Gardening in a smaller space

Raised bed fully planted

I’m surprised to note I’ve posted only a little about my new vegetable garden. Granted, we’ve had a lot going on since we moved to Waterloo in March, so it’s easy for things to slip by. One of my challenges was to figure out how to grow food in limited space, and I’m pleased to report things are going swimmingly. Here’s a more in depth post about what’s happening outside our living room window.

The above photo of my square-foot garden was taken two weeks ago. I learned how to set it up from some online videos. The frame is untreated cedar. I filled it with commercial potting soil enriched with compost from the worm composter. Here it is when newly established in early April.

Square foot garden 1

The ideal size for a square foot garden is four by four. This one is four squares deep and eight wide, with a keyhole for the basement window well. I’ve also filled two squares with stepping stones allowing easier access to the back rows.

I covered the newly sown seeds with cardboard to maintain even moisture and warm the soil. This strategy is useful for the cabbage family (kale, Brussels sprouts, broccoli and kohlrabi) that requires even moisture to germinate well. However, it didn’t work for everything, as I would soon learn.

We received a cold snap with persistent snow in late April. This had no negative impact on kale, spinach or arugula.

Germination was poorer for lettuce, carrots, calendulas and magenta spreen. I don’t know whether they objected to the cold, but I think lettuce and spreen seeds may be light activated so the cardboard would have inhibited them. Later I added more seeds without covering and now they’re coming along fine.

I’m growing additional crops in containers. The barrels contain bush beans, zucchini and acorn squash. Pots provide room for extra tomatoes, peppers and a variety of herbs. Having them in containers also allows an earlier start for frost-tender vegetables (beans, tomatoes, peppers and squash, among others) because they can move indoors in case of a cold night. Here they are May 12. Our official last frost date is May 17.

Square foot garden 2

Warm weather in May brought things along quickly. Unfortunately it has been interspersed with surprise late frost, with a fairly hard frost on May 26, which may have spelled disaster for nut and fruit crops. The bush beans in the barrel took a little bronzing on their leaves one night when I was careless, but they were indoors on May 26 and have quickly recovered. Tomatoes and beans planted early against the foundation of the house came through the cold weather unscathed.

I first grew an herb called rocket when I was a kid. I’d read about it in British gardening books, but it was unfamiliar to my family’s palette. Apparently most North Americans responded the same way because it never gained popularity here. Someone renamed it arugula and reintroduced it a few years later. Now it’s popular. Maybe people are more receptive to healthy salad greens now than in the ’70s.

This year one single square foot of garden produced almost more arugula than I knew what to do with. I’ve never been particularly fond of bitter greens, but like anything plucked fresh from the garden, this arugula is different altogether, succulent and delectable. A little lemon juice, lemon zest and olive oil dresses it up nicely.

Here’s that abundance of arugula threatening to crowd out the calendulas and rhubarb chard, with healthy peas climbing in the background.

Arugula in the corner

We’ve also had plenty of spinach from two squares planted several weeks apart, but the second batch maturing in May’s heat was less productive. The moral: plant your spinach as soon as the ground can be worked (for best results, soak seeds for 24 hours first). I had a head start because I was establishing a new garden and planting directly into a purchased mix. I prefer to nurture my own soil, but this was a one-time investment. Here’s the second crop surrounded by thyme, tarragon, lovage, sage and onions.

Spinach in the square foot garden

With warm weather, the spinach and arugula were beginning to bolt, so I cut all the remaining plants yesterday. Succession crops of kale and bush beans went into the vacant squares.

Next up to the plate is this gorgeous selection of leaf lettuce. I haven’t even touched it yet, we’ve had so many other salad greens available this spring. I have more lettuce seedlings coming along in a pot, which I can move to shade to keep it nice through the inevitable hot weather ahead.

Square foot garden 4

This square foot garden is a delight to the eye as well as the palate. I can’t count the number of times new neighbours have complimented it while I’m working there first thing in the morning.

