Celiac – Cathy Salustri

The rarest type of celiac

Update on the KAN-101 drug trial and why it’s no fun to be unusual sometimes.

I don’t qualify for the KAN-101 celiac drug trial. Since traveling to Miami to undergo the screening, I waited for confirmation of my Sept. 8 infusion appointment, 21 days after which I would, in theory, be able to eat gluten (bread!) with no ill effects for an as-of-yet-undetermined mount of time. When I saw the doctor’s cell number on my list of missed calls, I got excited. Very. Excited.

Dr. Saltzman’s voicemail, however, gave me pause: “I need to talk to you about your bloodwork.” No one wants that call from a doctor. I called him back and he gave me the not-great news: While otherwise healthy, I have the wrong celiac antigen in my blood and do not qualify for the trial. Which also means if and when this drug gets approval, it probably won’t work for me. The conversation went something like this:

Doctor: No one is more disappointed about this than I am.

Me: Oh, I highly doubt that.

Then I hung up the phone and cried. The Gabber office is about as big as a closet, so my staff had already figured it out. And yes, I know people have far worse health problems than “can’t eat bread,” but that does little to help my particular disappointment.

The wrong antigen — HLA-DQ8 — is uncommon in people with celiac. Really uncommon. My friend, colleague, and scientist-by-training Jen Ring explained it all to me in gentle, no scientist terms. The long and short of it is this: Five percent of celiacs have HLA-DQ8. As only one percent of the population has actual celiac, that means I have something that impacts five percent of one percent of the population, or: one-half person per thousand has the same genetic makeup of celiac and antigens.

This should have shocked me. Years ago, I learned I didn’t have the same RH factor as either of my parents. Rare, but not impossible. This, incidentally, prevented me from getting a specific treatment for an immune disorder (doctors now believe my undiagnosed celiac may have triggered that disorder) so instead of getting drug therapy, doctors removed my spleen.

And *why* did my celiac go undiagnosed? Because, friends, I have silent celiac, which — you guessed it — doesn’t happen that often. I didn’t have traditional symptoms.

The moral of this story? I really should look into PowerBall as a career strategy.

#BecauseGluten: A drug to treat celiac?

I’m part of the first clinical trial for a drug that will treat celiac and let celiacs eat gluten

Ever since my December 2016 celiac diagnosis, I’ve longed for the day I could eat gluten again. If you’ve slogged through this gluten-free journey from the beginning, you realize that getting a celiac diagnosis changed my life.

See, I didn’t exhibit the typical signs of celiac. When I ate bread, my stomach was fine. I didn’t have what we celiacs politely refer to as “gastrointestinal distress” and also, in a kick in the ass from karma, I loudly and proudly scorned the gluten-free movement sweeping America.

I did have severe anemia and osteoporosis, and my doctors found that peculiar and alarming for an otherwise-healthy 43-year-old. My regular doctor referred me to a hematologist who referred me to Dr. Abithitch Patil, a gastroenterologist who exhibited far more patience with me than I deserved. Five days before I turned 44, Dr. Patil diagnosed me with celiac.

Happy birthday to me.

I stopped eating gluten on January 1, 2017. While I’m grateful to Dr. Patil for his diagnosis — I do have more energy and my bones aren’t crumbling to dust anymore, which by and large makes me happy — not a day goes by that I don’t resent my gluten-free bread and pasta. Yes, food chemistry’s come a long way but trust me, not far enough.

I have coped in various ways, not all of them healthy. I’ve gained almost 60 pounds I cannot seem to shake. I will smell bread when it comes to the table at a restaurant. Going out to eat is actively stressful. I have many thoughts about the ways the gluten-free movement has helped and hurt celiacs. I have investigated almost every gluten-free product available (see: gaining 60 pounds.) I’ve created workarounds for baking without gluten. I scour the celiac.org website in search of news about treatments on the horizon. I’ve signed up for every trial I’ve seen in the past almost-four years and have qualified for none of them.

Until now.

