads and this banana bread is their favorite of the bunch. Roo, a relative latecomer to the world of breads, will eat this over most any other. Throw some of the batter into mini muffin tins and you have one of our favorite lunchbox treats.

Egg-Free Banana Muffins (or Loaves)
adapted slightly from The Divvies Bakery Cookbook

3 & 1/2 cups all-purpose flour
2 tsp baking soda
1 & 1/2 tsp salt
1 tsp cinnamon
1 tsp nutmeg
1/2 tsp ground cloves
1/2 tsp ground ginger
5 ripe bananas
1 cup baby food pears (or pear puree)
1 cup canola oil
1/2 cup water
2 & 1/2 cups granulated sugar

1. Preheat oven to 375 degrees. Line muffin tins with paper liners or spray with cooking spray. Alternatively, spray loaf pans
2. Whisk together the flour, baking soda, salt, cinnamon, nutmeg, cloves, and ginger. Set aside.
3. Peel the bananas and place in a separate mixing bowl. Beat on medium speed until pureed. Add the pear puree, oil, water, and sugar and beat until all elements are well-combined.
4. Add the dry ingredients to the wet and beat at medium speed until well combined, remembering to scrape down sides of the bowl.
5. Bake full-sized loaves for 65-80 minutes, mini-loaves for 45-60 minutes, muffins for 25-27 minutes, and mini-muffins for 12-15 minutes, testing with a toothpick for doneness.
6. Remove from oven and cool on wire rack (muffins 10 minutes, loaves 20 minutes) then remove from pan and allow to cool completely.

Makes three 9x5-inch full sized loaves, six 5x3-inch mini-loaves, 12 muffins, or 36 mini-muffins

Our Allergy-Friendly Restaurants

If you or someone you dine with has food allergies, trust me when I say I know how frustrating and downright dangerous it can be to go out for a meal. I could regale you for hours with stories of Roo's uncomfortable, but thankfully not lethal, restaurant adventures. Too many hives, tears, and fist-clenching tummy aches to count. And the vomit. So very much vomit I've taken to carrying a Tupperware container and washcloth in my purse. You think I'm kidding.

This is the list I wish I had three years ago. It's definitely not exhaustive, but I hope it might give someone out there a starting point for traversing the restaurant scene with food allergies.

Roo's current allergies include eggs, peanuts, tree nuts, peaches, and beef. I do not claim that the restaurants listed below have menu options suited to every person with food allergies because there are just too many variables to consider. In our personal experience, however, these standouts have gone above and beyond in helping our family enjoy a safe meal time after time. Perhaps more importantly than what's on the menu is the restaurant's attitude about food allergies in general.

All-stars:

California Pizza Kitchen
Our personal experience here has never been bad, dating back to the days when Roo was off all dairy and apple (in addition to the eggs, nuts, beef, and peaches). The waitstaff has always been willing to check labels, ask questions in the kitchen, and use foil under pizzas in the oven to avoid cross contamination. They've allowed us to dress our own pasta at the table, which sounds so small but when you're presented with a plate of glistening noodles in a bowl, how can you really be sure that's olive oil and not butter? Better still, here's a link to their allergy information.

Chipotle
Chipotle is our safety net. Did you know that Chipotle is a nut-free establishment? It took me long enough to figure that out. Did you know they have kids meals that include a cheese quesadilla (or taco or whatever), a side of rice, beans, and a small bag of tortilla chips? They make their allergy information readily available and are always willing to put on clean gloves or grab a fresh tub of beans to avoid the potential of cross contamination. Perhaps the best part about Chipotle is that they are ubiquitous. We can almost always find one in a time of need. One word of caution, however, if you suffer from a soy allergy, Chipotle is not your savior. There is soy in almost everything.

Seasons 52
Interestingly, owned by the same parent company as Bahama Breeze, but SO much better equipped to handle allergies. 