The Potters’ Market

The Potters' Market 2015 fox pot

[Update: The Potters’ Market has been cancelled for May 31, 2015, due to a forecast of strong wind gusts, cold and more rain. But please peruse my photos of the previous day.]

It’s indicative of Guelph’s fertile character that one of the cultural events most anticipated (at least among people I know) is a pottery festival. This is not to say that there aren’t many more exciting things to do, more important and more widely attended: Hillside Music Festival, Eden Mills Writers’ Festival, the jazz festival, the film festival, the studio tour, Art on the Street, Fair November, Faery Fest Inc.’s Enchanted Ground and Guelph Pride, to name a few.

What’s surprising about The Potters’ Market is its quality. The website lists 55 vendors this year, and every single one of them creates works of art. Everyone seems to be talking about it. Everyone goes, if they can.

I’ve collected pottery all my life, not on a large scale, but I still have several small spice pots acquired during my teens and twenties. These were beautiful in themselves. But the tools available to potters must have increased exponentially in the past three decades, considering the diaphanous splendour of contemporary ceramics.

Click any of the thumbnails below to view the larger images in a carousel.

One of the things I love about pottery is how, even with such diverse colour and technique, it inevitably expresses the earth from which it emerges. This might be naive because I’ve hardly ever made any pottery myself, but I think you must be inherently grounded in something to make good pots. Everywhere I look I see colours and textures of lava, foliage, sea foam, fungi. These are the kinds of images I like to collect for inspiration.

My partner and I are gradually adding to a small collection of gorgeous, handmade coffee mugs.

The Potters’ Market continues tomorrow, May 31, 2015, from 10 to 5 if you’re lucky to be within driving distance from Guelph. It takes place at the historic Goldie Mill Park. Otherwise, I believe it always happens the last weekend of May. I hope you don’t get drenched as we did, but it’s a warm summer rain and pottery doesn’t dissolve like people do.

Amy Tyler: the creative process

Polyporus squamosus Dryad's Saddle 1

Amy Tyler’s talk on Sunday at Ontario Handweavers and Spinners biennial conference gave me pause to reassess my creative process. For a brief introduction to Amy, read the previous post.

The term “creative process” has a pompous air about it. Amy, to her credit, didn’t use it. It can give the misguided impression that creative people have an esoteric method for conjuring things of beauty and meaning.

In fact my process is more like a brittle piece of metal that needs to be gingerly hammered into shape. When it frequently falls apart, I must carefully, patiently reassemble it. The shape evolves. Each reworking teaches me more about the nature of the mind.

I believe the creative process is itself as much a work of art as any painting or poem. It’s a process in process, sometimes frustrating but mostly rewarding. Many creative people like to talk about it; others don’t. Sometimes it’s easier if you don’t study it directly; like trying to see in the dark by looking to the side. Some disciplined people religiously follow a routine; these individuals are often highly productive. I imagine many of them became well-grounded early in life in their modus operandi. That wasn’t the case for me.

When someone like Amy talks about how she works and finds inspiration, I sit up and listen. Everyone’s creative process is unique as a work of inspired fiction. No novelist ever succeeded without reading great literature, so I learn from others.

Find your medium

Amy’s experience as a dancer inspired her to look for rhythms. Like the beat or the line of melody in a piece of music, patterns also appear in physical objects, giving rise to texture. She looks for inspiration from patterns in nature, not only the obvious ones like the disks on a Petoskey stone, but from the microscopic and analytical delving of science. For instance, she showed us a sweater she had made in which all the features had to do with the structure of muscles.

As an example of an intriguing pattern from my own photography, see the image above, looking down on the mushroom cap of Polyporus squamosus, more poetically known as dryad’s saddle. Apparently it’s edible, though I’ve yet to sample one.

Texture is Amy’s thing. Colour isn’t, she says, but it’s definitely mine.

I suppose colour is akin to the mood of music, which may explain why I’m so drawn to 19th Century Romantic composers: Tchaikovsky’s deep melancholy purples, Schubert’s beaming yellows, Dvořák’s boisterous oranges, Sibelius’s edgy silvers. But I digress.

