Abigail Keel: As a kid, I was just your straightforward, extreme picky eater, like only ate buttered noodles, hot dogs, etc ...

Dan Pashman: This is  my friend and former colleague Abigail Keel. Abigail grew up in St. Louis, with some very strict rules for what she would eat. She’d have ketchup … but not mayo. She didn’t like “crusts." And anything green was off the table. 

Dan Pashman: Then in high school, her friends took her to a Mexican restaurant and ordered something that sorta woke up her culinary senses. 

Abigail Keel: I had, like, guacamole for the first time. Ooooh!

Dan Pashman: Oooh! Wow! You're really stepping out? 

Abigail Keel: I know! [LAUGHS] Then around college I was like, oh yeah, food is actually a really awesome thing. 

Dan Pashman: This is when the Abigail I know began to emerge. She started eating mushrooms, aioli, sushi! Then she got into cooking shows. She started following celebrity chefs. By the time she was in her late twenties, living in New York City, Abigail was shopping at the farmer’s market and throwing dinner parties.

Abigail Keel: And it becomes like a real part of my life — and a love of my life.

Dan Pashman: Eating is a pleasurable experience.

Abigail Keel: Yeah!

Dan Pashman: [LAUGHS]

Abigail Keel: You know, there are people who eat to live and people who live to eat. And I became ... [LAUGHS] someone who lives to eat.

Dan Pashman: But one day a couple years ago ... something very unexpected happened. Abigail was at home, just standing in her kitchen ... 

Abigail Keel: All of a sudden, I just got this kind of weird headache and felt super dizzy ...

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Abigail Keel: And needed to close my eyes, like I couldn't have them open otherwise I felt like everything was spinning.  

Dan Pashman: This feeling Abigail was experiencing, it's called vertigo, and it can be pretty severe. People get so dizzy they fall and get hurt. The nausea alone can be debilitating. Abigail had never had vertigo before. She laid down on the couch and closed her eyes. Within a few hours she slept the feeling off.

Dan Pashman: Then a few weeks later, it happened again. And as she started trying to unravel the mystery, she was confronted with a startling possibility. Maybe… it was coming from inside the kitchen. 

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Dan Pashman: This is The Sporkful, it's not for foodies, it's for eaters. I'm Dan Pashman. Each week on our show we obsess about food to learn more about people. 

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Dan Pashman: After a few spells of this vertigo, Abigail started to be able to sense it coming. It began with a weird feeling in her right ear. It would feel kind of muffled.

Abigail Keel: Like how if you have a really bad cold or whatever, you just, like, can't hear as well out of one ear and you feel some pressure. So I would feel that way and I'd be like, "Oh, am I getting sick?"

Dan Pashman: After that, she would hear a light ringing sound. Then a few days or sometimes up to a week later, the vertigo would hit. She’d need to lie down immediately and stay completely still. Even after the worst of the vertigo passed, she'd still feel a little dizzy and off for days. Eventually, she’d go back to normal. 

Abigail Keel: And then every month or so, it would just happen again. 

Dan Pashman: Abigail read online that vertigo and dizziness often come from an inner ear problem. So after a couple months like this, she went to see an ear, nose and throat doctor.

Abigail Keel: She was like, let's do some tests, basically, and send you through the like, ringer of medical whatever. So I did that, [LAUGHS] which included, like, MRI's and this weird test where they put these goggles on me, and there were lasers that I had to track with my eyes and then they would watch for my eye movement and ...

Dan Pashman: What was that supposed to be testing? 

Abigail Keel: It tests your inner ear, which controls balance for your whole body — it somehow [LAUGHS] is connected to your eyes and eye movement, so they can test, like, if your eyes are slow, when they should be fast, or if they're switching back and forth.

Dan Pashman: Sort of like how, like, if you're ever trying to hold your balance, like if you're trying to balance on one foot, if you lock your eyes in one spot, you can keep your balance better than if you if your eyes are darting around.

Abigail Keel: Yes. And if you close your eyes, it gets harder to balance.

