The Gluten Free Diet is NOT a Fad Diet!

Posted: October 31st, 2013 | Author: | Filed under: Celiac | Tags: , , , | Comments Off on The Gluten Free Diet is NOT a Fad Diet!

I wrote the following as a comment on another blog after someone said they couldn’t wait for the gluten free fad diet to go away. Usually I ignore those comments. This time, for whatever reason, I didn’t. The words poured out and I decided to edit it and post it on my blog. So without further ado, here is my response to those who believe the gluten free diet is just another fad diet.

Okay, that’s going to prompt me to pull out my soapbox. 😉 I have to confess, I have mixed feelings about the current faddish aspect of the gluten-free diet. On the one hand, it’s educated the broader population. A lot more people now at least know what gluten is. That makes it much easier for me to explain what I can and can’t eat. Restaurants have become a lot more sensitive and knowledgeable about food allergies, sensitivities, and intolerances in general and gluten specifically. (Even though what I have isn’t an allergy, the treatment is the same as that for an allergy.) And it’s now a lot easier than it was to identify a gluten-free food product with confidence. (Part of that is also a result of the labeling regulations the FDA has developed.)

With that said, it has also led to a widespread dismissive attitude by people who treat it like just another fad diet. Mostly I ignore it, but the stories of restaurant chefs and servers who deliberately contaminate food because they are irritated about this “fad”, though thankfully uncommon, are always in the back of my head any time we eat out. Even when someone isn’t malicious, they can still be careless if they think it’s just a fad. We’re very selective in the restaurants in the area that we know and trust, but there is always that first time you try a restaurant that isn’t already on your list. There have been times I simply haven’t eaten the food because something about the food or the service set off warning bells. ( I don’t make a scene based on a gut feeling, but I don’t like that I have to worry about it.)

Fundamentally, the gluten free diet is emphatically not a fad; it’s a medical diet. Nobody would dismiss a diabetic diet as a fad even if, for some reason, it gained a faddish quality among some people who did not have diabetes.

Celiac disease is at the top of the list of medical conditions that are treated with a gluten free diet. Celiac disease remains widely misunderstood by the general population, even when they’ve heard of it. It’s not an allergy or food intolerance. Nor is it limited to GI symptoms.

Rather, celiac disease is an autoimmune disease like lupus, type 1 diabetes, and a number of other pretty serious diseases. When a person has an autoimmune disease, their body produces auto-antibodies that attack itself rather than an invading pathogen. Unlike all the rest of the autoimmune diseases, we actually know what triggers the autoimmune response for those of us with celiac disease — consuming gluten. In a way, I consider myself fortunate. At least I have a chronic, incurable disease that I can keep in complete remission simply by maintaining a strict medical diet. People who have lupus, for example, aren’t so fortunate. All they can really do is try to treat the symptoms and keep it under control, but they are never symptom-free. And none of the medication is free of side effects. And if the first medicine used becomes ineffective, the next one is actually a chemotherapy drug. Similarly, I’ve known a number of people with type 1 diabetes. They have to follow a fairly strict medical diet, watch their blood sugar, and give themselves insulin shots. And their disease is never in remission or fully controlled.

A lot of studies have been done over the past decade or so, including a controlled study here in the US that tested something like 13,000 people in the general population across the country. So we know the rate of celiac disease. In the US, roughly 1% of the population has active celiac disease. That’s roughly the same rate as type 1 diabetes, making those two diseases by far the most common autoimmune diseases. Unfortunately, nearly 90% of those with active celiac disease remain undiagnosed. Moreover, other studies have shown that the rate of celiac disease in the general population has been increasing for decades and is still increasing. (They tested blood samples going back to the 50s and discovered active celiac disease back then had about a quarter of the rate it currently does.)