Here’s the thing: a creative person needs to find the medium that gives him or her the most ideas, according to Amy. This can be hard because some creative types want everything. Amy was a dancer fascinated with science, but ultimately didn’t have original ideas in those realms as she did for textile design, she says.

This question still puzzles me at times. I considered a career as an architect or landscape designer. I studied wildlife biology. Nothing else inspires me quite as much as ecology: the way communities of diverse organisms cohabit, communicate and intersect. My favourite geekery is the taxonomy of plants. I’m so profoundly drawn to images and sound, sometimes I wonder whether I wouldn’t have made a better painter or composer. I need the visual creative outlet of spinning and making colourful yarn things. Nevertheless, I’ve been more prolific as a writer than anything else and this is the path that makes sense for me now. I’m intrigued by the metaphorical link between yarn, storytelling, imagery and language.

Amy spoke at length about an essential part of the creative process: inspiration.

Sources of inspiration

Inspiration isn’t a thing we can make happen. As Annie Dillard wrote in Pilgrim at Tinker Creek, “I cannot cause light. The most I can do is try to put myself in the path of its beam.”

We need to give ourselves time viewing, reading or simply being in places fertile with ideas. I make myself go for walks, otherwise I’ll miss the spring bloom of forest ephemerals and never discover anything unfamiliar, like a dryad’s saddle.

Polyporus squamosus Dryad's Saddle 2

Amy recommended various sources of inspiration, but two particularly intrigue me as having excellent applications for writers as well as any kind of artist: deadlines and constraints.

Inspiration can come at any time, but it isn’t necessarily tied to motivation. Even the most fascinating dream will soon fade to oblivion unless you tell someone or write it down. Unless we do something about our great ideas, logic and cynicism soon drown them in  a sea of practicality.

Pitching a story idea to an editor is, for me, one way of turning a glint of inspiration into reality. If my proposal gets accepted, I have to do the work.

A deadline is a writer’s fertile ally because it forces him to make phone calls, put fingers to the keyboard and clack out some words. Awkward, foolish, transient and brilliant, language mashes together. One way or another, we have to make sense of these words in a limited amount of time. Nothing forces me to work better than a deadline, and this is most often when the rough outline of a story comes to life. Deadlines call all our faculties especially courage into play. Inspiration follows inspiration.

I’d say a deadline is one kind of constraint but there are many others — imposed limitations.

For example, Amy has knitted numerous boot socks over the years. She always follows the same pattern, which forces her to experiment with different colours. Constraints can be unavoidable, as for farm wives a few generations ago who had only worn out clothes to turn into quilts, making beauty out of rags.

But constraints are often chosen. A journalist must choose whether to write a first-person narrative including personal experience and knowledge, or a third-person account obtaining all information from other sources. One approach has an intimate appeal, but the other may be more authoritative; they’re persuasive in different ways.

A composer sets the tone for a musical work by choosing constraints, such as the key signature and instrumental ensemble. A knitwear designer may set out to create an item based on a particular kind of yarn or technique such as entrelac, cabling, mitred squares or some novel combination of stitches.

The power, beauty or significance of a work often depends on rules the creator sets in creating it, or possibly how she breaks them. The constraint may be the theme at the heart of a novel or a series of paintings. Constraints narrow our focus from the whole universe to a small intersection. Inspiration often springs from this place.

Work strategies

But the creative process can’t complete anything without work strategies. As Thomas Edison famously said, “Genius is one percent inspiration, ninety-nine percent perspiration.” This is where popular impressions can misguide people aspiring to an artistic path, because it isn’t enough to sit with pen in hand gazing out the window. That beautiful yarn lying in the closet won’t magically decide what it wants to be, turning itself into a cowl.

Amy suggested some useful strategies for a textile designer, like keeping a bedside notebook, learning new skills, and making lots of samples and swatches.

“If asked to do something new, say yes,” she says. “If asked to do something old, say no.”

