Reverse Engineered EEN Smoothie

To approximate food like Modulen or Kate Farms medical meal replacement shakes, I made this smoothie. I drink two of these a day currently, in addition to 3-4 Kate farms shakes. The Kate farms micronutrient profile hits all essential vitamins and minerals at 3-4 shakes a day. My last meal of the day is yogurt and granola, soup and bread or chicken, or something like that. Blended blended blended. I occasionally eat some crackers because I want to CHEW. I have stopped drinking coffee, rip.

There has been one study out of Seattle children’s hospital that did a proof of concept with using smoothies to induce remission in Crohn’s. They did a smoothie protocol for 4-6 weeks and 80% of trial participants ended up in remission. This won’t work for everyone, but smoothies and blended food might make EEN more realistic for adults, as it provides more variety than chugging Ensure every meal. Also this is more cost effective. My weekly grocery bill was about equal to what it normally is buying the smoothie ingredients.

Reverse Engineered EEN Smoothie

  • 1/3 nuts (almonds)
  • 1/2 cup rolled oats
  • 2 pitted dates
  • 2T hemp seed
  • 2T chia seed
  • 1/2 cup to 1 cup frozen spinach, another leafy green, raspberry, blueberry, blackberry – your choice, but these are all nutrients dense foods that you can play with for flavor
  • 1 scoop whey protein powder (I add this after everything else is blended because it can whip too much air into the final product)
  • 1/2 cup whole milk yogurt (optional)
  • 2-4 cups water, depending on how thick or thin you want it to be. add more water if you want to travel with it and drink later

I recommend using a high power blender like Vitamix.

Macro profile (without yogurt)

  • 40% carb (97g)
  • 22% protein (54g)
  • 38% fat (40.5g)
  • 970 calories total

With the yogurt, the macro profile closely approximates Kate Farms meal replacement shakes.

Tbh these smoothies make meal prep way easier for me, which is great when I’m in a flare and still going to work. I’m also able to eat SO MUCH PROTEIN, which in flare times will help with healing, and in non flare times will help with maintaining and building muscle for the athletes among us.

Finally, full disclosure: I use dietary methods to treat Crohn’s because I had anaphylaxis reactions to Remicade, really dislike steroid side effects, and EEN is the first line method for inducing remission in pediatric Crohn’s patients worldwide. It is scientifically backed, but adults often don’t stick to the diet.

Flare #5

Begins in fits and starts. After two weeks of creeping symptoms I start blending my food. Lentil soup for lunch all of week 3. Definitely brought on by work stress. Thursday of week 3 is a low point, 6 BMS and a bad headache, I went home from work early that day. Same day I ordered first batch of Kate farms een.

Saturday of week 3 I begin the dietary protocol in earnest.

  • 3 medical meal replacement shakes for breakfast (hits most of the micronutrients I need in a day)
  • Smoothies for other meals, the base of which have balanced macronutrients for healing, then adding berries and greens for “flavor”
  • I have ingredients for a veg soup to add in addition to shakes and smoothies for variety, but really I’m looking forward to reintroducing sushi rice and salmon as soon as possible

Already seeing improvement in bm by Sunday afternoon, however will probably take a couple of weeks to get my energy levels back to where I can exercise.

I think I need around 4000 calories a day when I am active and working out, so trying to hit 3-4000 during healing to build up energy and hopefully have some left over after work for a daily walk or swim.

Probably will need a month off of weightlifting. Need to be able to do cardio without getting light headed to safely lift.

It’s a bummer to be flaring but I’m very reassured by having a protocol that I know will work, is backed by science, and will support my nutrition needs (probably better than I have been eating lately, tbh).

Fit in my 40s – almost 41!

So an update. Since I started reframing my mindset about movement and fatigue (and since a colonoscopy showing no sign of disease), I have made major progress in my fitness in the last year and a half.

I started by working with a physical therapist to help with back pain and recover from a sprained knee and ankle from a fall. I walked a lot, thru all of the Ohio weather. I was very dedicated to after work walking practice and it helped.