Steak n' Shake
Health food it is not, but the service and attention to allergies we get here is fairly awesome for a fast food joint. Managers routinely let us read any and all labels, deliver food personally, and make sure everyone is breathing and smiling. Read the labels because everything is not transparent (for instance there is egg in the milkshake base), but I love the attitude toward allergy disclosure at Steak n' Shake.

Lettuce Entertain You Restaurants
How freaking awesome is it that all the Lettuce Entertain You restaurants, and there are a lot, have allergy info available and a responsible protocol in place for dealing with allergies? Many offer a gluten-free menu too! The downside is that Lettuce restaurants are not everywhere. We are lucky here in Chi-town that we can choose from a vast array of cuisines and varying levels of fanciness within the Lettuce Entertain You family. But, unless you're in Chicago, Minneapolis, Las Vegas, or Washington DC, you're out of luck.

Honorable Mentions

Noodles and Company
Tasty pastas and noodles, allergy info is available online and behind the counter (just ask for the allergy menu) but be careful of cross contamination. Remind them to use a clean pan or clean the griddle and watch out for the nuts.

Red Robin
They talk a big game about allergy sensitivity and they have allergy menus available but they probably shouldn't need to run up to the office to print them out and then act uncomfortable when we choose to order something.

Cracker Barrel 
Not the most consistent in handling allergies, but we always seem to be able to find something suitable and safe.

The Not-So-Good

Buffets scare the crap out of me. There is just way too much potential for cross contamination.
Five Guys (in case the peanut shells on the floor weren't a clue)
TGI Fridays
Sbarro
Bahama Breeze - Yikes! Read about our Bahama Breeze fiasco here.

And no, that doesn't mean that these are terrible restaurants and that no one should ever go there. It's just that in terms of allergies, we personally have had one or more sub-par experiences there.

Crowd-Pleasing Middle Eastern Salad

Ok, y'all. In case you haven't noticed, it's Food Allergy Awareness Week. Also in case you haven't noticed, food allergies, or more accurately, cooking delicious meals for those with food allergies, is kind of my wheelhouse. And that, my friends, is why I love this salad.

Peanut-free, tree nut-free, egg-free, easily dairy-free (just skip the feta), soy-free, fish-free, shellfish-free, and wheat-free (without the pita), this Middle Eastern Salad is a bright, tangy, colorful crowd pleaser of a side.  

Middle Eastern Salad

1 English cucumber
20 grape tomatoes, halved
3 green onions, sliced, white and light green parts only
1 tbsp. flat-leaf parsley, chopped
1/4 cup pickled beets, chopped
3 tbsp. freshly squeezed lemon juice
2 tbsp. olive oil
1/2 cup feta cheese, crumbled (optional)
1/4 tsp. ground sumac, or smoked paprika, to sprinkle on top

1. Combine cucumber, tomatoes, green onions, parsley and beets. Squeeze lemon juice over veggies and drizzle on olive oil. Toss to coat.
2. Portion onto plates and top (or not, depending on dairy tolerance) with feta cheese. Sprinkle a little sumac or paprika on top. Serve with pita triangles or rice crackers, as appropriate.

And as always, read your labels. I used Rick's Picks Phat Beets which state they are manufactured in a facility that handles wheat, soy, milk, peanuts, and tree nuts. For us, that's a risk I'm willing to take. But if you're not sure about the severity of the allergies of the crowd you're cooking for, the best thing you can do is keep all of your labels handy.

Nut-Free (and easily dairy-free) Granola

It's funny, though not in the ha ha sense, what a wreck I was back in 2009 when Roo received his first peanut and tree nut allergy diagnosis. No more hazelnut latte? No peanut butter cookies? No mid-afternoon hand full of chocolate covered almonds? What about Pad Thai? How about my favorite breakfast, granola?!

Today our nut avoidance is par for the course, and at this point it's so ingrained in our daily routine that I don't devote much energy to it. And you know what? With recipes like this, what's to miss?