And that’s because celiac disease can be largely asymptomatic for years as it creates long-term damage. Or its symptoms can seem unconnected to each other and and can range across all the bodily systems. Since even most doctors still associate it exclusively with GI symptoms, if someone doesn’t present with those symptoms, they never consider celiac disease. In reality, celiac disease has over 300 potential symptoms ranging from the classical GI symptoms to neurological to diseases related to nutritional deficiencies and many more. The list is mind-boggling. Over the long-term, it can trigger other autoimmune diseases. It can cause depression. It can trigger ADHD or make it worse. Active celiac disease can even lead to cancer.

The presenting symptom for me when I was finally diagnosed was iron deficient anemia. However, I was then discovered to have osteoporosis in my spine (now almost completely returned to normal). I discovered the “aches and pains” I thought were just part of growing older largely went away. They were apparently the result of systemic inflammation. I was suffering from depression, which is now completely gone. I had mild neuropathy and “brain fog” now also gone. I was an extremely advanced case when I was finally diagnosed and even after almost five years, my body is still healing.

Active celiac disease will kill you. (Studies have shown it significantly reduces longevity.) And it will do so slowly and with significant suffering.

There is a strong genetic component to celiac disease. If you don’t have certain genes, it’s extremely unlikely you’ll ever develop celiac. As a result, though, that means that family members, especially first degree relatives, of someone with celiac disease are much more likely to have or develop active celiac disease than the general population. So after I was diagnosed, I let all my family members know, including my older children. (Unfortunately, except for my older son, I don’t think any of them have actually gotten tested.) My two younger children were both still minors at the time, so we had them tested as a precaution. We were shocked to discover they both had full-blown celiac disease. They were completely asymptomatic. Fortunately, unlike me, we caught it early with them. So they’ll never suffer the extensive systemic damage I did.

However, the diet is extremely strict. I forget the exact threshold, but something like 20-50 milligrams of gluten in a day will trigger a full-blown autoimmune response. (Yes, they’ve studied that as well.) And even smaller levels can trigger some autoimmune reaction. As a result, we talk about gluten as “parts per million” in any given food we consume to avoid reaching the very small daily thresholds. 20 parts per million is the threshold used in the FDA regulations, if I recall correctly. (Mostly I think that’s because we don’t have a test that will reliably detect lower levels of gluten.) But that means that food that has been fried in the same oil as flour battered items or has otherwise been in contact with a gluten-containing food is typically not safe for us to eat.

Moreover, once triggered by exposure, the autoimmune response can take weeks to completely subside and for the disease to return to full remission. (Generally, the acute symptoms from an exposure, if any, subside in a matter of days, but the autoimmune response itself takes much more time.) I recall another case study of a nun who strictly adhered to the gluten free diet except for weekly communion with only a small piece of the eucharistic wafer. Her celiac disease remained fully active even from that small weekly exposure. (I will note that both the Catholic and Orthodox churches hold that communion with either bread or wine alone remains the fullness of communion and can commune those with celiac disease with wine only.)

The doctors who research celiac disease are trying to get it added to the regular screening process like diabetes and cholesterol. Given that around 3 million people in the US have active celiac disease and roughly 2.7 million of them remain undiagnosed and since the disease can activate at any age, that seems reasonable. It’s especially reasonable since it’s so hard to diagnose from the symptoms and can even be largely asymptomatic for years as it damages the body. Moreover, they now have a blood test that is highly accurate and specific, so it’s relatively easy to screen. But the medical community generally moves pretty slowly on such things. Hopefully we’ll get there.

I’ll put the soapbox away now. But please, even though there is presently a faddish quality to the gluten free diet, don’t dismiss it as simply another fad diet. It isn’t. It’s a life-saving necessity for those of us with celiac disease.