Freelancers or artists who struggle as I do with motivation may find strategy has a lot to do with time structures. I have a weekly calendar allotting adequate room for all the necessary activities such as marketing, assignment writing, exercise, tidying my office and different things I do for relaxation. When I’m focused on a project I work in 90-minute intervals with breaks between, otherwise concentration and productivity decline. I have alarms on my phone to remind me when to switch activities. I don’t follow my calendar religiously but when I do I’m usually happier and more satisfied with my work.

Periodically I tweak the calendar. I’m forever learning more about how to work more effectively. One idea I gleaned from Amy is that I’d like to make time in the morning for my sources of inspiration. This time of year I work a while in the garden every morning, but I’d also like to spend more time walking, reading and looking at images that feed me. While this might seem like an untimely distraction, I’m unusual in that my best creative time is 2 p.m. to 7 p.m.; everyone needs to find this out for themselves and plan accordingly.

I hope you’ll find some of these tips useful. What are your favourite sources of inspiration? What strategies do you use to get the work done you most enjoy?


Amy Tyler: connections through a Petoskey stone

Selfie with Gnarled Roots Cowl

A weekend conference has given me more fodder to contemplate the creative process. My partner and I attended Panoply 2015, the biennial conference of Ontario Handweavers and Spinners. Overall it was a fun and relaxing time. I dabbled in workshops, completing the Gnarled Roots cowl shown above with Cheryl Roberts from Fullin’ Woolens, visited friends and plodded through without much serious introspection until the final address, given by a fibre artist from Michigan.

After a career that touched on modern dance and science, Amy Tyler says she left academia to make hand-spun yarn, create knit designs and teach fibre arts. But the rhythm of dance and patterns of nature continue to influence her creations, as evidenced from some of the gallery images on her business website, Stone Sock Fibers.

Particularly striking are the wall-hanging, Petosegay, and afghan, Wool Into Stone. They’re inspired by Petoskey stones, a kind of fossilized coral, the best examples being found in Amy’s home state, Michigan. She fashioned large knitted disks then sewed them together to create a mesmerizing pattern.

Petoskey stone unpolished with cm scale

Where I grew up on the shore of Lake Erie, we found countless fossils on the beach, though none of this particular type. The first time I encountered it was more than 20 years ago in the poetry of Luci Shaw, who had a book of poems published under the title Polishing the Petoskey Stone. She tells of picking one up, spitting on it to reveal the pattern, then carrying it with her on a trip across the continent, polishing it against her denim jeans.

The second day it starts
to shine like glycerin soap. As I buff it
smooth, the print rises to the surface—
the silk stone honeycombed with
eyes opening from a long sleep

between lashes of fine spines. Born
eons ago in a warm sea over
Michigan, buried in a long, restless
dream, now the old coral wakes
to the waves of cloth.

I met Luci at a writing conference in about 1994. I credit her with inspiring me to begin writing poetry. Her use of nature as a subject and metaphor is mirrored by writers who have become even more important sources of inspiration: Annie Dillard, Wendell Berry, Barry Lopez and Mark Doty, to name a few. Writing poetry became an important mode of expression and helped me work through a traumatic period of my life.

It was a coincidence to discover Amy, another creative person, connecting the Petoskey stone with cloth, but I also note some irony. My life and beliefs have changed radically since 1995. At the time I was trying to launch a freelance writing career, an ambition that only reached fruition recently. All the while and for the past 350 million years, Petoskey stones have been lying under the surface, waiting to catch my eye. Perhaps it’s a call to rouse from my own restless dream.

I’ll reflect in more detail on Amy’s lecture in my next post.

Goldthread, brief beauty in the woods


The charming wildflower, goldthread, is one of the earliest to appear in Central Ontario woodlands, even before trilliums. The ground around our cottage is covered with it, so I had a chance to take photographs when we visited for a few days to fix water pipes last week.

Goldthread gets its name from vivid, deep yellow rhizomes forming a fine network through the balsam fir and hemlock needles where it likes to grow. Another colloquial name, canker-root, indicates they’re useful for treating mouth cankers. First Nations Canadians utilized them so. As I seldom get these sores, I don’t plan to harvest any plants, preferring to appreciate their beauty as early spring ephemerals.