Kanyos Bio, a biotech company that has found a way to fidget with T-cells, has a drug that’s progressed to trials on humans. When Dr. Saltzman called me to tell me I’d been approved for the study, I had cautious optimism. It took me a few weeks to decide to try it, and after much deliberation, I decided to proceed. Monday I traveled to Miami for a screening to ensure I checked all the boxes. Here’s what I learned about the KAN-101-01 study.

After a few phone conversations with Dr. Saltzman about the study, we reviewed everything in person. He took my medical history, and his staff drew blood, took urine, and did an EKG. We’re waiting on my medical records from my gastro to proceed, but I have the infusion date tentatively set for Sept. 8.

Here’s what I learned, in no particular order:

1. While I am either the first or second celiac in the study to get the infusion, they have given this to non-celiac adults in much higher dosages. One person (I believe) had slight gastrointestinal distress, but, again, this is at much higher doses than what I’ll get. Non-human primates tolerated the drug well, overall.

2. My phase — Phase A — is what they call “open-label,” which means no one gets a placebo.

3. The drug will alter the part of a celiac’s T-cells that cause the reaction that takes place when we consume gluten. The rest of the T-cell remains intact.4. The infusion itself should take no more than 30 minutes. I will spend the night at the facility and they’ll take my blood an insane number of times and make sure I’m not having any reactions. This is the only infusion I will receive.

5. I’ll return once a week over the following 21 days. Day 1 is a 24-hour stay. Days 4, 7, and 21 are shorter visits not unlike a doctor’s visit.

6. On Day 22, I am released from the study and should be able to resume a normal diet, gluten and all. They do not know how long the efficacy of the drug will last; indications point to anywhere from 6-12 months.

They have several sites around the country; I am one of three celiac patients in Phase 1A at this location. They need more celiacs; getting people to travel to sites during COVID-19 has slowed the trial.

The study still needs volunteers who have a celiac diagnosis via biopsy and blood. Here’s more information.

Finally, I’ll chronicle how it goes as I go through the trial — and what it’s like afterwards. Search this blog for #becausegluten to find more entries about my journey with celiac.

#BecauseGluten: A return to baking

It’s a weird holiday, and an ugly cake, but I baked for the first time this year — sans gluten.

Food gluten free Peep O Ween cake Cathy Salustri — *The power of cake compels you. Photo by Cathy Salustri.*

If you’ve never attended a Peep-O-Ween — and I’d wager almost no one reading this has — you’re likely looking at that picture and thinking (or, perhaps, actually saying), “what the actual fuck am I looking at?”

What you’re looking at is my first foray into baking without gluten.

When I threw out all my “good” flour on New Year’s Eve, I couldn’t imagine baking again. I’d yet to try a gluten-free baked good I found tasty, and I had no interest in making any of my friends my guinea pigs. I remember thinking, too, that as much as I loved baking, I wasn’t good enough at it to succeed where others had failed in making a GF cake or bread that didn’t actively make people chew for far too long before swallowing hard and assuring me, “no, no — I’m just not that hungry right now.”

The 2016 homage to *Ouija* and my first successful foray into fondant. This, incidentally, is probably the best a PeepOWeen cake has ever looked. *Photo by Cathy Salustri.*

But then Peep-O-Ween came around this year. My friends and I have this bizarre tradition that started with a poorly decorated cake that tasted awful, and an even worse movie. That first year, my mom and I decorated it with marshmallows, but that next year, we graduated to Peeps — yes, those Easter-centric mallow chicks that people either love or hate. Part of the “tradition” is that she and I make the cake, she bitches about what a stupid tradition it is, we laugh a lot, and she refuses to come to the party with me. The scene atop the cake must be from a horror movie, and if anyone can tell what it is, I have failed. Past cakes have included Psycho, Poltergeist (complete with a pool made of blue gelatin), Jaws, Alien (that was the year Amanda was about to give birth; it was made in her honor), Plan Nine From Outer Space, Ouija and, this year, The Exorcist. The horror movie we watch, selected by Stacey, must be so bad that if, at any point we start to care about the characters in the film, she has failed (the best so far was Peter Jackson’s Dead Alive — yes, that Peter Jackson). Leah orders pizza from Cappy’s; Dan picks it up. Calypso wears a costume she hates (she hated I Dream of Weenie the most). Dan outdoes himself with the decor (one year there was a moving alien tentacle emerging from a spaceship crash-landed in their front yard, complete with smoke and flashing lights, making them the envy of Broadwater).

