My journey to 100% relief

[Macadwel]

Hello all and Jim,
So it has been about another week and I thought I would update you on my journey on the low oxalate diet. I had two bad nights but six great nights of sleep and seven great days! I am finding a few foods that are not good for me, at least I think they are the foods that are not good for me, blueberries and mangos seem to be the culprits. I am using a low-gluten diet and looking at low-fluoride veggies to help keep my low-O diet low in fluoride too.

Switching from normal pasta and bread to gluten-free has its challenges, the taste is not good but I tolerated it. I will use regular pasta once I know what my vegetable triggers are, I am kind of going at this like an infant adding in a few new non-oxalates at a time. I can find some organic frozen veggies which are good, and I am finding some good info on the www, but there is a lot of conflicting info too. I have joined three Facebook groups, and Sally Norton's email list, and I keep looking at different websites.

Jim, can I eat regular bread and pasta? Do I need to use gluten-free bread, pasta, and flour? those are my stumbling blocks with this diet.

I have told my pain management doctor I am on this diet, and I will let my internest know at my next doctor's appointment. I have high hopes for this diet.

I am going on a tramadol holiday and going on 5 mg hydrocodone-acetamidacine 3x per day but I am worried that it will not be enough to cover the 2/50mg tramadol 1per day, 1 each 200 mg tramadol at bed time. I will stay on the pregabalin 100mg 2x's a day and 75mg 3x's a day the new meds, and hope the diet will be enough to mitigate the RLS.

Jim, I am very happy I came across your thread and I will keep you updated as I go through my journey.

Thank you,
Mel

[Polar Bear]

Well done Mel. Good luck.

[Rustsmith]

I am going on a tramadol holiday and going on 5 mg hydrocodone-acetamidacine 3x per day but I am worried that it will not be enough to cover the 2/50mg tramadol 1per day, 1 each 200 mg tramadol at bed time. I will stay on the pregabalin 100mg 2x's a day and 75mg 3x's a day the new meds, and hope the diet will be enough to mitigate the RLS.

Be careful how you start your Tramadol holiday. Tramadol is both a mild opioid and an SNRI Anti-depressant. Abruptly stopping the opioid isn't too bad, but abruptly stopping any anti-depressant can throw you into Anti-Depressant Withdrawal Syndrome, which is something that is much worse than RLS. The symptoms include severe depression, anxiety, nightmares and migraine headaches that do not respond to anything less than the drugs used to treat migraines in the ER. Further, these symptoms last for at least three months (parts of mine has lasted for four years now). I went through almost a year of therapy to treat the depression and anxiety (total waste of time) before seeing a therapist that specialized in treating PTSD.

So, you need to slowly taper off of the tramadol. My pharmacist (better resource than doctors for quitting meds) recommend dropping to half your dose for three or four days, dropping in half again and again, until you are cutting pills in half. Then go to every other day for four days before stopping.

[notnowdad]

Hi Mel, I’m glad to hear about your progress. I don’t worry about gluten. I avoid bleach agents and all the other stuff they usually add to wheat flour. I bake myself a small loaf of bread every three days and also enjoy a lot of pizza.

To make a small loaf of “no knead bread” or 4 small pizzas:

270 grams of unbleached, unbromated, unenriched flour (I use King Arthur brand Bread Flour or All Purpose Flour).
If you don’t have a kitchen scale, measure about 1 5/8 cup of flour, or 1 ¾. (Dip the measuring cup and scrape off the excess. Don’t pack the flour.)
½ tsp., or a little more, active dry yeast (not the “quick rise”)
1 tsp., or a little more, salt
6 oz. water (If you measured 1 ¾ cups of flour, you might need an extra teaspoon or two.)

Put the flour in a large bowl. Thoroughly stir in the yeast by itself. Thoroughly stir in the salt. (I use about 32 strokes for the yeast and another 32 for the salt.) Stir in the water. The goal is to get it to all stick together. It is OK for it to be a little lumpy looking because you will squeezing it together 30 minutes later, after the moisture has hydrated all the flour. Loosely cover the bowl with a flat lid. After 30 minutes, with wet hands pick up the dough, squeeze it a couple of times. Stretch it out a little bit and fold it back on itself 2 or 3 times. Let it sit covered another 30 minutes. Repeat the resting and stretching process 3 to 6 times through the evening (more is better). Let the covered bowl sit on the counter over night. In the morning wet your hand and use it like a squeegee to scrape the dough off the sides of the bowl and into a ball. Stretch and fold it 2 or 3 times. Let it sit for a few hours or all day. Score it three times across or one time down the middle with a very sharp, wet razor or knife. Put a cast iron Dutch oven (with a metal, not plastic, handle on top) in your oven. Preheat it for an hour at 500 degrees. With wet hands and fingers spread very wide gently scoop and lift the dough, coming at it from both sides simultaneously, and place it on a sheet of parchment paper. (Paper that is rated for 425 degrees works fine.) Take the Dutch oven out of the oven and remove the lid. Gently lift the parchment and lower into the DO. Cover and place in the stove. Bake 18 minutes at 500. Remove the lid from the pot, lower the temp to 450 and bake 14 minutes more. Place the loaf on a cooling rack. A well cooked loaf produces a produces a hollow sound when tapped on the bottom. A thermometer inserted into the middle will read 200 degrees or more.

