Got Milk?

I haven’t really been cooking anything new this week, but have been making good use of some of the recipes I’ve posted here. The reason for this, is this -



Milk. Lactose-free milk.

I really like the dietitian that works in the IBD clinic, but NHS constraints mean that I’ve only managed to see her for about 5 minutes at a time when I’ve been in. So I decided that it was worth hiring a freelance dietitian.

Worth. Every. Penny.

She spent 1 ½ hours with me on Saturday afternoon going through absolutely everything I was eating, explaining everything really in depth, and giving me some really helpful and useful suggestions to get my calorie and protein intake up to help get some weight back on and to help combat the malabsorption and malnutrition.

One of the biggest frustrations of this illness for me has been not being able to get dairy down. Normally, I’m a dairy fiend. Milk on cereal in the morning. Yoghurt almost every day. Butter instead of margerine. Ice cream. And cheese!

Cheese, Gromitt!!!!!!

Oh, how I love cheese!! There are very few cheeses that I don’t like, I like them all!!

And I haven’t been able to eat dairy since the end of August. Everyone says that yoghurt is good for you and is fairly low in lactose, but that was the first thing to start bothering me. Soon, I couldn’t get milk down on my cereal, and I switched to toast. Then even hard cheese was making me sick.

You have no idea how much this has pained me. Not only are these some of my most favourite foods, they are also full of calcium, which I desperately need while on steroids (yes, I’m taking calcium tablets, but it’s just not the same thing) and are a source of protein. I know there are many people out there who argue that human’s aren’t meant to consume animal milk, but I don’t belong to that camp. Whether or not we are meant to, it tastes great!

Having been a carer most of my life, I know that dairy can often be the key ingredient to increasing protein and calorie intake. Use evaporated milk in cooking. Fortify milk by adding dried milk powder. Cook with copious amounts of cheese. Slather butter on everything. And none of these have been options. Not that huge amounts of dairy are consistent with a low-residue/low-fibre/fat restricted diet. On low residue, milk is limited to no more than two cups a day. And lots of cheese, particularly the ones that tend to be lower in lactose, have a lot of fat. But still, at least it’s something.

As I have a long-standing intolerance to soya (I can handle a small amount of soya sauce and soya letchin in chocolate, but that’s about it), soya based alternatives are not options. I’ve started trying out some other dairy-free alternatives, but I find them a bit hit and miss. Oat milk, while being rather tasty in hot chocolate in a slightly oatmeal/Horlicks kind of way, didn’t sit too well on my stomach. Oats never have. Almond milk has a reasonable taste, and cooks up a mean dairy-free Alfredo sauce, but isn’t really consistent with a low-fibre diet and is low in calories, which isn't going to help my current situation. Rice milk is quite palatable on cereal, but virtually useless in cooking and has no protein in it.

And to me, none of these are substitutes for cow's (or goat's, or sheep's) milk.

The bigger frustration is not knowing what’s causing it. Is it the milk protein? Milk protein allergies are pretty uncommon, but with my allergic nature, it wouldn’t have surprised me. If so, virtually all of the dietary supplements the hospital prescribes have cow's milk protein in them. The one I'm currently using gives me wicked wind and it isn't clear what's causing that. The only non-milk alternative is soya based.

Is it the lactose? Hard to know until it’s been tested for, and neither my GP nor the GI doc have been willing to do this.

Is it just the Crohn’s flare, and this will go away eventually? That’s what the IBD clinic keep telling me (God I hope!). Either way, it’s frustrated me, and when I was really unwell, I just didn’t want to challenge my stomach by finding out the hard way.

The dietitian on Saturday did hear this frustration though, and really encouraged me to give lactose free milk a go. I am under strict instructions to not to introduce anything else new into my diet this week other than the milk, and to start with 1/4 cup the first day, and ½ cup the second day, and hopefully rounding up to 1 cup on the third day, provided that it doesn’t all go disastrously wrong.  Then next week, I’m to try yoghurt the same way. In her view, even if I can only tolerate ½ cup, that’s an improvement, and then I can add that amount into my diet every day, say for example, having half lactose-free milk and half rice-milk on cereal, or making custard.

I’m on day 2 at the moment, and so far, so good. I think. I made the mistake on the first day of having it not long after having one of the nutritional supplements the hospital gave me, so it was hard to know how that one went. This morning I had half a cup after breakfast, and it seemed to go down okay. My tummy has been slightly unhappy, but I’ve also doubled up those nutritional supplements on advice of the hospital dietitian (ugh!) and dropped the dose of Prednisolone down a bit this week (yeah!). I’m hoping it will settle more over the next few days. And I’m really hoping that tomorrow’s “dose” of milk goes down okay too. Fingers crossed!