It’s every bit as awful as it looks, and totally worth it.

This year, I figured I’d make the cake and simply not eat any, but then my friend Sandi brought over two bags of Trader Joe’s all-purpose gluten-free flour. What the hell, I shrugged, the cake’s supposed to taste like crap. And one of you sweet people — who happened to be a former book editor — sent me a copy of The Gluten Free Bible a few months back, so I used the yellow cake recipe from that. The batter didn’t taste horrible, but the real test would come after the cake baked.

Yellow cake gluten free recipe Cathy Salustri — I used butter, not margarine and cow’s milk, not soy or almond, and it was a touch grainy, it tasted more like cake than other GF cake I’ve tasted. *Photo by Cathy Salustri.*

I dumped the cakes on a cooling sheet late the night before Peep-O-Ween. They looked like real cake. As they cooled, I swiped a fingerful of what remained in the pan. To my shock, it tasted good. But it was late; everything tastes good at 11 p.m. The next morning, my mom came over for our annual decorate-the-cake-and-bitch-at-each-other tradition. I did not grow up with “everyone is special” parents; this is a woman who once turned to me and said, “honey, I love you, and you usually are a good cook, but please don’t ever make that again.”

We both ran a finger through the cake left in the pan.

“That’s really good!” she said.

And for the first time in history, the cake didn’t suck at Peep-O-Ween.

In 2015, the PeepOWeen cake honored the best worst movie ever: 'Plan Nine From Outer Space.' That alien Peepship, complete with alien Peep, still sits on my desk at CL. The Peep looks exactly the same as it did two years ago. Photo by Cathy Salustri. — In 2015, the PeepOWeen cake honored the best worst movie ever: *Plan Nine From Outer Space*. That alien Peepship, complete with alien Peep, still sits on my desk at CL. The Peep looks exactly the same as it did two years ago. *Photo by Cathy Salustri.*

Of course, taste itself isn’t the problem with GF baked goods; it’s the texture and cohesiveness. The texture was a bit grainier than real cake, but not so far off that it reminded me of every other GF yellow cake I’d ever tasted. Xanthan gum; who knew?

I called Leah and asked if it would be OK for me to bring over a pizza crust (again, Trader Joe’s makes the best GF pizza crust outside of Ozona Pizza) and she informed me we weren’t eating pizza this year, but brisket, potatoes au gratin and a salad.

“What kind of asshole would I be to invite you over and serve food you can’t eat?” she asked me

“But it’s tradition!” I said. “I don’t expect the world to bend to this celiac thing.”

“It’s six people, Cathy, not 30. We’re having brisket, potatoes au gratin and a salad,” she said. “And explorateur cheese. I couldn’t find any gluten-free crackers, though.”

I grabbed a box on the way out the door that night. No way was I missing that cheese.

Sorry, Cappy’s.

This article initially appeared in Creative Loafing.

#BecauseGluten: Make me a sandwich

Triumph and heartbreak with Cali-based La Brea Bakery.

“Cathy, I have found your new favorite gluten-free bread!”

Normally, I would delete any email that used my first name in the subject line, but gluten-free bread that tastes good is like ice cream with no calories, wine that won’t get you drunk and a Harrison Ford who isn’t stubbornly in love with Calista Flockhart. I want to believe. Odds are, it isn’t going to happen. Still, there I am, waiting outside his mansion, with my bowl of chocolate ice cream and glass of wine.