Nut-Free Granola

Cooking spray or flavorless oil of your choice
1/2 cup honey
1 tbsp. butter (or dairy free margarine, such as Fleischmann's Unsalted Margarine)
1 tbsp. brown sugar
1 and 1/2 cups old-fashioned rolled oats (not instant)
2 cups puffed corn cereal (or puffed rice, if you prefer)
1/4 cup dried cherries
1/4 cup dried mango, chopped
1/4 cup dried pineapple, chopped
2 tbsp. pepitas
2 tbsp. sunflower seeds
1 hand full of fresh berries

1. Preheat oven to 350 degrees. Spray a baking sheet with cooking spray or grease with your oil of choice.

2. Place honey, butter, and brown sugar in a medium, microwave-safe bowl. Microwave 25 seconds and stir until butter is melted, sugar is dissolved, and honey is runny.

3. Toss rolled oats and puffed corn with honey-butter mixture. Spread on greased baking sheet. Bake at 350 degrees 10-12 minutes, stirring often to promote even browning. Remove oat mixture from oven and cool completely.

4. Gently stir together oat mixture, dried cherries, dried mango, dried pineapple, pepitas, and sunflower seeds. Serve over yogurt, milk, or munch on its own as trail mix. For a dairy-free version, serve over soy milk or yogurt, rice milk, coconut milk yogurt, hemp milk, or anything else you like. Top with a few fresh berries or other seasonal fresh fruit.

Cheese!

Giordano's pizza party Wednesday, veggie-feta pasta topped with Parmesan last night, good Wisconsin cheddar, lactic acid starter culture-laced salami, real buttered toast, and plans for Valentine's Day ice cream sundaes.  I don't know about the kids but I'll be kicking and screaming if and when we're forced to return to our dairy-free ways.  So much fun.  I might make macaroni and cheese for lunch and I don't even like macaroni and cheese.

Growth Charts and Milkshakes

We had our big appointment yesterday with our GI team including our CNP, GI doctor, nutritionist, and various researchers and residents.  Overall, the meeting went better than expected.  Aside from parking garage chaos and Roo's buffoonery which included repeated diving off the examination table, pilfering and eating 3 Dum Dum lollipops from my purse - mostly in front of the nutritionist, and running head first into a porcelain sink that happened to be at his eye level, things went OK.

We're now about 10 days into our Budesonide trial.  I still can't tell if it's working to clear the EoE, but we're cautiously optimistic.  The team gave us an approximate 80 percent chance that the meds will work to clear him up, however temporarily, and said it could take a few weeks before we start seeing results.  I would be a lot more comfortable with 99.9 percent odds in our favor, but I suppose it could be a lot worse than 80.

Exciting for us, though not as much for our CNP, was that Roo tipped the scales at 11.1 kg.  That's 24.4 pounds!  Yes, he was fully clothed, but his shoes were off, so how much can a pair of sweatpants and a long-sleeved t-shirt really weigh?  The CNP was discouraged because he was "down a little bit" (maybe a few ounces - but they weighted him WITH his shoes!) from his last weigh-in at the January scope.  But, as Mufasa and I studied his growth chart in detail, we were happy to point out to her that he is up almost 2 pounds since early November.  In fact, that gap between him and the bottom of the growth chart has closed up quite a bit.  He's still not exactly on the chart, but he's more of a finger width away now, rather than an entire finger length as was once the case. 

We talked about what if the meds don't work, what if they do, NG-tubes (nasogastric - the kind through the nose) versus gastronomy tubes (g-tube - the kinds directly into the stomach).  We talked about his behavior issues and steroids are likely to blame, at least to some extent.  And we have decided to reintroduce dairy to his diet.

According to GI, if the Budesonide is working, he should be able to eat any of the foods that are causing his EoE.  We've opted not to go so far as to put beef, peaches, or apples back into his rotation since he has had at least once positive allergy test to those foods.  Eggs and all nuts are still strictly off limits because they are IgE mediated allergies for him (he reacts immediately).  Dairy, however, has always been questionable.  The prospect of opening up his diet to include dairy is a beautiful beautiful thing.  The fat, the calories, the variety, the possibilities!!  On the other hand, we might be doing more psychological damage here as we allow the kid to indulge in macaroni and cheese, pizza, milkshakes, and full fat cheddar cheese only to take them all away again in a couple of months if the Budesonide course is unsuccessful.  So, where there's an up, there's always a down.  Seven weeks to the next scope.