Dan Pashman: That's right.

Abigail Keel: So it's like, all ... Yeah, it has ... It's connected. 

Dan Pashman: So you had the MRI ...

Abigail Keel: Did the test.

Dan Pashman: You had a test that involved lasers.  

[LAUGHING]

Abigail Keel: Exactly. 

Dan Pashman: Sounds like ... It all sounds pretty high tech.

Abigail Keel: Yeah. And I went back to the ENT and she was like, "I think you have this thing called Meniere's."

Dan Pashman: Meniere’s — like the name of a French guy with an apostrophe S.  M-E-N-I-E-R-E apostrophe S. It’s a rare, chronic disorder that affects the inner ear. Abigail’s doctor explained that there’s a little tube inside the ear that's part of your body’s system for balance. When fluid builds up in this tube, it can throw off your balance — that’s where the vertigo comes from. Meniere’s can also cause tinnitus, which is a ringing or buzzing in your ears, and eventually, it can lead to partial or complete hearing loss in one or both ears. No one is really sure what makes someone develop Meneiere’s — maybe allergies, or previous infections, or physical damage to the ear. None of those theories have been well-tested.

Dan Pashman: There is no cure for Meniere’s. And it’s really tough to live with.  Abigail’s doctor laid out some treatment options.

Abigail Keel: She said, "You know, the first kind of course of action we’ll do is to put you on a diuretic, which is basically a drug that makes you pee a lot. It just, like, moves fluid through your system. We'll put you on that. We'll have you drink a ton of water and you should reduce your salt. You want to be under 1500 milligrams a day." 

Dan Pashman: This advice about drinking water and eating less salt, it’s all an effort to help keep that fluid in Abigail’s ear at the right level. Her doctor explained the basics of how it works, but the big takeaway was: Keep your salt intake under 1500 milligrams. 

Dan Pashman: Now, the recommended daily amount of sodium is 2500 milligrams, so this was a lot less than that. The doctor didn’t give Abigail a plan or a pamphlet. No referral to a nutritionist or a specialist. Just a number: 1500 milligrams.

Abigail Keel: And then she kind of is, like, "Goodbye!" [LAUGHS]

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Dan Pashman: At first, Abigail was like, no worries. She understood nutrition labels. She cooked all the time. She figured: 1500 milligrams … I got this. 

Abigail Keel: In my mind, salt is like fast food, chips and fries and stuff like that. And I'm like, I don't eat that much of that stuff. I'll just kind of cut that stuff out. I'm not going to, like, sprinkle table salt on my food anymore.

Dan Pashman: And also 1500, it sounds like a big number. You're like, [Abigail Keel: Yeah!] if I can have 1500 of something a day, that's still a lot. 

Abigail Keel: [LAUGHS] Exactly. 

Dan Pashman: Abigail stopped eating salty snacks. She didn’t eat all that much fast food before, but now she cut it out completely. And she skipped the salt shaker. She ate like this for a few weeks. But then … another attack. And it seemed to be getting worse. 

Abigail Keel: It's, like, my eyes are spinning. I feel like I'm on a boat. I have to be horizontal. And it's like, I just sit there in the dark for a couple hours, like, really just hoping that I would fall asleep because that was the only way to escape. And then even after the actual crazy spinning vertigo feeling faded, I would just be wiped out and kind of feel vaguely carsick, for like two days afterwards. So it was hard to work. [LAUGHS] It was hard to, like, make a plan because what if the vertigo happens? I don't want to be too far away from my house because I need to be home. And if I tried to move, I would just get nauseous. And if I did move, [LAUGHS] I would throw up. Truly, not in control at all. 

Dan Pashman: And you're saying this is happening to you once a month. 

Abigail Keel: Yep. Yeah.

Dan Pashman: So this is a big issue. This is a major life disruption.

Abigail Keel: Yes. Exactly. Yeah ...

Dan Pashman: And extremely unpleasant.

Abigail Keel: I was like, what about travel? What about work? Like all these —the regular parts of your life that you got to deal with, I was like, this is going to really impact that. 

