Sharing the joy of catering for a vegetarian coeliac teenager
This blog has had a few incarnations over the years, since 40 first hove onto the horizon and scared the bejesus out of me. I think I’ve found its real purpose at last, as I suddenly find myself concerned mum to a vegetarian coeliac teenager. I’ll call her Tamsin, but it’s not her real name. I have lots to say, more to ask, and I’ve always believed in sharing information for everyone’s benefit.
I worked out today that it took two months to the day from initial visit to the GP to confirmation of the diagnosis. As usual the NHS gives excellent clinical care but the admin leaves something to be desired. Clearly that two month wait was the easy bit; having seen the dietitian today I realise that all my food and cooking knowledge is only so much help (god only knows how people cope who have no knowledge of or interest in cooking, especially if they’re on a small budget) and that I’m going to have to be super vigilant all the time.
On this blog I’d like to share our experiences, starting from the first moment I realised we needed to see the doctor. A great deal has happened since then and I can see issues piling up for the future. Fortunately (so far) my daughter’s co-operation isn’t one of them, but her engagement with it is also pretty low. I’m going to write blog posts to cover each stage of the process to diagnosis, and everything we have to wrangle with afterwards. I’m no expert but I’m always happy to help where I can, so please feel free to leave comments. I’m on Twitter and Instagram as @mamafication, and if you’re a knitter find me at www.theordinaryknitter.net.
Gluten free baking is more different from ordinary baking than I could ever have imagined. I understand the chemistry involved but hadn’t realised just how much of a difference gluten made to the finished product, both to the rise and more surprisingly to the moisture content. I’ve fallen flat on my face with both of these.
Early efforts at gluten free baking
Shortly after Tamsin’s diagnosis we went away for a few days. I wouldn’t have chosen that timing but we had a long-standing commitment. It was before we saw the dietitian though and I know now that I made loads of mistakes with the best of intentions, mainly through contamination. I wanted to take a ginger cake to one of our hosts but didn’t want to exclude Tamsin, as my ginger cake is one of her favourite things. It’s also a real volcano of a riser and a bit of a crowd pleaser. It’s probably a good thing I didn’t know how badly the GF version was going to turn out when I started.
Being a complete beginner with gluten free baking I took no chances and looked up a gluten free gingerbread recipe on the Doves Farm site. For all that I love the range of GF flours that Doves Farm makes, I really don’t recommend this recipe. Annoyingly I can’t find the image of the finished gingerbread but it was a disaster. The picture here shows it before coming out of the pan but it doesn’t look much better. It was barely an inch high. Having said that it tasted nice straight out of the oven, and if I’d been going to serve it straight away I would probably have got away with it, but this needed to be stored for 48 hours then presented to my hostess – I didn’t think it was going to cut the mustard, somehow.
Instead I decided to cut it into squares and take it away with us as a snack, perhaps for a picnic with a flask of tea. I produced the gingerbread at an appropriate moment, we all took a bite in happy anticipation of the sort of delicious slightly sticky gingerbread we were used to, and we all more or less spat it out. It wasn’t the taste but the texture that was so unnerving. It was dry but not crumbly, rather rubbery and just impossible to force down. Ever since we came home it’s been sitting in the freezer waiting for a suitable occasion to be heated up and drowned in custard.
Gluten free apple cake
This weekend sees an annual family tradition that always includes apple cake and, worryingly, ginger cake.
I felt the apple cake stood a chance as it’s a melted recipe that’s more like a cobbler than a sponge cake. I have a tried and tested recipe that I used, simply subbing ordinary self-raising flour for Doves Farm gluten free ST flour. So far, it looks like it’s worked out just as I hoped. I tried the bits that thoughtfully fell off as I transferred the cake from tin to rack and other than being a bit dry, which I now take for granted with GF baking, it tastes pretty good and isn’t too far removed from what we’re used to.
My biggest concern with the ginger cake is that it will turn to rubber overnight, so I’m going to make it in the morning and hope it cools in time. I’m following the Sticky Ginger Squares recipe that came with the Glutafin freebies, but without the rhubarb topping. I’ll report back. If I can find a good gingerbread recipe then Tamsin will be happy. The next step after that will be gluten free Christmas cake, which must be the ultimate GF recipe to get right.