 


Celiac Update – Osteoporosis

Posted: July 23rd, 2012 | Author: | Filed under: Celiac | Tags: , , , , , , | Comments Off on Celiac Update – Osteoporosis

After I was diagnosed with highly advanced stage celiac in April 2009, my gastroenterologist ordered a bone density scan. The results showed full blown osteoporosis (I believe around -2.4) in my spine. I was shocked. No middle-aged man ever thinks about osteoporosis. My doctor referred me to an endocrinologist. She decided to treat me with a regimen of maximum calcium supplements (600mg three times daily) and see if that in combination with strict adherence to a gluten free diet would suffice. She noted that none of the medicines for osteoporosis are tested on middle-aged men and there’s no clinical data of any significance. She didn’t want to make me a guinea pig and I wasn’t inclined to be one.

The following year, my bone density scan had improved to the osteopenia range (-1.9 or -1.8, I believe) so my instructions were to continue my treatment plan. Last year, there was no significant change, but since it didn’t get any worse, my doctor wanted to continue the regimen.

This year my numbers improved to -1.1 (anything under -1.0 is considered normal). It’s still osteopenia, but barely. My doctor wants to wait two years for my next bone density scan since at this point there’s unlikely to be significant change in a year. But it looks like I beat osteoporosis! That’s good news in my book.


Gluten Free and Now Dairy Free

Posted: November 10th, 2010 | Author: | Filed under: Celiac, Personal | Tags: , , , , , , | 3 Comments »

Sigh.

That’s a significant part of my reaction to the subject of this post.

As I’ve maintained a gluten free diet and healed from the fairly extensive damage to my body, there have been certain symptoms that have not improved and which have even gotten worse. I mostly put them out of my mind and tried not to think about them — mostly because I had a pretty good idea what they likely meant.

Finally my wife put her foot down and told me I had to figure out what was wrong so I could continue getting well. She suggested that as a result of the damage from celiac disease I might not be able to tolerate dairy any longer. Of course, I’m reasonably well-read and already knew that a fair number of those with celiac also can’t tolerate dairy. I just didn’t want to be one of them. I really didn’t want to have to give up yet another major food group.

But I couldn’t just keep running away from it, especially with my wife insisting I deal with it, so I decided to try a few weeks on a strict dairy-free diet. And I quickly began improving which, since I didn’t change anything else in my diet, pretty much confirms that I can’t tolerate dairy anymore.

I know it’s good to identify what’s wrong with you so you can get well. But I would be lying if I said that it didn’t piss me off. I like dairy. Oh well, I know I can deal with it, but an increasingly restricted diet is still a pain.


Celiac Family

Posted: July 12th, 2010 | Author: | Filed under: Celiac | Tags: , , , , | 1 Comment »

It’s been a rough couple of months. Since celiac has a strong genetic component, we decided it would be wise to have our two younger children screened for celiac disease as part of their annual physicals. My wife and I were shocked when both of their blood panels came back not just positive, but strongly positive for celiac. (The most specific celiac test was literally “off the chart” for both of them. It exceeded the maximum measurement used by the test.) It’s been an emotional roller coaster. The odds that any first degree relative (parent, sibling, or child) of someone with celiac disease will also have active celiac are roughly 1 in 22, so we didn’t really expect either test to be positive, much less both. It was enough of a statistical oddity that my wife decided to get screened as well, just to make sure they weren’t getting a genetic double-whammy. But her celiac panel was normal, which means they both got it from me.

Of course, there isn’t anything I could have done about it. I didn’t control my own genetic makeup, much less the genes I passed on to my children. Rationally, I know that. But it still feels awful to know that you passed an incurable (though manageable) disease on to your children.

We’ve now gone through the cycle of gastroenterologist appointments and small intestine biopsies. The biopsies confirmed the celiac blood panel for both of them, so there’s really no room left for doubt. I’m proud of my kids. They’ve both handled the diagnosis surprisingly well. Obviously, they aren’t happy about it, but they are putting as positive a spin on it as possible. My son, who is headed off to college, commented that it would force him to avoid most fast food, which he called one 0f his “weaknesses”. He’s something of a fitness nut and was happy to confirm that his preferred protein shake powder was gluten free. College will be a challenge for him, but he’s going to a university that seems to have a pretty high degree of awareness about celiac and other special dietary needs, so that’s a plus.