Dan Pashman: Right. And I would imagine there's also it's kind of draining on your mental health, is that you start worrying about it more. And it's kind of — it's always in the back of your head. 

Abigail Keel: Totally. Yeah, not wanting to be in a situation where if it happened that it would be really bad. Like, what if I'm with people I don't know very well, and then all of a sudden I'm throwing up on them or, you know, just stuff like that  [Dan Pashman: Right.] would be a worry. 

Dan Pashman: Living with Meniere’s can be so hard on your mental health that many doctors prescribe antidepressants to patients — that doesn’t do anything for the vertigo, it’s just meant to help patients cope.

Abigail Keel: Yeah, I was like, I want to figure this out. And if they’re telling me 1500 mg of salt per day is gonna help, then okay, let’s try that.  

Dan Pashman: Abigail had been cutting back on salty foods, but she wasn’t really counting milligrams. When the vertigo attacks continued, she decided to get a lot more serious about that number. She did some research and the first fact she learned: one teaspoon of table salt contains over 2,000 milligrams of sodium. 

Abigail Keel: I was like, whoa, okay. Like 1500 is even less than a teaspoon a day. So that's not very much. And then I also learned that most Americans eat around, I think it's 3500 milligrams per day. 

Dan Pashman: So the amount of salt Abigail was supposed to be eating is less than half of what most Americans consume. And she also learned that sodium in your food doesn’t just come from salt. It comes from a lot of sources: 

Abigail Keel: One is table salt, one is sodium bicarbonate, which is baking soda, which is in a lot of baked goods.

Dan Pashman: Right. Even things that you don't think of as being salty.

Abigail Keel: Yes. It's not even there as a flavor enhancer. It's there as just a basic thing that it needs to rise in the oven or whatever.

Dan Pashman: Right.

Abigail Keel: And then all everything in a box or a can, like processed food basically, all has salt for preservatives. So, that was like, uh oh. There's salt everywhere. [LAUGHS]

Dan Pashman: It’s almost like Abigail was standing in a dark room, and put on a pair of night-vision goggles. All of a sudden there’s salt everywhere, lurking around every corner. 

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Dan Pashman: Hoping to find some consolation and advice, Abigail visited a place she knew she’d find other people like her. 

Abigail Keel: I went on Reddit, [LAUGHS] which, like, I would recommend that no one with health problems consult Reddit, but ...

Dan Pashman: [LAUGHS]

Dan Pashman: The subreddit for Meniere’s was full of people with different solutions for keeping their vertigo symptoms at bay. Some did cut their salt back to less than 1500 milligrams a day. Others said they found success just keeping their sodium levels steady from day to day, so making sure there were no big spikes or dips. Still others didn’t make any dietary changes, but took dozens of supplements. There were frightening stories about vertigo attacks hitting people while walking across a busy street. Abigail found it all a little overwhelming. 

Abigail Keel: One woman was like, "When I travel, all I do is just bring my rice cooker. And that makes it so easy because I will have steamed rice and steamed chicken for all my meals in my hotel room, while my husband and daughter enjoy whatever they want to eat." [LAUGHS] And I was like, "Oh God, it's like, is this my future?" You know?

[LAUGHING]

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Dan Pashman: After all her research, Abigail decided to go with the most concrete thing she had — a number. She would strictly adhere to the 1500 milligrams of sodium per day as directed by her doctor. She would not go over that number. She would fix this Meniere’s and stop having vertigo. 

Abigail Keel: So I started to keep a little list on my phone of everything I was eating and to the best of my ability, its sodium content, which is kind of hard because if you're eating a food that came in a box, you can look on the box and see the nutrition facts. And that is, like, a good place to start. But even then you have to be like, okay, well, did I eat 12 crackers, which is the serving? Or did I eat 15 crackers? And if I eat 15 crackers, then like, what is actually the per cracker sodium level, you know? So, like, I had to start doing a lot of math around that kind of food. And then some food doesn't have a nutrition label, but still has salt in it, like everything else. Eggs, even vegetables have, like, a basic amount of sodium in them because it's just a mineral.  