Prescription changes can be a pain, but it does get better. I’ve catalogued our prescription woes in great and largely negative detail on this blog, but at last I’m feeling better about it all and getting a good feel for Tamsin’s new food intake.
Setting up alerts
I’ve set myself up a four-weekly alert for Tamsin’s prescription changes – prescriptions of gluten free food come every four weeks rather than strictly once a month, so you have to pay attention to your dates if you want to make any changes. It’s great to get 13 deliveries of food a year instead of 12, but it does make it a little more of an administrative headache.
Tamsin is still struggling to come to terms with GF bread, which tends to be dry and not terribly good for sandwiches, and has eschewed bread for school lunches in favour of a rice salad. As she’s reasonably grown up at rising 15 she can manage this, but I wouldn’t want to try it with a seven year old. This means I need to make prescription changes next month, as to date at least half her prescription has been bread and rolls, ordered deliberately with school lunches in mind. Mainly Tamsin has bread for toast and a few rolls which she puts under the grill for cheese on toast. We gambled on Glutafin‘s baguettes (224-0117) last time and she loved those. What I’ve never really noticed before is how Tamsin has a bit of this and a bit of that, and as she’s the only person eating her GF products, we need to keep an eye on things not going out of date. I now halve loaves before freezing them, freeze rolls individually if that makes more sense and have a tendency to bung anything bread-like in the freezer if I have any doubts that it will be finished before going off.
It’s difficult for Tamsin as she doesn’t necessarily want to eat a family-sized amount of something in three days, but then she finds that the thing she does want is in the freezer. I don’t know what the solution is, but I do know that if I left it to her to manage these things, our hens would be eating a hell of a lot of gluten free food.
Going crackers for crackers
Crackers, crispbread and savoury biscuits have been a revelation. We ordered Glutafin GF crackers (009-3302), Juvela Crispbread (236-6136) and Juvela Savoury Biscuits (310-7893) and she loves those, so we’ll be ordering more of those. The Juvela White Mix (035-2161) has been very useful (for balance we have Fibre Mix too) so a couple of boxes of that a month will be a fixture, especially as we come into a more baking-y time of year. I think pizza bases are something to stockpile or order if we’re a unit or two under the limit. I do plan them for family meals once or twice a month and they’re something Tamsin will create for herself on a whim.
So my advice with prescriptions is to be prepared to make changes, identify the foods you’d rather not have to buy, the things you find yourself not wanting to run out of, and the foods that naturally suit your coeliac’s habits.
Before Tamsin’s diagnosis I’d been chatting to a friend of mine who has an overactive thyroid. I’d thought that might have been Tamsin’s problem and I was keen to learn as much about it as I could (the general pattern here is that I think I know what’s what and then realise I’m actually at square one!). It turned out that her young daughter has an overactive thyroid as well, and coeliac disease on top of that, poor little thing. My friend was chatting about her daughter’s symptoms and suddenly I realised Tamsin was more likely to be coeliac – for once I actually was right and was prepared when the doctor told us this is what it was.
This friend of mine has been a fount of knowledge. Something she recommended was sending away to the main gluten-free food companies for gluten free samples. She said that the boxes were very generous and well worth obtaining. About 10 days ago the boxes started arriving and we were blown away! I was a little naïve at first and didn’t realise that these companies supply the prescription foods so of course they have a vested interested in coeliacs testing their foods and deciding they want them on precription but even so, the sample sizes were huge and have made a real difference to Tamsin over the last couple of weeks. Big boxes full of goodies arriving was just what she needed in the aftermath of her diagnosis.
There was so much food that I had to clear out and rearrange the pantry so make space for it, but I needed to do it anyway so it just spurred me on. Both boxes contained information on how many units each food represents, which is vital to know, plus prescription order forms and recipe books. As gluten free baking is so different from what I’m used to, I find the recipe books very handy. Who doesn’t love a recipe book?