Our youngest is just entering her teen years. I imagine the next few years will be particularly challenging for her. And she’s more visibly upset about the diagnosis than our son. Still, she tries to be more positive than not.

This does demonstrate the importance of screening, especially if someone in your family is diagnosed with celiac disease. The one positive from this is that neither of my children yet have any celiac-related health problems and if they maintain a gluten free diet, they will never develop any of them. The immediate effect of celiac disease — damage to the villi of the small intestine — rarely produces visible symptoms until significant damage has been done. So if you wait until visible symptoms appear to test for celiac, then you’re waiting for the person to be hurt enough by the disease that it will take a lengthy period of time to recover from both the primary and the secondary effects of the disease. My kids have had relatively little damage done to their bodies at this point and do not yet have any of the secondary symptoms. With a moderate amount of self-discipline, they’ll never develop the myriad problems I developed. That, at least, is something positive.  I try to reinforce that with both of them.

A negative celiac blood panel does not rule out the possibility that you will develop the disease. Only a genetic test can do that. So if you have an immediate family member with celiac, it’s probably a good idea to still be screened every 3-5 years after a negative blood panel. It’s a simple blood test and trust me, it’s much better than having the disease ravage your body undetected for years.

I guess I would say that I’m crushed both kids inherited this from me, but glad that we caught it before it really hurt them. I’m also really glad the new health insurance law allows both kids to stay on my insurance until they are 26 and prohibits coverage denial for pre-existing conditions.

On a personal note, I had my first annual follow-up appointment today for the celiac-related osteoporosis in my spine. After a bit more than a year gluten free and taking 1800mg of calcium spaced out three times each day in 600mg doses, my osteoporosis has improved to the less serious osteopenia. Basically, I’m gaining bone density without medication, which is a really good thing. (Nobody tests osteoporosis medication on middle-aged men.) Hopefully next year I’ll be at or near the normal bone density range. That was really good news to hear. I’ve been as careful as I know how to be and it’s good to have my effort validated. I’m also feeling better than I’ve felt in years. Now I need to get back on a more disciplined diet and exercise regime. I used to be really good at both, but that’s one of the things that fell by the wayside as I felt worse and worse before my diagnosis.


One Year Gluten Free

Posted: April 14th, 2010 | Author: | Filed under: Celiac | Tags: , , , , , , , | Comments Off on One Year Gluten Free

It’s been roughly a year now since I was diagnosed with celiac disease and began a gluten free diet. It was quite a shift at first, but it’s almost become second nature now. I read the ingredients on everything I pick up and am still sometimes surprised. Just the other day my wife was making a Thai sauce when she noticed that the container of peanuts said it could contain wheat. (She noticed before she added them.) Who expects to find wheat in peanuts? Such is life these days.

We don’t go out to eat that often anymore, and when friends or family want to meet at a restaurant, I tend to skip the food and stick to coffee if it’s not a place I already know. It’s surprising how often food is involved when people gather for any reason, business or social. Whole foods are the safest at such gatherings. I always look for the raw vegetables, though I skip the dipping sauces that typically come with them.

It’s not been as difficult for me in many ways because I’ve always liked vegetables of different sorts, even as a kid. And many of my favorite dishes were already rice, bean, or lentil based and required little, if any, adjustment. The transition has also been easier since both my wife and I can really cook. I’ve always been grateful to my Dad for teaching me how to cook, but never more so than this past year. And my wife has been amazing. She was a little overwhelmed at first, but adapted quickly and has since become quite an accomplished gluten free chef. I know that a lot of people in our modern world never truly learn how to cook for a wide variety of reasons. But if your lifestyle and eating habits revolve around dining out and eating packaged, processed food, I’m not sure how you could make this particular transition. At the very least, it would have to be a lot more challenging than it has been for us.