Dan Pashman: Like, naturally occurring. 

Abigail Keel: Yeah. Yeah. For that stuff, I would just Google like, "Celery, does it have sodium?", you know, and figure it out. And even if it was minimal, like 20mg, I still was keeping track adding it up throughout my day to just get a sense of, like, how much am I actually eating.

Dan Pashman: Once she started keeping track like this, it was hard for Abigail not to be fixated on that 1500 number. Breakfast was easy — a couple hard boiled eggs, or some yogurt and fruit. That was usually less than 200 milligrams. But then lunch would creep up and Abigail would be like, "What do I eat?" Any food with even a moderate amount of sodium started to feel dangerous. It added too much to the final tally. 

Abigail Keel: And that's when I really started to feel the impact of what a low-sodium diet means. And what it means is you pretty much need to cook at home almost all the time, because eating out is just dangerous. [LAUGHS] You don't know how much salt they're using. And even if you go to the restaurant and you say to the waiter, like, "Hey, I have, like, a medical thing. I need to eat low sodium," if they tell the chef then the chef is probably be like, "Okay, cool. I just won't salt the top of this food," but it's probably food that's been like marinating in some sort of dressing or ...  you know, like something salty because that's how you make food taste good, so …

Dan Pashman: Right. And either way, it’s just impossible to count.

Abigail Keel: Yeah.

Dan Pashman: Unless you’re counting every grain of salt yourself. 

Abigail Keel: Right. 

Dan Pashman: So going out to eat, which as we heard was something Abigail loved to do, was now scary … but cooking at home wasn’t that much easier. Abigail loved to cook and host dinners, but now any sort of elaborate meal became a nightmare as she started doing the math for each ingredient. Two tablespoons of soy sauce for a stir fry? Well that’d be over 1,000 milligrams right there. 

Abigail Keel: Soy sauce has a ton of sodium. Fish sauce has a ton of sodium, parmesan cheese, anchovies, olives, everything delicious.

[LAUGHING]

Abigail Keel: So ...

Dan Pashman: All these foods that you had spent your 20s falling in love with! 

Abigail Keel: Learning to love. Learning to love, yes. 

Dan Pashman: Now turn out to be the enemy. 

Abigail Keel: Yeah, they were my enemies. 

Dan Pashman: Despite these challenges, Abigail started cooking at home pretty much exclusively, where she could fully control her sodium intake. She talked with her partner, Steve, and her roommates, who she shares meals with, about how to check nutrition labels and which grocery store items to buy low-sodium versions of. 

Dan Pashman: A few weeks into Abigail’s super strict approach, the reality of this low-salt diet hit her. She and her roommates were throwing their big annual backyard party.  

Abigail Keel: We call it the rager. We get like a keg. [LAUGHS] And before the rager, my roommates all ordered pizza. And pizza is, like, so bad for salt because you have the crust, which is bread — and that's got salt.  And then the cheese is very salty. All cheese, all dairy is very salty. And then of course, there's salt in the tomato sauce. And then if you add something like pepperoni, you know, or anchovy or all over any of the good toppings, that's like just exploding. So pizza is basically, like, off the table. So they all order pizza. And I like, made myself, like, a whole wheat pasta with, like spinach and garlic or something. And it was just like, "Oh, like you guys are having the party food and I'm eating this." [LAUGHS] Yeah … Yeah, it was just kind of sad and extremely isolating.

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Abigail Keel: So much of my time was spent thinking about it, and a lot of time would be spent thinking about food before that, [LAUGHS] but in a fun way. Like, what am I going to eat for dinner? And what new restaurant am I going to try? And that was all replaced by anxiety and worry. And this pressure that if I messed it up, I was maybe going to cause this really uncomfortable vertigo and it's — I'm not going to have anyone to blame but me.