Historic dye use

The Cree used the rhizomes to provide a “beautiful and permanent yellow dye” for quills and leather, according to 18th Century references in The Use of Plants for the Past 500 Years (Charlotte Erichsen-Brown, 1979). European settlers used the plant to dye fibre. The research for  Dye Plants of Ontario (Nancy J. McGuffin, 1986) using leaves and roots extracted pale colours at 1:1 plant to wool ratio, suggesting higher proportions are required for good pigment; “It is also used as an herbal medicine, and we suggest it should be reserved for this use.” I hate to think how many plants would be sacrificed to dye a useful quantity of fibre.

Goldthread ecology

Goldthread is a member of Ranunculaceae or the buttercup family. It’s Latin name is Coptis trifolia, although I like the synonym C. groenlandica, indicating it ventures well into Arctic regions from Alaska to Greenland. I’ve never seen it in Southern Ontario, where few old growth forest remain, but its range extends through the cool Appalachians as far as the South Carolina.

The splendid jewel of a blossom, no bigger than one of my fingernails, isn’t primarily comprised of petals but sepals. In typical plants sepals protect and support the flower as it unfolds, but sometimes they evolve to do the work of showing off, attracting pollinators. Goldthread typically has five sepals, but I noticed a few with six or seven.

The petals in this case are the five short, gelatinous-looking clubs half-hidden under numerous, delicate pollen-producing stamens. This specimen has five gourd-shaped green pistils containing ovaries, but these might number from three to 10.

The plant produces a few low three-part, dark green, leathery leaves. One is visible in this photo. They’re evergreen, persisting under the snow. The star-like seed clusters can be used to propagate the plant, but must be planted when fresh.

Forest ecology

The genus Coptis has a few species, several in western North America and several in Asia, but C. trifolia is the only one in eastern North America. It’s throughout the 10 Canadian provinces, New England, Oregon and Alaska. Its status is endangered in Maryland and sensitive in Washington.

It won’t survive logging or intense forest fires. It needs trees with a canopy open enough to allow some light. It doesn’t handle temperatures much above 27°C (80°F), which explains its absence from Southern Ontario woodlands. At our cottage it shares bedroom space with wintergreen (Gaultheria procumbens), partridge-berry (Mitchella repens), red trillium (Trillium erectum), corn-lily (Clintonia borealis), Canada mayflower (Maianthemum canadense) and pink lady’s slipper orchid (Cyprepdium acaule) among other wildflowers, all of which bloom a few days or weeks later.

Steward or citizen

I used to think of myself, a gardener and land owner, as a steward of nature. Now I realize nature is our steward that protects and nourishes every living thing. I’m grateful when it allows such graceful inhabitants to share the space where I live and take pleasure.

The vast majority of people residing across this huge country of Canada will never see goldthread, certainly not in flower, despite its abundance. It opens for a few days during the unpleasantness of black fly season, then quickly ends its show. But I’m happy to demonstrate its beauty here today.


Victoria Day garden idyll

Raised bed fully planted

I just ate an omelet made with wild leeks foraged from the nearby woods, shiitake mushrooms grown locally and outdoors, and the first spinach from our garden. The seeds were sown April 13. This is probably the earliest I’ve ever harvested my own spinach, as our southern exposure collects heat against the wall of the house. It might not be such a blessing in July, but for now I’m pleased.

This morning I also enjoyed watching a tiny wild bee pollinate the tomatoes.

Our official last frost date is May 17, but the actual last, very light frost happened around May 6 and was not enough to harm the already-planted tomatoes and peppers. Everything is planted now.

In case you’re interested, here’s what’s planted in the raised bed: (back row, left to right) scarlet runner beans, Cosmonaut Volkov tomato, peas, (second row) lovage, dill, kale, amaranth, spinach, sweet pepper, Thai basil, brussels sprouts, (third row) tarragon, sage, magenta spreen, lavender, leek, chard, arugula, (front row) thyme, spinach, onions, onions, leaf lettuce, carrots and calendula. Peppermint is growing in shade behind the house.