The email was from a PR rep for La Brea Bakery, who’d offered to send me some sample loaves to try. Sure, I told them, thinking, “What the hell… we can try in on our podcast and, if — when — it sucks, it’ll be fun capturing people’s reactions.”

When the big box of bread arrived, David and I decided to take a sneak taste, to know what to expect when we made everyone eat it during the podcast recording. So sure were we that it’d taste like crumbly bits of potato, wood fiber and sadness that we hesitantly split a piece.

Now, I have no choice. If I want to eat bread, it must be gluten-free, and I’ll be the first to tell you, gluten-free bread is not, technically bread (everyone saw my last #BecauseGluten column, right?). You need gluten for it to be bread. The whole point of bread is the way the gluten binds the molecules of flavor together — and, apparently, kills the lining of my duodenum. David, though, is a live-on-the-edge kind of guy, by which I mean he eats more than beef, shellfish and lunch meat (work in our office for a day to realize how rare that is, because we are a gluten-free, vegan, vegetarian, non-beef-eating, why-would-you-eat-something-with-a-face, I-only-eat-yellow-foods-on-Tuesday, I’m-fasting-until-4-o’-clock, how-can-you-eat-commercially-farmed-vegetables, is-that-kale-dolphin-safe type of office). However, his husband, Larry, does not eat gluten, and so every morning David and Larry feast upon slices of gluten-free cinnamon raisin toast. In short, David knows the pain of bad gluten-free sliced bread, which, really, is most of it.

Watching us eat the La Brea white bread was like watching a commercial. As we chewed, time slowed down. Our eyes met across the counter; we smiled in pleasant surprise.

“This…” David floundered, grasping for words. “This… tastes like real bread.”

And it does. This bread is the best gluten-free bread I’ve ever tasted (and, if memory serves, better than a lot of gluten-filled bread I’ve eaten). The next day, our food editor, Meaghan, made some toast and some happy noises.

“Don’t put the bread away,” she said. “I’m probably going to want to make more toast.”

I sent El Cap to work with some, and he texted me and told me how much he loved the bread.

Almost everyone at the podcast tasting agreed: They would eat this bread. One holdout, our food intern Alex, said she’d eat it, but not on purpose.

Now, the heartbreak. While Publix does sell bread from this California-based bakery, it doesn’t sell the gluten-free variety. No one within 100 miles of the CL offices in Ybor City does, actually. And, unless you have Amazon Fresh in your town (we don’t), you can’t mail order it.

So what do you do? You march into Publix and take advantage of the grocery giant’s generous customer-service policy that allows you to ask them to order it for you. Seriously. It’s about $5 a loaf, more than reasonable for gluten-free bread. I confirmed this with Meaghan, whose family has some sort of shrine to Publix in the living room (everyone in her family works there, I think). All you have to do is go to the customer-service desk and ask them to special-order La Brea Bakery gluten-free bread, and they’ll do it (at least I’m hoping).

You won’t be sorry. Pinky swear.

This article originally appeared in Creative Loafing.

#BecauseGluten: Celiac cheat days are a thing, right?

Maybe I can have gluten one day a month.

As long as I’m being honest here — and, really, I find when discussing my intestines for roughly half a million of my closest friends, honesty works best — I would’ve happily wallowed in anger for a lot longer than I did if not for Meaghan Habuda, CL’s intrepid food editor and my appetizer BFF.

See, I’m familiar with anger. I’m comfortable in it; I know how it feels against my skin, and, yeah, it’s like an itchy wool coat that doesn’t flatter my figure at all, but I know where to find it. So staying there would’ve been easy, except Meaghan made me feel bad. We had decided to go grab something to eat and get a drink after work, and — for reasons not at all related to anything we stand for at CL, like local, fresh ingredients or innovative dishes — found ourselves at the Tyrone Square Ruby Tuesday (we judge us more than you ever could).

Meaghan wanted to write about a new ice cream something-or-other in the area, so Calypso and I sat on the dog-friendly patio and perused the menu (well, OK, I perused and she lay down, bored with life and unable to get to any of the good crumbs). Certainly something here would be gluten-free, right?