Dan Pashman: This feeling, of watching what she was eating, thinking about it all the time, being obsessed with a number ... was a feeling that Abigail was familiar with. She says it reminded her of the diet culture she grew up in as a girl in the '90s and early 2000s. Sure, this restriction on salt, it wasn’t counting calories, but she was still counting something.  

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Abigail Keel: It put me in this dieting mindset that's very much about — it's like a scarcity mindset. It's like, you can't have certain things. Watch out. you've got to, like, protect yourself. You've got to hit this number. If you don't, it's all your fault. Like, all those kinds of messages were really where my brain went. On the one hand, it felt nice to have control over something, because the vertigo, I didn't have any control over. So it felt good to feel like, okay, well, at least if I can keep this number where it should be, then maybe I can control this really bad symptom. 

Dan Pashman: Abigail kept up this intense monitoring counting every milligram of sodium, all with the hope that her Meniere’s would get better. That the terrible, debilitating vertigo would stop. 

Abigail Keel: I went without vertigo for a few weeks, and that felt great. And then I had it again. 

Dan Pashman: So even after all this effort, it didn't actually solve the problem.

Abigail Keel: It didn't. No.

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Dan Pashman: Abigail was stuck. Eating had lost all its pleasure, and she was exhausted from worrying about every bite. And it wasn’t even fixing the problem. Coming up, Abigail continues her search for answers. Then later, her condition changes drastically, and without warning. Stick around. 

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+++ BREAK +++

 

Dan Pashman: And now a moment from our partner, American Express. 

Dan Pashman: I don't have enough time to get into full detail about all the things I love about my AmEx Gold Cards. And yes, it is cards, plural. I have a personal AmEx Gold Card and a Business AmEx Gold Card. But today, I'm gonna talk to you about my personal AmEx Gold Card. What I love about my personal Gold Card is that I get 4 times points at restaurants globally on up to $50,000 annually. When I travel, I rack up more membership rewards points that I can then use to take my family on a trip. Also, I love AmEx customer service. When I need support with my card, they're there to help. And look, if you're an eater like me, the AmEx Gold Card is the way to go. Cardholders can enroll and earn up to $120 back in statement credits after paying at participating partners up to 10 bucks each month. And you can get up to $100 back annually after you pay with the American Express Gold Card to dine at U.S. Resy restaurants, or make other eligible Resy purchases. Honestly, with my AmEx Gold card, I just feel like a V.I.P. and I always feel like I'm racking up points. AmEx Gold can help elevate your dining experiences, allowing you to check out new restaurants, connect with your family and friends, and explore exciting flavors all while earning rewards points. That is the powerful backing of American Express. For terms and to learn more, visit AmericanExpress.com/withAmEx. 

 

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Dan Pashman: Welcome back to The Sporkful, I’m Dan Pashman. Last week on the show, I talk with Sara B. Franklin, who wrote a new biography called The Editor: How Publishing Legend Judith Jones Shaped Culture in America. Judith Jones is the American food icon you may not have heard of by name, but she’s behind groundbreaking works like Julia Child’s Mastering the Art of French Cooking. Sara, the biographer, first met Judith when she was hired to record Judith’s oral history. And she quickly learned one very important thing about Judith’s personality:

CLIP (SARA B. FRANKLIN): She did not, um, want to work with or associate with people who were really performing. She had an incredible radar for nonsense.

CLIP (DAN PASHMAN): She didn't like bullshit, it sounds like what you're saying.

CLIP (SARA B. FRANKLIN): She did — that's right. I didn't realize we could say the word, [DAN PASHMAN LAUGHS] but let's go. Right. Her bullshit radar was very, very good.

Dan Pashman: That radar served Judith well as an editor, and she went on to change the very idea of what cookbooks could be. Judith is also the person who pulled a very famous book manuscript out of the rejection pile and pushed to get it published. That book? The Diary of Anne Frank. Hear more about Judith’s extraordinary life and work in the episode, it’s up now.