Barrels and raised bed

Container gardening can stretch the abundance of a small space. The pots contain (front row, from left) wild bergamot, cayenne pepper, Tiny Tim tomato, bush beans, zucchini, chives and rosemary. Hiding are lemon balm, basil, parsley, oregano, lemongrass and a later crop of leaf lettuce. The two containers on the edge of the stoop contain lemon verbena and Table Ace acorn squash, which apparently is compact enough to grow in barrels. I planted the squash last weekend and it’s the only thing that hasn’t germinated yet.

Once spring greens have been harvested, more kale and beans can go into the ground, but I’m divinely tempted to replace the early spinach with another tomato; it’s not too late! This will be my best and most blessed experiment with succession planting. I’m amazed at the opportunity to plant a second crop before the end of May. A lot of food can come out of a little soil.

Discovering wild leeks

Wild leek

In the woods behind our house I was delighted to find wild leeks, also known as ramps or Allium tricoccum. I’ve never encountered them before. These native food plants are so delectable even Martha Stewart approves and suggests some ways to use them. But when foraging for any wild edible observe two important cautions.


First, be absolutely sure of identification. Don’t risk eating something poisonous. It’s best to start with an experienced wildcrafting mentor to learn the basics, especially what to avoid. Use a good field guide.

Lily-of-the-valley closely resembles the wild leek, and it’s deadly poisonous. However, break the foliage of a wild leek and it will give a distinctive garlic-like scent. It also has a diagnostic reddish-purple stem and onion-shaped bulb, unlike lily-of-the-valley.

Wild leeks like rich soil in deciduous woods throughout Eastern North America. The leaves can be harvested in early spring. The plants need to do all their photosynthesis and store energy for next growing season before tree leaves unfurl. Once the canopy closes, wild leeks die back. The flower stalk appears later.

Be a conservationist

Here’s the second important precaution: think like a conservationist. Anyone who doesn’t respect a valuable source of nutritious food and can’t be bothered to harvest it sustainably has no business foraging. Wild leeks have been so depleted in Quebec that they’re now protected. Help ensure that ramps and other wild edibles remain abundant for next year and the next generation of foragers.

Never take more than 10 percent of the plants. And select one or two other strategies to ensure a continuing source of wild leeks for everyone who wants to enjoy them:

  • Collect only from large beds of plants, leaving small colonies to grow.
  • Digging into the soil, use a pocket knife to cut the bulb above the base, leaving the roots to regenerate.
  • While the bulbs are delicious, the green leaves are also tender and packed with intense onion-garlic flavour. Each plant has two leaves, so take one and let the other nourish the root.
  • Start a new colony by transplanting one or two bulbs into a nearby, similar patch of ground that doesn’t have any plants.
  • Avoid trampling nearby wildflowers; they need protection, too.

This week I enjoyed cooking wild leeks in a mushroom and cheese omelet, and in crab and asparagus soup. I’m also eager to forage for stinging nettles to combine them with ramps in a zesty spring pesto.

Enjoy spring foraging and let us know how you like to use ramps for a culinary sensation.

Ephemerals in our new backyard

Click an image to view the gallery in a carousel.

What new beauty do I behold, just steps away from our back door?

I’m probably more of a wildflower geek than any other kind of geek. So it’s a lot to say that I like spring ephemerals best of all. It’s hard to resist a September meadow burgeoning with asters and goldenrod, the delightful freakishness of carnivorous plants, or the unexpected surprise of a wild orchid. But nothing quite moves me as the watercolour burst, at once modest and rampant, that floods Ontario’s spring woodlands.

Melting snow reveals the marbled leaves of dogtooth violets. The rest soon emerge through last year’s crust of maple leaves, hastening to complete another round of delicate flora-lust before the new canopy unfolds, casting them in shade.

How can I express my joy at finding so many familiar favourites blossoming just steps from our new home? I am smitten. White and red trilliums, spring-beauties, jack-in-the-pulpits and violets grew under the silvers poplars at my childhood home. Memory and spring come hand in hand when these flowers greet me again.