The first summer of my fitness, I traveled to Big Sky, Montana, and Yellowstone National Park. The altitude kicked my ass, but my love of the outdoors and the awesomeness of nature was rekindled. I was surprised at how far I could hike and the incline I could do at a slow and steady pace.

The fall of my 39th year, I started working with a physical trainer, having completed my physical therapy. My trainer has been working with me on weightlifting and all of the benefits that come with that. I have found weightlifting to be an amazing hobby and am super passionate about it. I am seeing big benefits in my endurance, strength, stamina, and power from lifting. It has reduced nearly all of my pain and allows me to get back into hiking, biking, and swimming more effortlessly.

This summer, as the weather got gross, I got a pool membership at the RPAC, one of the finest pools in central Ohio. Swimming has been a joy, and I quickly got back to swimming a mile slow and steady.

I am now working on building my cardiovascular base so that I can enjoy the endurance sports I love. A few weekends ago I lifted, walked for two hours, biked 12 miles and swam 750 yards all in two days. That’s a sprint triathlon baby! I was wiped out for two days afterwards, but it was a great accomplishment and showed me what my body is capable of now (even while working full time)!

The nutrition knowledge I have gained from living with Crohn’s really helps with recovery. It also helps with listening to my body and avoiding injury, and taking time to heal when I am injured.

I have found the 10% increase rule to be helpful in building back my fitness capacity and avoiding injury as well. Any time I try to do too much too fast my body gets mad. But if I increase slow and steady I see great results.

It’s an expensive hobby, but paying for gym memberships and a personal trainer has been the best money I’ve ever spent. I have a whole new outlook on movement and the capability of my body as I move further into adulthood.

Blended breakfast

I’ve had some creeping Crohn’s symptoms so trying to stave them off with blended foods. The aim is gut rest and nutrition for healing.

Blended breakfast:

  • 2-3 dates
  • 1/2 cup old fashioned oatmeal
  • 2 gobs of almond butter
  • Water to the consistency you like (I like this one pretty thin because the oats get gloopy if it’s too thick)

Blend until smooth.

Basically it’s a hearty oatmeal breakfast with no chewing or gut effort. Also super yummy! This is based on an almond date lhassi I had in Philly.

I have found the oat based smoothies are better if you drink them immediately rather than traveling with them because they get super thick if they sit. But you could drink this later if you watered it down more.

Mac n cheese with protein

In a high power blender, combine:

  • Like 8 ounces of hemp seeds. Idk how big the bag was.
  • 6-8 oz of raw cashews. Again, this isn’t rocket science.
  • Half a cup of nutritional yeast
  • Two teaspoons of garlic powder, onion powder, smoked paprika
  • One teaspoon of tumeric
  • One tablespoon of mustard
  • 1-2 tablespoons of soy sauce
  • Salt to taste
  • Then fill up the blender almost all the way to the top with water and let her rip!

Boil 16 oz of cavatappi pasta 10-11 mins. Strain and set aside.

Start a bechamel….4 tbps of butter and about 1/4 cup of flour heated over medium heat for a few mins until it smells nutty. Then slowly dump in the flavor sauce from the blender and whisk it until it’s thick.

Cut into cubes 4 oz of cream cheese and 4 oz of Vermont white cheddar. You can use more cheese if you want. Then sprinkle this cheese in and stir it until it melts.

Taste the sauce. If it isn’t tasting quite right maybe it needs more salt?

Okay now dump in the pasta and stir it into the thick and creamy sauce.

Top with cracked black pepper.

GET JACKED WITH MAC

Fit in my 40s update

It’s been about two months since I have reframed my thinking about fatigue, chronic illness, and fitness. My therapist has been very helpful in reinforcing my new mindset, as well as looking at the scientific evidence of my recent colonoscopy, which shows no signs of inflammation. With my Crohn’s and Hashimoto’s medically managed, I should be able to exercise and build up my physical endurance and stamina.

Therapy is helping me reframe facets of my identity that I gave up when I became chronically ill/disabled, like being a cyclist, and coming back into those identities with a more open mind, not comparing myself to my previous ability levels, or to others. Working on this mindset, and being supported by a professional, has been immensely helpful for me.