Business travel remains a challenge. Fortunately, I don’t have to travel very often and I typically have plenty of advance warning when I do, so I can do research and plan how I am going to eat. It’s almost like putting together a battle supply plan in unfriendly territory. I know the stores, restaurants, and other resources in the Austin area pretty well. It’s much more of a challenge in an unfamiliar place. Moreover, the worst time to make yourself sick would be when you are traveling, so I tend to be especially conservative about what I eat when I’m on the road.

My family has also pretty thoroughly adjusted. Even though I’m the only one who has to eat gluten free, we don’t make separate meals for me. So much of what we eat at meals does not contain gluten. On my last business trip, my wife asked the kids if there was anything they had missed and would like for meals while I was gone. They couldn’t think of anything.

I feel better than I’ve felt in years, even if I’m still a long way from healed and healthy at this point. I’m not thrilled at all the doctors I’ve acquired over the past few years. I was used to having only one whom I saw infrequently. That’s not only no longer the case, it’s unlikely to ever be the case again. I’ve landed in a new phase of life.

Now that I’ve made the transition to life as a celiac and am feeling better, it’s time to start trying to get back into some kind of shape. I’ll make that my goal for this next year.


6 Months Gluten Free!

Posted: September 28th, 2009 | Author: | Filed under: Celiac, Personal | Tags: , , | 5 Comments »

This marks my first six months on a gluten free diet (or within a couple of weeks of six months, anyway). Since I got the results of my blood tests today during my appointment with my gastroenterologist, it seemed like a good time to post a status update.

I had great results! One test (I’m not sure what it measures) went from >160 to <1:10, which the doctor tells me is a dramatic improvement. Of the two TTG auto-antibody tests, one went from almost 100 to 2.8. The other went from almost 40 to 10.3 and was the only test that was still a little out of the normal range.

My doctor told me that I’m obviously complying with the diet, that what we’re doing as a family is working, and to keep doing it. He’s going to have the tests reworked annually to monitor my progress. He was a bit impressed at the rate of improvement. He mentioned that everyone has ‘cheater’ days on a medical diet. I actually don’t. While it’s very hard to be certain you have completely avoided gluten in all situations, I have never yet consciously eaten anything I knew to contain gluten. Any gluten I’ve consumed has been accidental. However, my wife and I have worked hard to avoid such accidents. It’s nice to see those efforts pay off.

For whatever reason, I’m less prone than perhaps some people are to ‘cheat’ once I have actually decided to do something. A friend once told me that most people aren’t like me. They don’t decide something and then do it. Or something to that effect. I didn’t and don’t exactly understand his comment, but perhaps my lack of ‘cheating days’ fits in there somewhere.

I was worried that I was missing something somewhere and that my blood work would not show significant improvement. Changing to be gluten free has not been the easiest thing I’ve ever done. While it takes significantly less willpower than quitting smoking did, eating gluten free is much more complicated. There is so much to check and it’s so easy to make a mistake, misjudge a restaurant or product, or even end up with a contaminated product. I was extremely relieved at the results today.

And, a couple of weeks ago, my HDL (good cholesterol) tested high enough to be in the normal range for the first time since they started testing it some years ago. So I’ve really had two good blood tests in a row.

It seems I really am getting better. 😀


3 Months Gluten Free

Posted: July 21st, 2009 | Author: | Filed under: Celiac | Tags: , , , , | 3 Comments »

Actually, it’s more like 3 1/2 months now, but I decided it’s time for an update. I finally got the results of all the latest series of tests in and I have no other condition besides celiac causing bone loss. That’s the best news I could have expected under the circumstances, and hopefully means I will begin to recover bone density in my spine naturally at some point. The endocrinologist wants to do another scan next year. In the meantime, she’s increased the calcium + vitamin D supplement I’m taking to 3X daily: morning, midday, and evening. I do wonder how many years I had undiagnosed celiac for the malabsorption of calcium to actually lead to osteoporosis in my spine. I don’t think that happens overnight.