At this point, I continue to cling to the idea I don’t have to tell people I have celiac and that I can find workarounds with maybe a little gluten here and there to accommodate what I still refuse to admit is a disease.

By the time Meaghan arrived, I’d found a compromise: some sort of dip with Parmesan, and we’d get it with corn chips instead of pita. Still unwilling to utter the words “gluten” or “celiac” in public, I ask in what I thought was a casual tone if the topping had breadcrumbs in it, and if I could get the corn chips instead of pita. The waitress answered my questions — she didn’t think so, and of course I could — and she walked away, turned back and fixed her gaze on me.

“Are you gluten-free?” she asked.

I felt the white rage bubble up.

“Apparently.”

She nodded and disappeared inside.

“You were so mean to her,” Meaghan (unquestionably the nicer of us; see above) said. “She was only trying to help, and you yelled at her.”

I only had a moment to ponder what a jackass I’d been before a man with a walkie-talkie wire in his ear came over to our table, introduced himself as the manager, and informed us the cheese dip we’d ordered likely had come into contact with gluten and, as such, wouldn’t be set down in front of me.

My anger dissolved into abject horror. It was as if a secret agent from the bowels of the Ruby Tuesday lair had come out with a top-secret gluten warning. So much for trying to surreptitiously order gluten-free food. So much for walking a thin line between gluten and gluten-free without anyone noticing.

To his credit, he tried to help me find something for a pre-dinner snack. I settled on cauliflower, which tasted nothing like cheese dip.

I didn’t apologize to the waitress, who came over and apologized for not being able to bring me the food I wanted. I started to strategize in my head.

Maybe I can have gluten one day a month, I told myself. Like a cheat day.

Then I floated this past my medical team.

“No,” said Dr. Gorgeous’ PA. “If you have celiac — and you do,” she said, seeing the look on my face, “you shouldn’t have gluten. Ever.”

“Not ever?”

“Not ever.”

Nevertheless, I persisted.

“OK, but, I don’t get sick, right?” I didn’t wait for her to answer. “So, if, say, I had gluten every now and then, or in small amounts, how much could I have before it damaged the villa in my intestines?”

“With an actual celiac diagnosis, the amount of gluten you can have,” she said, and my eyes widened with hope, “is none.”

“Even if I don’t get sick?”

She didn’t sigh with great patience, which is to her credit.

“So, here’s the thing: Gluten may not make you sick now, but once you’re gluten-free for a few months, if you have gluten, it will probably make you sick.”

Great.

Next up: Depression.

This article originally appeared in Creative Loafing.

#BecauseGluten: Read the label, swear, put it in the bin

In which I find myself firmly out of denial about my celiac, and full-throttle into anger.

These people are fucking crazy.

If you read my first column about my recent celiac disease diagnosis, you know I dallied with denial. I transitioned from that right into anger and, well, let’s simply say I have lots of feelings about this stupid new lifestyle, none of which you would call “calm” or “accepting.”

Here’s how that went:

So, OK, I have celiac. Sure. So, um, give up breads, right? I can probably swing bread. It’ll suck some, because nothing compares to a hot loaf of bread with feta and smoked beef, or my dark chocolate bread smeared with Brillat-Savarin, accompanied by a glass of dry merlot and maybe a few walnuts. And the occasional late-night English muffin, like Barry and I do sometimes, with a little butter and strawberry jam…

Stop. Thinking. About. Bread.

You know what sucks? I gave up most “white” foods years ago because of the sugar (diabetes runs in my family). So I’ve been eating those goddamn whole-wheat English muffins for, what, 10 years now, and it’s done me no good whatsoever. Sure, I don’t have diabetes, but hell, at least every now and then diabetics can have a slice of white bread.