The large-flowered bellwort is unusual, a plant I’ve only seen once or twice before. It’s also a member of a peculiar clan, Colchicaceae, the autumn crocus family. Odd taxonomy always fires my geekish enthusiasm.

As if that weren’t excitement enough, the woods is full of ramp, otherwise known as wild leeks (not shown here). I’ve never had them before! I can’t wait to add them to some recipes over the next few days. Not long after we spotted them, we met a man on a bicycle collecting them, but there’s plenty to share.

I had to concede that I was unable to keep up with the daily macro challenge. It’s not that I never have enough time, but there have been quite a few days when I didn’t. But it was a valuable exercise while it lasted, and helped me become more familiar with my new lens.

Days like this one will make up for it, though. All these images were taken in the space of an hour in an acre of woods visible from my office window; all except the last violet, which is in our lawn. We’re feeling lucky indeed in our new home in Waterloo. Life certainly has its moments.


Macro a day, week 4

Click an image to view the gallery in a carousel.

The macro lens is forcing me to get to know my camera and equipment better. This week I learned how to change the autofocus point on the camera and reassemble my tripod so it can take photos near ground level.

Stability is important because closeup images of small things like the snowdrops often require good depth of field, requiring a small aperture. Depending on how much light is available, these have to be shot at a relatively slow speed shutter speed, around 1/100th of a second or more. Without lens stabilization, camera shake can blur the image. Using the tripod helps create sharp images.

It also saves my back having to maintain uncomfortable contortions while trying to hold the camera with both hands.

Why I’m taking the gluten challenge

Celiac disease via euthma

After seven years on a strict gluten-free diet, yesterday afternoon I met a gastroenterologist to begin the process of determining whether, in fact, I have celiac disease. This means that for the next 12 weeks I’ll undertake a gluten challenge in preparation for a small intestine endoscopy and biopsy in July to look for damage indicative of the disease.

Since I don’t have trouble tolerating the diet and I’ve had good results from it, people would be justified in asking, “Why bother?” Even the gastroenterologist, without arguing for or against this procedure, wanted to know my answer to that question. It’s important to know and here are my reasons.

  1. For people with celiac disease, even traces of gluten can cause damage. Often it is invisible and doesn’t provoke symptoms but can have long-term health implications. As far as we know, the concern is not so serious for people with non-celiac gluten sensitivity. If I’m going to follow this diet for the rest of my life I want to know how careful I need to be. It’s not a concern when eating at home. We maintain a strictly gluten-free kitchen. But the gluten-free diet becomes a source of anxiety every time I enter a restaurant or eat dinner prepared by anyone who doesn’t know the finer points. Even in restaurants that have gluten-free menus, many servers roll their eyes when you tell them you have a gluten sensitivity. If I’m going to be hardline about this for the rest of my life, I want to know.
  2. Bearing in mind those hidden implications of celiac disease, patients need appropriate medical follow-up even in the absence of symptoms. The gastroenterologist yesterday said he recommends a biopsy every five years. According to my research, CD patients should also be monitored for bone mineral density. They are at higher risk for certain kinds of heart problems and other diseases. CD patients on a gluten-free diet tend to have elevated cholesterol, as I do. I’d like to have a clear picture. Perhaps what’s more important, if I have CD I like my general practitioner to treat me like I have CD.
  3. It’s partly academic. As a journalist who often writes about CD, I’ve interviewed leading experts like Dr. Joseph Murray and Dr. Alessio Fasano. I’m research editor for Gluten-Free Living magazine. Several of my articles have presented the argument that no one should ever go on a gluten-free diet without first ruling out CD because it can only be diagnosed by the effects of eating gluten. I support this position particularly considering all the controversy around the diet, which can obscure serious health risks for a small but important minority of people. My job as a journalist is to inform and my lack of diagnosis might suggest I’m a hypocrite.

However things turn out, it will be another adventure, another story to tell.