November Social Calendar

Roo had the pleasure of a 3 hour appointment with his new allergist this week.  She seems qualified and knowledgeable, she pricked his back 32 times and injected various poisons looking for hives...the usual.  We didn't test for nuts to avoid another exposure but he's still very positive for eggs - both yolks and whites but no new culprits appeared on the prick test, so that's positive.  That and he didn't throw up even while the nurse and I pinned him to the table, pricked his back and forced him to lay face down in a puddle of his own snot for 20 minutes.  On the other hand, now she has me freaked out that he probably has asthma too. 

Still to come this month...

- Pre-op physical with the pediatrician
- Surgury (5th Upper Endoscopy to date to check for eosinophils since re-eliminating milk)
- Blood draw for RAST for peanuts and tree nuts
- Allergist (patch test application)
- Allergist (patch test removal)
- Allergist (patch test evaluation - all separate appointments, of course)
- Flu-shot testing
- And eventually, we hope, one flu shot, rather than the series of 4, but remains to be seen.

Can barely wait to see what's on tap for December!

Off the Sauce

The verdict is in and while it wasn't what we wanted to hear, at least we can begin healing up Roo's welted, pus-ridden esophagus now.  I still have no idea how or why we didn't notice any change in eating habits, behavior, etc. with the reintroduction of milk last spring, but I do know that all those cheddar goldfish crackers and ice cream cones this summer were not as innocuous and they seemed.  Aside from the white plaques and pus, his eosinophil count was back up to 20-30 hpf (per high power field in the microscope).  Normal is zero.  Chronic GERD sufferers can have up to about 5.  Our hospital makes the EE diagnosis with 20 hpf, some places diagnose anyone above 15 hpf.  So, it could be worse since his initial count was 70-80 hpf a year ago, but needless to say we've eliminated dairy once again.

Believe it or not I'm still waiting to hear what our official course of action is from the doctor's office.  We've been instructed to take away all the milk, whey, casein, etc. and we've made the switch back to soy infant formula with much less kicking and screaming than I anticipated.  I'm guessing we'll need to rescope in 8-10 weeks to see if he's clean but don't know for sure.

We're heading back to speech therapy for a new evaluation on Friday.  I can hardly wait.  I am so looking forward to a day when every meal takes less than an hour to consume.  He tries but he's just so painfully slow, and then of course, there's the constant threat of the gag.  He threw up Saturday night moments before the babysitter arrived, and gagged on a chick pea at breakfast this morning.  I don't know what I was thinking with the chick pea.  Just got a little ahead of myself, I guess.  Depending on how the new evaluation goes, we might need to start looking into some early intervention programs for the oral delay.  Hmmm...why do I feel like I've been here before?

EE strikes again?

Roo had his annual GI check-up today and in all my naivete I was considering it a non-event.  I was planning to blog about how his EoE is under control, he's eating a wider variety of foods, starting to gain weight here and there, doing great.  Right? 

His original GI doctor moved away this spring.  Then, I found out his allergist is no longer at the hospital we use.  So today we met with a wonderful nurse practitioner we saw once last year, a new doctor, a nutritionist, who, no offense intended, but I could give suggestions for increasing caloric intake at this point, and no allergist.  I would love to be witty about the appointment but I just don't have it in me.

Roo needs another scope to check up on his EoE.  That wasn't a surprise.  The part I did find surprising, was the new doctor berating me for reintroducing dairy.  The new doctor is convinced that Roo's allergy cells are back and that the premature reintroduction of dairy is to blame.  Did I mention that it was a flipping GI specialist in the very same hospital who told me to give him dairy back in April!  This is not a huge department.  Given the fact that the new doctor is the department head I'm guessing doctor number two, who told me to put dairy back into the diet, is about to get a workplace whooping.  Unfortunately it still doesn't make me feel any better. 