Otherwise I’m beginning to settle into something of a routine with the gluten free diet. I wouldn’t say it’s easy, but I try to keep my focus less on what I can’t eat and more on the goal for which I am striving. All things considered I could be in worse health. For now it’s a matter of taking it one day at a time.


And If I Don’t Heal?

Posted: June 17th, 2009 | Author: | Filed under: Celiac | Tags: , , , , , , , , , , , , , , , | 1 Comment »

I prefer the best and most accurate information I can obtain. At all levels and circles of my life I try to interact with reality as it is rather than as I desire it to be. That does not mean that my understanding of reality does not adapt or evolve. It is constantly doing both — anything less would simply be another form of hiding from reality. I think I understand some of the reasons I am shaped that way. Some of it probably has something to do with developing some sense of control in situations where I often had very little.

But sometimes reality can be a little disheartening.

I’ve read this article, When Celiac Disease is Diagnosed in Adulthood, Intestines Don’t Always Heal Completely, several times now. The article reports on two studies presented by two different research teams at a recent medical conference.

The Irish study is not too bad — though I do have a lot of Irish in me, so that catches my attention. In it, at least two-thirds of those who did not have intestinal healing at the two to three year mark also had poor compliance with the gluten free diet. They did not stick to the fast. That stresses the importance of strict adherence to a gluten free diet over the long haul, but I had already absorbed that. Believe me, I am taking this seriously.

The Mayo Clinic study, though, does not share that problem. Most of their participants had good adherence to a gluten free diet. But their percentages were not markedly different.

In one presentation, Dr. Alberto Rubio-Tapia and colleagues from the Mayo Clinic in Rochester, Minnesota described their study of patients whose celiac disease had been diagnosed (and confirmed with a biopsy) during adulthood and who later had additional biopsies to determine whether or not their intestines had healed.
— Of 141 adults who had been gluten-free for less than 2 years, only 79 (56%) had healed intestines.
— Of 65 adults who’d been gluten free for 2 to 5 years, only 37 (57%) had healed intestines.
— Of 27 adults whose intestines were examined more than 5 years after they became gluten-free, only 14 (52%) had intestinal healing.

It seems that my odds are about even that my small intestine will heal completely. I can do everything I’m supposed to do and it still comes down to a flip of a cosmic coin. I do not appreciate the irony.

It seems that two of the factors that appear to influence recovery are age when diagnosed and the extent of villi damage. Neither of those are in my favor. I’m a middle-aged guy in my forties and my villi were basically gone when I was diagnosed. Visually, instead of white shag carpet, my small intestine looked like pink tile. Under the microscope, my doctor said it looked like my villi had been mown down by a lawnmower on its lowest setting.

On one level it doesn’t really change anything. I have to continue to develop the rythms and patterns of a life free from gluten. I will continue to work to shape my life with the rythms of prayer, not because I believe it is some form of magic or that I can somehow manipulate God, but simply because I know I need help to maintain this fast. It goes back to that integration between body and spirit I’ve discussed elsewhere.

I’ve already seen some of the acute symptoms, including ones I had no idea might be related, subside. And as I maintain the fast from gluten, I will heal at least some. And some healing has to be better, even if I remain at greater risk for complications associated with celiac. And who knows? My particular coin might still be heads. I might heal completely. If these studies had not been done, I wouldn’t even know that it’s something we need to monitor.

Still, I would be lying if I said the study didn’t bother me. I had more of a sense of control before I read it. And at least when it comes to my closest circle, the circle of my mind and my body, I strongly dislike loss of control. I suppose I find it threatening.

Oddly, I’m already doing as well as I know how on the gluten free diet. I will try to make it even healthier to the best of my ability. And I will continue to learn more. But there is little more I can do in that arena.

I can, however, do much better at developing and maintaining the rythms of my practice of prayer. Perhaps a place to start?