In February, results finally came from a test done last summer. They showed I have HLA-DQ2, one of the genes that predisposes people for CD. This only proves that I’m not among 60 percent of the population that doesn’t have the genes and can’t get celiac disease. But based on the results, my doctor referred me to the gastroenterologist.

The usual path to diagnosis begins with a blood test for antibodies while the patient is eating gluten. However, I would have to pay for these tests and the cheapest, most readily available test for tissue transglutaminase antibodies (anti-TTG) is at best inconclusive. The specialist recommended that I forgo blood tests, do not pass go, head directly to biopsy. I was surprised, however this reflects the fact that many experts still regard biopsy (a collection of small tissue samples from the gut lining) as the gold standard for diagnosis, particularly in adults.

Starting this week, maybe tomorrow, I start eating gluten again. Fortunately, only modest amounts are necessary to provoke markers of the disease. Dr. Murray advocates a kinder, gentler gluten challenge than was considered necessary in the past. My gastroenterologist said three doses per week should be enough, although he encouraged me to eat more if I can tolerate it.

I don’t know what to expect. I have mixed feelings. Besides the suspicion of CD, I’ve benefited in many way from the gluten-free diet. It has sparked creativity in cooking. I pay more attention to healthy eating. But nobody wants a disease like this. I’d be happy to uncover a less dire explanation for the symptoms.

The gastroenterologist suggested I might enjoy the chance to eat whatever I like. I should be looking forward to tasting the things I miss most like a good crusty baguette, regular pizza and apple fritters from St. Jacobs Farmers Market. But having interviewed CD patients who briefly went back on gluten, I doubt that it will be any fun.

I had lots of low-grade digestive issues before the diet. I’d been diagnosed with hiatal hernia and reflux disorder years ago. I suspect these were somehow related. I have to take a proton pump inhibitor to treat reflux. For a couple of years I had frequent diarrhea. This became markedly worse after I acquired a bread machine and started eating delicious bread every day. Twice I soiled myself while out in public. It was humiliating, no help to someone who suffered from social anxiety.

My uncle had celiac disease so I suspected gluten might be the problem. But I didn’t have enough income at the time to justify (in my own mind) paying for blood tests. I wish I’d known better. I went on a gluten-free diet in March 2008.

I stopped having the runs immediately. But in the ensuing weeks I noticed improvements in other seemingly unrelated symptoms. Depression and anxiety were alleviated. So was joint pain, which I’d attributed to an inherited tendency toward arthritis. At age 44 I would commonly get tired of being on my feet for long (normal shopping trips were physically grueling). It’s strange to realize I’d accepted that as normal; now 51, I seldom experience fatigue like that. All these complaints are typical for people who don’t know they have CD.

In light of this, people might be justified in questioning my curiosity – why I need to pursue a diagnosis now. If the treatment works so well, maybe I should just accept it. But as a journalist I’m obsessed with knowing and speaking the truth. It might be easier to tell restaurant servers a little white lie: “I have celiac disease.” But it runs against the fibre of who I am.

It’s also possible that the condition is not CD. The biopsy might be negative, which could indicate non-celiac gluten sensitivity or other possible food sensitivities, for example to fermentable oligo-, di-, mono-saccharides and polylols (FODMAPs). If that becomes the questions, I’ll pursue the answer.

I need to know.

[Edit: As an afterthought, I recall that in 2008 I couldn’t obtain a referral for biopsy without first taking the blood test for celiac disease. It’s an encouraging to find that medical awareness of this disease and its implications have shifted, and that the gastroenterologist wants to take the simplest approach for a clear diagnosis. It’s also important to note that here in Canada we have to pay for the blood tests (though some employee benefit programs would cover it) but not the surgical procedure of endoscopy and biopsy. Strangely, the lab didn’t charge me for the genetic test last year. I suspect this was an oversight.]


The photo shows a tissue sample from an intestinal biopsy illustrating flattening of the villi, which is diagnostic of celiac disease. It comes courtesy of Ed Uthman on Flickr via Creative Commons.