Oh, shit, pasta. I’m going to gave to give up pasta. Listen, that’s not exactly a Dutch name up on my byline, there. One of the best memories of my grandmother is making macaroni with her — cutting them on her hand-cranked machine and letting them dry all over the house. It’s safe to assume there was gluten everywhere, from the distinctively Italian wrought-iron wall by the stairs to the crushed-gold velvet striped wallpaper. This is like watching my childhood die.

Although I have a few days before I meet with Dr. Gorgeous (whose PA has asked me not to ask Dr. Google about my condition) and a week before I’ll have a session with a dietitian, I can’t wait that long. I’ve decided that I’ll quit gluten New Year’s Day, so I want to be prepared. I head over to Facebook — after all, that’s not Google and the PA didn’t say anything about social media, right? — and start seeking out celiac groups. Taking a deep breath, I post in one, explaining that I’m a recent diagnosis who previously viewed the GF movement with disdain. But now, in a turn of karma so severe 2,000 years from now Buddhists will meditate about me, I need advice.

“You’re going to have to throw out all your pots and pans and cutting boards and dishes.”

Um, excuse me? I can understand the wooden stuff — wood’s porous, so maybe some gluten got ground in there. However, I have my grandmother’s pots. When my father was a baby, she cooked breakfast for him in those. No way in hell do those go. And the dishes? Jesus fuck, it’s not like they’re made of bread. They’re ceramic. One set is depression glass. No fucking way.

“Make sure your makeup and lotion are GF!”

GF? WTF? I absorb gluten through lotion? Aside from my Sephora stuff, I don’t buy cheap lipstick. I’m not throwing out my Dior, not even if it’s made with camel feces, which, come to think of it, might be gluten-free, so maybe that’s the way to go. But no. The Dior lasts forever and looks amazing. And my lotion? My conditioner? This is too much. These people aren’t doctors. Some of these comments are helpful while others are clearly over the top. For example, the lady who won’t let gluten in her house. Can you even accomplish this? It would be easier to move than to do that, right?

I scroll away from my post and read others.

“I pooped my pants!” one post reads.

These people are fucking crazy.

I shut my laptop.

Grocery shopping also makes me rageful. See, I’m trying to buy things that don’t have gluten in them because in a few weeks I’ll be totally GF, so I have to start studying labels like there will be a test later (and there kind of will). And of course I forget my damn glasses. Trying to figure out if Trader Joe’s Carolina Gold Barbecue Sauce has gluten in it or not, I about lose it in front of the Lululemon-clad suburbanite and the middle-aged hipsters stocking up on Three-Buck Chuck for their shitty dinner parties and the poor cashier who doesn’t understand why I have a nasty look on my face.

In our pantry, I have two shelves filled with bread flour, whole-wheat flour, whole-wheat pastry flour, White Lily all-purpose flour, semolina flour — you get the idea. I start putting everything I can’t have anymore into a big copper basin, the kind you use to hold drinks at a party. I don’t know why. Maybe I’m thinking that arranging it all pretty-like will make this easier. I develop a rhythm: Read the label, swear, put it in the bin.

Flour, the stuff of bread, macaroni, pie crusts and muffins.

Oh, bloody hell.

Basin.

Durum wheat semolina elbows. Mixed with peeled tomatoes and butter and salt…

Dammit.

Basin.

Peanut butter pretzels.

Shit.

Basin.

Soy sauce.

Wait a minute, fucking soy sauce? *Rereads label.* Fucking soy sauce.

Basin.

This fucking sucks.

Next up: Bargaining.

This article originally appeared in Creative Loafing.

#BecauseGluten: Me? Celiac? Impossible!

For me, the first stage of celiac disease was denial.

From my friend Meaghan Habuda, when she was the Food & Drink editor at Creative Loafing and I wrote this for her: #BecauseGluten is a new semi-regular column chronicling CL A&E Editor Cathy Salustri’s journey into an involuntary gluten-free lifestyle. She’s taking her recent celiac diagnosis kinda hard.

I stared at the phone message, hoping my iPhone had transcribed it wrong:

“This is Kristin from Center for Digestive Care. We have your EGD and lab results back and they are suggestive of celiac disease. Can you call me back?”