Celiac and the Cost of Cheating

Posted: June 11th, 2009 | Author: | Filed under: Celiac, Faith | Tags: , , , , , , , , , , , , , , , | 2 Comments »

I thought I would pause in my series on the Didache to reflect on this video by Dr. Vikki Petersen that I think relates to what I tried to express yesterday. In it she is answering a question from a woman who suffered severe weight loss as a result of celiac. (From what I’ve read, weight loss is a symptom to one degree or another in roughly two-thirds of those with the disease. The other third tends to experience weight gain.) She spends a good deal of time discussing healthy food that will help the celiac heal. Toward the end of the video, however, Dr. Petersen discusses the consequences of “cheating” on the gluten free diet for the celiac.

As she notes, sometimes and for some people the consequences are obvious and clearly directly related to consuming gluten. For others, however, the consequences are less obvious and the linkage between what they ate and what happens to their body is not as clear. Yet in both cases the ultimate price is the same.

Is that not how it is with the two ways? Sometimes the consequences when we choose the way of death are clearly visible and obvious to ourselves and to others. But often they are not as clearly related or as obvious. What price do we pay when we choose to inhabit our pride, for example? Unless we take it to such an extreme that we alienate those we encounter, probably little that is immediately visible or obvious. We might even look praiseworthy to others and to ourselves. And yet we are living and breathing within the way of death as we do so. We are shaping ourselves into distorted beings unable to stand in the unveiled light of God.

God gives himself to us. Jesus has healed the human nature and made it capable of true union with God. The Spirit inhabits our bodies transforming them and limited only when and to the extent we set our will against his work. We must learn to worship God, to take his reality into our bodies, to submit our will freely and allow his substance to work within us — individually and corporately.

There a two ways, a way of life and a way of death, and a great difference between the two.

So with celiac. So with the whole of life.


The Didache 1 – The Two Ways

Posted: June 10th, 2009 | Author: | Filed under: Celiac, Didache | Tags: , , , , , , , , , , , , , , , , , , , , | 3 Comments »

This series is reflecting on the Didache if you want to read it separately.

There are two ways, one of life and one of death, but a great difference between the two ways.

I’m not the sort to separate the crunchy physicality of the Christian story from its spirituality. Yet, as I’ve read this opening line from the Didache lately, I realize that I have nonetheless kept its earthiness at a certain level of abstraction. Celiac makes that starkly real to me.

I face two ways. I can continue to consume gluten if I choose. If I do, I will pay a price. My health will continue to degenerate. I will get sicker though there is no specific, predictable progression. But it will certainly involve pain and decline leading to an unpleasant death after decades of ill health.

Or I can cease consuming all gluten to the best of my ability. As I succeed in doing so my body will heal, my health will improve, and the ultimate quality of my experience of reality will take on brighter hues.

There is a way of life and a way of death. Which way will I make the rule of my life?

It seems obvious to me, but I understand there are some celiacs who refuse to stay on a gluten free diet though they know the price they will pay. Even when the choice is so stark and obvious, because it is not immediate, some choose the way of death.

I’ve been captivated by this line since my diagnosis. It runs through my mind unbidden and at odd times. The choice for the human being is just as stark. We can choose to consume God and be progressively healed, experiencing ever more of true life, learning to taste, touch, smell, hear, and see reality around us as God pierces our delusions. Or we can consume that which is not God and take death into the core of our being.

Yes indeed, there is a great difference between the two ways.

There is more connected to this one line. It’s deeply Jewish in nature. The Way of Torah was a way of shaping life and experiencing God through the mitzvots, feasts, and rituals of Torah. It’s in that context that Jesus’ statement about being the way stands revealed. As the fulfillment of Torah, he places himself in its stead. Follow Jesus and shape your life through his commands, through his body, through his blood.

Jesus is the way of life. Certainly life in the present, but also a life that endures.

Why would we choose to eat death instead?