Secondly, I have been slowly building up endurance and stamina for physical fitness. Before I could do this, I had to overcome my limiting thinking that exercise would send me into a fatigue flare or I would crash from pushing myself physically. Because I am being intentional about the pace and amount of exercise, I have been able to build my endurance steadily over the last two months. This looked like starting with a walk around the block, then two blocks, then four blocks, then moving to the river walk and pushing a mile, mile and a half, and now I am up to two miles.

In addition to walking, I am facing my PTSD from getting hit by a car on my bike, and working toward conditioning my sitz bones for longer rides. In order to get back on the bike, I started with short rides around the block by my house, up to a mile and a half. I now think I am ready to ride the river trail two miles. I know I don’t want to ride on streets because of my history with being hit by a car, but I needed to start with very short rides to start to get my butt used to the bike saddle. I am hoping today to get out on the trail and do a two mile ride. The more frequently I can get in the saddle, the less my bum will hate me.

And, because life wouldn’t be complete without swimming, I got a YMCA membership last week and completed my first five laps with my after work swimming buddy. She is also interested in swimming for fitness, stamina, and endurance, not for weight loss, so we are becoming mermaids together.

In just three short months I have made HUGE gains in my physical ability and fitness. December was definitely a low point for me. I had a bad fatigue crash over winter break, as well as my seasonal depression hitting full force. I’ve basically come around 180°. And, like all the research says, I am seeing other benefits outside of just physical stamina:

  • More energy in the evenings after exercise
  • Stress management, an easy buffer from work to non work life, and feeling my nervous system reset while walking after an anxious or stressful work day
  • Less napping, so a more regular sleep cycle
  • More stamina in doing activities of daily life, such as being able to stand the whole time I shower AND wash my hair, being able to do back to back chores, less rest breaks in my cleaning
  • Less depressed feelings, more positive self image, more time in nature, more feelings of control, agency, self efficacy, less fear about my body and fatigue, feeling more resilient, and like I know more tools I can use the next time I have a Crohn’s flare to regain my wellness

Even though it was kind of trash, I have to credit that book I read about the woman slowly pulling herself back to health from chronic fatigue syndrome to fitness and health. It was an anecdote, but it was inspiring, and it helped me take a risk in just TRYING something different to try to get back into my physical body. If she could do it with CFS, I could at least try to do it with Crohn’s and Hashimoto’s.

I hope as spring and summer come along I will continue to get more and more fit. The way my body has responded in just two months has been an astounding amount of progress. I dream of reaching the fitness level I had in 2016, when I was 31, right before Crohn’s…

I could swim 55 laps in a session, I could bike 20-30 miles in a day, I could deadlift 100 pounds, and I could walk just about any distance I needed to at a leisurely pace. Probably not all of these things in the same day, but at least any one or two of these things in a single day. I think that level of fitness will really help me live my adult life to the fullest, and hopefully squeeze another 30 years of fun and adventure out of this body of mine.

I was a cyclist/I am a cyclist

Ten years ago I was hit by a car when I was riding my bike.

I was accustomed to biking everywhere and had been a bike commuter for the past decade. Every other cyclist I knew had been hit, and statistically I knew it was just a matter of time before I got hit by a car.

After the accident, and a few days getting over the back pain, I got back on my bike. But I found that when I rode in the street, any vehicle that passed by me caused a wave of panic and I would have to get off the bike and walk. Eventually that came to mean putting my bike in storage indefinitely.

I got a car, and my identity radically changed from a Chicago-winter-hardened commuter cyclist to a driver.

Ten years passed.

Recently I talked to my therapist about the regrets I feel over hanging up my bike for so long. During those ten years I came down with Crohn’s disease, which meant long periods of time where exercise was basically impossible, but I didn’t even try to get back on my bike. And in doing so, I lost an important part of my identity.

My relationship to cycling is about liberation. A bicycle is a relatively affordable mode of transportation, and with a supportive community and access to tools like with a bike co-op, one can become incredibly self sufficient with a bike. I have gone on several long distance bike tours, and have never again felt the intense freedom of being able to move my body from point a to point b, as well as a tent and sleeping set up, with just food and water as my fuel. I felt like a self sustaining autonomous zone.