The first gluten free samples to arrive were from Glutafin. The box is very big and sturdy and contained masses of food. Pasta, pizza, bread, cereal, crackers, the list goes on. The pizza bases were especially welcome as we’d ordered just two at first. Tamsin’s happy to throw herself a pizza together so we’ll up her prescription of those – she doesn’t need to restrict herself to a night when we’re having pizza as a family meal.
The crackers were also a revelation. She loves them so we’re going to try to get those on prescription (wish me luck, the way that’s going). She liked the cereals but the cornflakes are a bit light nutritionally so we won’t bother with those on prescription, they’ll be a treat I’ll buy her from time to time. Overall the Glutafin box was a big success.
Later the same day the Juvela box arrived. This wasn’t quite as bountiful but ever mindful of what really matters, Tamsin much preferred the colour scheme of the packaging. She really enjoyed the fibre flakes from that box so we’ll try to get those on prescription. It was helpful to have boxes of white mix and brown mix. They sound pretty unappetising but for general cooking they’ll be very helpful. Tamsin’s taking Food Tech GCSE, somewhat ironically, so they’ll come in handy there.
We received bread separately from Juvela. Although we’ve waited weeks for rolls, we’re up to our ears in bread. I’ve split some of the loaves in half and frozen them like that, so that we don’t risk a loaf going mouldy, as one did this week.
We received some bumf and couple of vouchersfrom Schar. I used one of the vouchers today to buy Tamsin some chocolate fingers so she has something treaty to eat when her friends are over tomorrow. I have a couple of smaller vouchers that I’ll use at some point.
With the help of these gluten free samples I’ve managed to avoid buying horrendously expensive foods for Tamsin, but I doubt that will last. Despite the clear marketing opportunity, it’s been great for Tamsin to try these foods. We knew the initial prescription was a bit of a guess and we’d have been unlikely to choose some of these foods if Tamsin hadn’t had them put under her nose. Wish us luck getting them prescribed!
When we first discovered that Tamsin was coeliac, I was more concerned about her being vegetarian than anything else – as I say, when we *first* discovered. Since then all sorts of things have taken over as my main concern, in fact they’ve been competing for top place. Any teenager can be hard to feed healthily, but the teenage coeliac diet is another order of magnitude of tricky.
I went in to the dietitian feeling quite smug that I was a decent cook with a good understanding of nutrition. I feed my family varied meals with vegetables and mixed protein sources. Well that’s all well and good, but a coeliac has ground to make up after anything from a few years to a lifetime of nutrient malabsorption, so we came away from the hospital with a list of ‘musts’ as well as a loo roll length list of don’ts. I realised that I was going to have to be quite vigilant to make sure that Tamsin was getting everything she needed. I’m just so relieved that Tamsin and I pull together quite well on these things; trying to do all this with a teenager you find yourself at loggerheads with would be hell.
Vitamin C and dairy
One of the main points I’ve kept front and centre (horrible phrase but accurate) is ensuring Tamsin has enough vitamin C, and keeping up her calcium levels. Tamsin herself has come up with the answer to one of these. She likes PLJ, the pure lemon juice drink, and Morrisons thoughtfully has it on special offer just now so I’ve stocked up. Tamsin has it with fizzy water and gets a good vitamin C hit that way.
Bumping up her calcium isn’t proving too tricky either. Tamsin likes dairy and her breakfast usually includes either natural yoghurt or milk, and our meals often include cheese sauce or cheese as an element, eg cheese soufflé, baked potato with cheese & beans. I’m also making more of an effort than usual to include leafy green vegetables in our meals (rainbow chard, kale and cavolo nero are all hits). In the evening I go over with Tamsin how much dairy she’s had during the day and if it’s been a bit light I make her a hot chocolate. We get full fat milk from the milkman but I keep a couple of pints of UHT to hand too so that we’re never too low that Tamsin can’t get as much as she needs. In these respects the teenage coeliac diet has been pretty easy, but they’re only a small element of what she eats.
Until this September, Tamsin was the only one having a packed lunch and she was pretty easygoing, so I could use up all sorts of odds and ends (nice things, I don’t mean scraps!) in her lunch. Now of course I can’t do that and her brother takes packed lunches too, so I’ve had to be much more organised.