I mix the dough in the evening when I’m preparing supper. I manually scrape it down in the morning so it can rise for the second time during the day. I turn the oven on and score the dough as soon as I get home in the afternoon. I recently got a Lodge cast iron “Combo Cooker” for $50. It is like a flat skillet with a very deep lid and is a very nice size for my small loaves. Because the bottom is flat, I can remove only the lid from the oven, place the dough and parchment on the base in the oven and then replace the lid. Enjoy!

[Frunobulax]

Be careful how you start your Tramadol holiday. Tramadol is both a mild opioid and an SNRI Anti-depressant. Abruptly stopping the opioid isn't too bad, [...]

My neuro would disagree He says he had patients stop opiods (for whatever reason), or temporarily go to a higher dose (for example they got opioid painkillers after surgery), and often they run into trouble afterwards if they want to return to their old dosage. He says it sometimes took years to get them stable again, often at a higher dose.

His recommendation for me, when I wanted to taper oxycodone, was to reduce it in 5mg-intervals of one month.

[Macadwel]

I am going on a tramadol holiday and going on 5 mg hydrocodone-acetamidacine 3x per day but I am worried that it will not be enough to cover the 2/50mg tramadol 1per day, 1 each 200 mg tramadol at bed time. I will stay on the pregabalin 100mg 2x's a day and 75mg 3x's a day the new meds, and hope the diet will be enough to mitigate the RLS.

Be careful how you start your Tramadol holiday. Tramadol is both a mild opioid and an SNRI Anti-depressant. Abruptly stopping the opioid isn't too bad, but abruptly stopping any anti-depressant can throw you into Anti-Depressant Withdrawal Syndrome, which is something that is much worse than RLS. The symptoms include severe depression, anxiety, nightmares and migraine headaches that do not respond to anything less than the drugs used to treat migraines in the ER. Further, these symptoms last for at least three months (parts of mine has lasted for four years now). I went through almost a year of therapy to treat the depression and anxiety (total waste of time) before seeing a therapist that specialized in treating PTSD.

So, you need to slowly taper off of the tramadol. My pharmacist (better resource than doctors for quitting meds) recommend dropping to half your dose for three or four days, dropping in half again and again, until you are cutting pills in half. Then go to every other day for four days before stopping.

I was not given any Tramadol to go off slowly, only given the 3 tabs of hydrocodone to go on. The sad thing is my new pain doctor, though he said he knows all about RLS, seems to only know about all the old meds. When he saw I was on Tramadol he was shocked and didn't understand why I was not on Mirapex or one of the other's like it, and I had to tell him I went through all those and already went through the agony of augmenting 15 years ago and retrying a few years ago, and that was shy I was on tramadol and asking for a drug holiday. It is hard when you are passed from doctor to doctor because there is no specialist in your area.

I will take care and watch for mood swings while off the tramadol. I have gone off tramadol for a week before and a few days in the past for surgery's and other reasons that I had to go on other opioids and did not have any issues, so I am hoping I don't have an issue with the new 5 mg hydrocodone-acetamidacine but will take care to watch my moods. I did not know Tramadol was an antidepressant so thank you for letting me know to keep watching for any signs. I keep learning from this group! Best Mel

[Macadwel]

Well done Mel. Good luck.

Thank you for your support!

[Rustsmith]

I did not know Tramadol was an antidepressant so thank you for letting me know to keep watching for any signs. I keep learning from this group!

I have found that even most doctors do not know that tramadol is an SNRI anti-depressant. Part of the problem is that the FDA refused to certify it for AD use because they didn't what psychiatrists prescribing a pain killer as an AD. All that they were willing to do was print a black box warning that it should not be given to any patient who is also taking an anti-depressant. And the same issue is likely to occur in the future with buprenorphine. It is also a very effective AD that helps those who are AD resistant, but the FDA flat out refuses to certify it for use in that manner and so doctors can only find out about that property if they look at the clinical trial results, which most will never do.

[Macadwel]

I bake myself a small loaf of bread every three days and also enjoy a lot of pizza.

Hi Jim,
You say you eat a lot of pizza what type of sauce do you put on it because I thought with low oxalate we could not use typical pizza sauce.

thanks
Mel

[Frunobulax]

I bake myself a small loaf of bread every three days and also enjoy a lot of pizza.

My oxalate table has wheat flour at around 60mg per 100g flour. The only flour that is low in oxalates is corn flour. Rice flour is around 20-30 mg. Buckwheat is extremely high at 260mg. And you won't be satiated with just 100g (~400 kcal).

Limiting carbs is really essential if you want to go low oxalate.

[Frunobulax]

You say you eat a lot of pizza what type of sauce do you put on it because I thought with low oxalate we could not use typical pizza sauce.

Tomatos have around 10-15mg oxalates per 100g. The flour is the problem, not the sauce.

[Macadwel]

Oh that is great news, I thought it was the sauce. Pizza here I come!