New doctor argues that the evidence is clear - Roo isn't growing or gaining weight according to the chart, his appetite is meager at best, he vomits, wakes at night, and still seems uncomfortable at times.  Well, I'm not convinced.  He was absolutely, exactly the same when he was NOT eating dairy.  And thank goodness for the blog for giving me a documented history of what he was doing while he was off dairy, namely, vomiting, not eating much, not gaining weight, and waking up at night.  Just like now.  The kid has an oral delay.  He gags.  He has reflux too but let's save that story for another day. 

Ugh, I am so frustrated.  The thought of taking him off dairy again, and this time for longer, makes me want to puke myself.  Maybe the kid just won't eat because his diet gets completely revamped every few months.  I just got him to tolerate some nice buttery, creamy, lusciously high-calorie foods.  Either way, the scope won't lie.  Here's hoping I'm right.

Dairy Trial

Last week's appointment with the "Feeding Team" was disappointing due to a critical miscommunication between the new GI doctor/food aversion/feeding specialist and me.  When we went through the basic "what's he eating?" drill, it appears as though he somehow missed the crucial part where I said that Roo drinks soy baby formula that has been fortified to 30 calories per ounce.  I swear he must not have heard that part because his advice was as follows:

• Reintroduce dairy on a trial basis (woo hoo!!)
• Change his formula to Bright Beginnings soy formula because it has 50% more calories
• Buy the book "Food Chaining" (written by said doctor, I might add)
• Bulk Roo up a few pounds and return to meet the rest of the feeding team in July once he's not so "undernourished" 

Wha????  So, I'm trying to keep my PG rating but seriously?  Bulk him up?  Isn't that why we're here?  If I could get the kid to eat, we wouldn't need the feeding specialist. 

I walked out of the appointment truly believing that Bright Beginnings must be some sort of super-fortified miracle formula with 50 calories per ounce that we had overlooked.  Of course, Bright Beginnings is a more expensive version of what we're already giving him - fortified soy formula.  It's 30 calories per ounce with roughly the same nutritional values in all areas.  Sweet. 

Call me crazy but I'm not switching his formula.  The Bright Beginnings is sweet and vanilla flavored - two things Roo loathes, and offers no benefit other than putting the poor kid through yet another formula overhaul. 

I'm allowing myself a cooldown period and then I'll broach the subject with the doctor.  Or maybe I won't.  I haven't decided yet.  In the interim I'm considering asking our pediatrician for a trial Zantac prescription because he is definitely refluxy and can't eat at all in the morning.  Today's breakfast - one bite of plain yogurt, one eighth of a strawberry and a sip of milk.  I'm full just thinking about it.

Okay, feeling a little better now.  Onto the good news.  We got the go ahead to do a dairy trial and so far it's going as smooth as Chantilly cream.  He's had real butter, cheddar cheese, a few bites of real yogurt, cheddar goldfish crackers, cheese pizza, chocolate pudding, and macaroni and cheese.  No Chantilly cream yet, but he's no worse for the wear with the new additions.  I am so happy for him.  And for us.  We have been liberated.

He doesn't love everything.  Yogurt, pudding, and other squishy stuff he's happiest smearing on the cat, but the other night be ate a whole square of pizza.  Looly and Bean cheered and shouted for him the whole time and he actually enjoyed it, I think.  I don't know if it was the cheering section or the pizza he liked more but either way, he ate a whole piece.  That's a veritable feast for him. 

The girls are so sweet and have been adjusting to Roo's new loosened food restrictions.  Several times Looly has reminded me that Roo can't have goldfish (or real cheese, or butter, etc.)  When I remind her we're doing a dairy trial she gets all smily and hugs her brother and congratulates him on his new options.  Honestly she is more of a help in this process than several doctors have been.  Bean too.  Our conversations go like this:

Bean: "No Roo eat pizza."

Me: "He's trying it tonight Maisie.  We'll see if it gives him a tummy ache."

Bean: "No tummy ache, Roo. Eat more pizza, Roo."

My sentiments precisely.