Dan Pashman: Okay, back to Abigail Keel’s story. After all her efforts to eat a low-sodium diet, Abigail was still experiencing regular attacks of vertigo. And now, she was coming up on a big trip she and her partner had been planning for months — a week in Copenhagen. But the excitement of the trip was turning to worry. What if she got vertigo on the plane? Would she have to be like that Reddit user who brought a rice cooker on vacation and ate alone at the hotel every night? 

Dan Pashman: Abigail went back to her doctor. She wanted to know: Should I stick with this low-salt diet? Will it work eventually? Is all this effort worth it?

Abigail Keel: She was just kind of like, "Might as well? It couldn't hurt," you know, that was really the message. It couldn't hurt to try to just be doing this diet. But I was kind of like, no, it hurts. 

Dan Pashman: At that point, Abigail decided to get advice from a different perspective.

Jessica Jones:  I think that many people think that dieticians are diet police, which is not the truth.

Dan Pashman: Registered dietician Jessica Jones says she’s seen many patients in Abigail’s situation — whether it’s people who have to go on a low-salt, low-sugar, or other diet for a medical reason. 

Jessica Jones: If anything, we're encouraging people to eat and eat more and eat more variety. And we want people to find the joy in eating, while also managing their chronic condition if they do have one. 

Dan Pashman: Abigail found a dietician like Jessica to talk to. And that dietician’s approach included a lot of empathy and understanding. 

Jessica Jones:  It's called medical nutrition therapy. And we're really trying to help people who are dealing with chronic conditions figure out what to eat that might be helpful for that condition, but also that's not so restrictive that they're not able to enjoy their life and food anymore.

Dan Pashman: Jessica says that doctors have a lot to manage when helping a patient with a new diagnosis. And they’ve been trained to prioritize a patient’s physical health, not necessarily their emotional health. 

Jessica Jones:  They'll just tell the patients, cut out carbs or to just eat protein and vegetables, or they'll give them a prescription of losing weight, which for many people, they have tried to lose weight in the past and it wasn't successful. And so I think that some of the challenges with doctors and kind of giving blanket recommendations are not having enough time to really have a conversation with a patient, and also having an understanding of who that patient is. Like, what motivates them? How much time do they have? Because all of those things are going to factor into what they're able to do, diet-wise. 

Dan Pashman: And I wonder if also doctors are looking at the range of options, the treatment options for a specific condition. And those could include medication. They could include exercise. They could include a surgical intervention of some kind and they could include changes to the diet. And so, I think maybe sometimes a doctor looks at that set of options and thinks that a change to the diet is like the lowest hanging fruit, it's the least invasive.

Jessica Jones: Yeah.

Dan Pashman: Because from a medical perspective, it's like, well, we’re not putting you on medication that could have side effects. We're not doing surgery, which comes with risks, so this is a lower risk option, but maybe they're not always taking into account the sort of psychological and lifestyle impact of having to make a radical change in your diet.

Jessica Jones:  Yeah, absolutely. And that's why I like to look at everything from many different perspectives and many different interventions, because for some people you might just need medication, or even physical activity — other things that can work in conjunction with nutrition, so you don't put so much pressure on the nutrition side of things.

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Dan Pashman: Going into her conversation with a dietitian, Abigail thought she’d get a pat on the back for monitoring her sodium so intensely. Instead, her dietician said, "Toss out that list. It was stressing you out." She told Abigail to go back to the approach she started with, “Avoid super salty foods, but don’t take it to an extreme.” Abigail said that advice was a revelation.

Abigail Keel: Having a professional be like, "You just need to try, but you're not going to be perfect at it," really [LAUGHS] was liberating, I think. Like it just made me feel like, I just need to do as good as I can do. And actually, the intensity of this attempt at perfecting this number is doing more harm to me than the possible good of actually keeping my sodium below that number. You know, like if I'm stressed about it all the time, if I'm, like, feeling sad because I can't go out with my friends, who are eating french fries, that's not very good for me either. And it's not vertigo, but it's not good, you know? So she just helped me realize, like, actually, I should choose what my priorities are. And if sometimes my priorities are having the meal I want to have, even if I might not feel great after that, like I'm allowed to choose that. 