Suggestive of celiac.

Suggestive.

I called Kristin back and explained to her that I did not have celiac.

“It’s a trendy disease,” I told her as I pulled into the Fairway Pizza parking lot.

“That it is,” she agreed. “Nevertheless, you actually have it.”

“It’s incredibly rare,” I said. “And I don’t get sick when I eat gluten.”

“So, there are two tests we have to do for a positive diagnosis of celiac,” she continued, “a blood test and a biopsy. We did them both, and both of them suggest you have celiac.”

“Suggest? OK, so what else could it be?”

“Celiac.”

I made a follow-up appointment, thanked her and hung up the phone. I walked into the pizzeria and ordered eggplant parm with spaghetti and garlic bread. Screw celiac.

I hate the whole gluten-free fad that’s sweeping the nation. People swear off gluten like it’s crack, but most of the people I’ve met who do this don’t really understand what gluten is — and, consequently, what gluten-free means. They’re avoiding it to lose weight or because it’s healthier (which doesn’t work when you sub in gluten-free processed foods loaded with sugar and fake things) or because they don’t feel well and read about gluten on their friend’s Facebook page.

I hate it. All my friends know I do; for years I’ve joked I was allergic to gluten-free food.

When I took the job with CL last year, I found myself with excellent health insurance and a wonderful doctor. Dr. Ligia Perez took one look at my bloodwork and ordered a bone scan and a hematologist. A few weeks later I learned that at 43, I had anemia so severe she told me to stop working out until we could get it under control.

My hematologist said he’d never seen iron levels so low and ordered iron infusions. He also gave me a shot called Prolia, which would help halt the osteoporosis but could cause my jawbone to become necrotic. He then referred me to a gastroenterologist to figure out where my iron was going — I suspected ulcers — and I found myself staring at the incredibly gorgeous Dr. Patil, who had to be a good 10 years younger than me and said I needed a colonoscopy.

Middle age was looking just ducky.

“Why, exactly?” I asked.

“It’s possible you have celiac,” Dr. Gorgeous told me. I politely replied that I did not have the “disease of the day.”

“It is incredibly rare, but given your symptoms” — anemia and osteoporosis combined with what my family calls “The Salustri Stomach” (when we get stressed, we become physically ill) — “you have a one in five chance of having it.”

Although I disagreed, the medical community seemed rather concerned as to why my body had almost no iron and also why my bones had started to disintegrate at a (relatively) young age. I couldn’t argue that I could barely get out of bed some days, and I did want to feel better, so I agreed to an endoscopy and a colonoscopy. Once they found the ulcers I had diagnosed myself with, I could get back on track.

I’m not going to go into the horrors of the colonoscopy except to say, there’s something not right about looking at an extremely good-looking man and knowing that, in a few minutes, he’s going to be more intimate with your bowels than any human being has a right to be.

A few days later, the phone call from Kristin. That night, Barry and I went to PJ’s for some oysters and contemplated what celiac meant. I declared I would only tell my family — if you have celiac, your family members may have it as well — and a few close friends. Our favorite waiter, Enoch (we go to PJ’s a lot), came over to see how we were doing and noticed I’d ordered Redbridge, a gluten-free beer that tastes like kittens dying.

“Oh, hey, are you gluten-free?” he asked.

“Me? Hell, no. That’s such a bullshit thing!” I said. And when our server came over, I ordered a Bud Light Lime. “See? No gluten-free here.”

“Yeah, it has gotten crazy. People do it because it’s popular,” he laughed and went back to his tables.

“See?” I told Barry. “This is what it means. I can’t tell people. They’ll think I’m an asshole capitalizing on a trend. I know, because I am that person.”

I finished the Bud Light Lime — gluten and all. To make my point, I grabbed a packet of crackers off the table and ate them, too.

Karma, man. She’s a gluten-y bitch.

Next up: Anger.

Note: This post initially appeared in Creative Loafing.