When I gave up cycling, I also gave up that feeling of freedom and liberation.

So I’m trying to change my thinking about my bike. I want to ride again, but on bike paths where I won’t be triggered by cars. I want to glide with the force of my own muscles. I want to feel the accomplishment of traveling 20 or 30 miles with just the power my body provides.

Now that I’m 2+ years into remission, I think it’s a good time to try conditioning myself to get back on my bike. I am not yet able to ride a long distance as my sits bones need more practice — but I went on my third ride today and doubled the distance of my last trip.

When I was younger, I thought the key element of being a bike enthusiast was enthusiasm — something spandex bandits on the bike highways of Santa Barbara, California didn’t seem to resonate with. But as I get back on my Surly Cross-Check, a bike I customized for long distance touring, I can’t help but rekindle the passion I used to feel for bikes and bike maintenance.

I want everyone to feel the same enthusiasm and autonomy I do when I hop back onto a bike after a decade of learning to overcome the trauma of an accident. New relationships and associations are possible! And we can choose to do our beloved hobbies in new and different ways that allow us to feel safe without compromising our identity, ego, or passion.

Vicious mind cycle

I had a colonoscopy last week and the results were really good. With my thyroid and Crohn’s managed, I shouldn’t been feeling fatigue. So what could the fatigue be from?

I have been working with my therapist to interrogate some mental blocks I have around exercise (exercise will make me sick, exertion will increase my fatigue, exercise will cause a pain flare) and balancing this with the scientific evidence that my body is more or less healthy right now, so I SHOULD be able to exercise.

What if my fatigue at this point is from lack of stamina and endurance due to self-protective behaviors against movement for the last 7 years? On top of the obvious, no you can’t exercise really when you’re shitting yourself 20 times a day, and the actual fatigue that comes with a Crohn’s flare; but, there have been times where I COULD have done physical training, and it could have benefitted my health, but I was afraid to based on how my body responded when I was in a flare.

I’m at a place now where I am well enough and I really want to work on increasing my physical fitness so I can perhaps prevent future illness, feel less fatigued (especially in winter), and in general increase my vitality and physical wellness.

I am starting with walking, and in the super baby beginning phases of trying to get back on my bike (sits bone conditioning).

The physical exertion and recovery has been fine, and mostly I feel like a big mental weight has been lifted. I started by asking myself: what if I didn’t have fatigue from an underlying health condition? What if I gently pushed my movement boundaries? What if I stopped being afraid of using my body and stopped with these over protective behaviors?

It’s going well so far, and I’m super hopeful about going on longer hikes and bike rides when summer and fall show up this year! I’d like to be able to walk 5k by the end of the year, that’s my loose goal.

Amazing detox cleanse!

Just kidding, this is the bowel prep from my latest colonoscopy! Tricked you! If you came here for some diet culture bull, I suggest you try to reframe your thinking around food, shift your relationship with food and your body from one of guilt and shame to one of pleasure and enjoyment, and learn a little about the toxic nature of diet culture.

Red Flags of Diet Talk:

  • Talking about calories
  • Talking about restriction
  • Talking about losing a few more pounds to fit into, whatever
  • Talking about your new fad diet
  • Making excuses for why you deserve to eat (fact: you DO deserve to eat, and you know it by your hunger cues)
  • Talking about carbs
  • Saying something is “healthy” as a way to justify eating it (you can and should eat whatever you want, including fruits and vegetables, but also treats you enjoy)
  • Listing facts about the ingredients of the meal, counting macros, trying to be really scientific about food…unless you have a food allergy this shit is not important.
  • Scale banter
  • Justifying what you are eating now by whatever form of exercise you did or will do (you deserve to eat because you are a being who relies on food to live!)

Cleanses, diets, and detoxes don’t work. There is plenty of research out there to support this. Like, real research, like pubmed.

Here is a graphic I stole from the internet if you’d like to share a quick reference with the diet trolls in your life:

Kim Counseling
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