Our first hurdle has been rolls. We’re still waiting for the roll element of Tamsin’s prescription. She received two packs of rolls in her coeliac samples, but one is part bake and the other is very heavy to eat. She’s taken sandwiches instead which has been fine. She has salad in her roll and takes a piece of fruit, sometimes raisins as well, and now and then a few Aldi chilli rice crackers as a treat. I discovered in the freezer some gluten free madeleines we bought on holiday, so she can have those as a treat too. She has crackers and crispbread from her sample boxes but they’re trickier to prepare in advance as they go soggy with spread. We’re still working on lunches. I’ve suggested Tamsin makes a low-sugar banana loaf but so far she hasn’t got round to it.
Eating at home
At home Tamsin eats well. Like all teenagers she’d cheerfully live on pizza and chocolate fingers but I have to say that the pizzas she creates are works of art. She likes to slice a whole mozzarella onto a pizza so that really helps with her dairy intake. She’s always liked peanut butter, especially with banana, and has taken a shine to Whole Earth peanut butter with sunflower, pumpkin and flax seeds. This morning she made herself gluten free pancakes (sadly she put syrup on them but you can’t have everything).
I’ve realised that convenience is a big thing for Tamsin. All teenagers like easy quick food they can disappear up the stairs with and though the teenage coeliac diet requires a little more planning, she can still do this. Most teenagers dislike feeling different from their friends so I do everything I can to give Tamsin a normal experience, especially when she’s with friends. With that in mind I’m going to see if we can get crackers and crispbreads on prescription, as she’s loved being able to eat those just with butter or peanut butter.
Together Tamsin and I have made up a jar of stuff she can sprinkle on her cereal. At the moment it contains dessicated coconut, sesame seeds, linseeds, flaked almonds and pecans. Tamsin loves nuts and I’m delighted to supply her with them. I’ve always tried to make sure the food we eat packs as much of a nutritional punch as possible, and now that feels more important than ever – I can’t miss a trick.
Prescription teething troubles have come to dominate my life. I posted a couple of weeks ago about the confusion with prescription foods – how to change your prescription, what your surgery will or won’t, or might not, prescribe, whether you’d know, how long it takes to come in etc etc.
Roll on rolls
At the time I posted we’d had problems with the initial prescription even reaching the dispensary, and I was hoping the foods would be in imminently. The next day *part* of the prescription was in. That was over a fortnight ago and we’re still waiting for the rolls. The pharmacist is chasing the companies that provide the food (it’s either Warburtons or Juvela – I can’t remember after all this time!) but so far nothing.
To add to the drawn out prescription teething troubles, the breads are delivered only on a Wednesday or a Friday. Then there’s the oats: gluten-free oats are available on prescription, but our surgery won’t prescribe them. Not only that, they don’t tell you they don’t prescribe them, so you just miss out. No-one rings or emails to ask if you’d like to change it for something else, your child just misses out on one of their units that month. Actually it’s not a month, it’s every four weeks; this is great as it means Tamsin gets 13 lots a year instead of 12, but it also means the date jumps about every month so I have to keep close track of what’s when. I’ve set a reminder on my phone in time to make any changes.
Working with the dispensary
Next month, or should I say in just over a week as that’s when we’ll need to make changes in time for the four-weekly prescription submission, I’m going to ring the surgery about the changes and get them to tell me there and then whether foods are prescribed. I accept that oats aren’t prescribed, but it’s irksome as gluten-free oats are so expensive in the shops and Tamsin loves them for breakfast with yoghurt and fruit. I swither between feeling grateful that Tamsin gets anything on prescription, irritation with the surgery over their lack of communication and annoyance with the bread company that it’s all taking so long. I keep telling myself it’s just prescription teething troubles and we’ll be fine when it’s all settled down.
The changes we’re likely to make are reining back the pasta – Tamsin’s eaten far less than we expected and far less than she did wheat pasta – and increasing the cereals and crackers, crispbreads and white mix/flour. These last two have proved very useful for general cooking. Things like xantham gum I’ve just bought as although they’re expensive they’ll be a rare purchase so not worth the palaver of a prescription change. There’s more on prescriptions foods in the gluten free samples post.