Dan Pashman: With this new feeling of optimism, Abigail took her trip to Copenhagen. She followed her dietician's advice to let go of the number and just focus on doing the best she could to avoid salty stuff. With that approach, Abigail was able to have a really nice time with her partner in Denmark. They even got to eat out together — no hotel room rice cooker chicken. 

Abigail Keel: It was like, ooh, I'm still worrying a little bit, but enjoying this meal in a new place with a person I love, like just kind of having a normal travel experience that still felt exciting and I got to participate. I wasn't left out.

Dan Pashman: So it felt good. But it doesn't sound like you necessarily had the first bite and we're like, oh my God, I'm back. 

Abigail Keel: [LAUGHS] No, I don't think so. It definitely was nice to eat food that tasted really good. Maybe the most thing where I was like, "I don't care, I'm still doing this anyway", was I did eat like a cardamom bun every morning. They're technically Swedish, not Danish, but they have a lot of them in Copenhagen, and they're really good. And we were, like, staying close to this bakery. And I was like, "I have to have one." So on the first day, I ate one and I was like, "Well, I didn't get sick today, so ... [LAUGHS] Maybe I'm safe?"

Dan Pashman: Right.

[LAUGHING]  

Dan Pashman: Back in New York after her trip, Abigail was feeling good. Finally, some of that pressure had been released. She went through the entire fall, all through the holidays with no vertigo. It was the longest she’d gone with no attacks since she’d been diagnosed. She tasted her neighbor’s Christmas cookies without asking for a detailed list of ingredients. On New Year's eve, she ate a few chips. Salt was no longer feeling like a monster lurking in the dark. Finally, Abigail had things under control. But then, in early February … 

Abigail Keel: Boom, it came back. And that I was like, "No! No."

Dan Pashman: Abigail was in bed for days. She missed a friend’s birthday party. She immediately slipped back into worry and anxiety. 

Abigail Keel: Oh, no. You know, I'm gonna have to go get serious about this again. I really messed this up. Have I loosened it up too much? I was also just confused, like, wait a second. I had these moments where I was eating salt and I didn't have vertigo, so is it the diet? I was just like, what's happening? What do I do? What can help me? Because I mostly just really don't want to have this vertigo.

Dan Pashman: Abigail felt like she was back where she started, at the mercy of her body. Worst of all, after all this focus on her diet, there didn’t seem to be a direct connection between how much salt she ate and how many vertigo attacks she had. She went back to her doctor.

Abigail Keel: I told her I was like, "Look, I did the diet and I did it good, and then the vertigo came back and it still didn't help, so what do you think?" and she was kind of like, "Yeah, well, if you haven't noticed it working for you, then yeah, I wouldn't do it anymore." And I was like, "Okay, cool ... Thanks."

[LAUGHING]

Dan Pashman: Right. That's one of those sort of maddening moments with the doctor, where you’re like, “Do you have any idea [Abigail Keel: Yeah.] what impact this has had on me in my life for months and months and months?” You know, they're not — I mean, some doctors, I think think about that more than others.

Abigail Keel: Yeah.

Dan Pashman: But that is frustrating. 

Abigail Keel: Yeah. And I told her I was like, "Look, I know this diet probably helps some people, but like, I really don't think it's helped me. And it actually was really hard. And if there are other options, I really think you should be sharing those with people." And she was kind of like, "Okay, yeah, that's a good note."

Dan Pashman: After this conversation, Abigail and her doctor decided to try some steroid treatments to help with the vertigo attacks. Steroids can have some serious side effects, which is part of why her doctor didn’t offer them initially. But ultimately, Abigail felt like they were at least worth a try. And they did help, but they didn’t make the vertigo attacks go away completely. 

Dan Pashman: Abigail was starting to accept that there was only so much she could control. Medical science doesn’t always have a neat and tidy explanation with a clear course of treatment. This might just be something she’d have to live with, something to manage. 

Dan Pashman: Then one day, a year after she first got that 1500 milligram advice ... something really weird happened. Abigail started to get the warning signs of a vertigo attack. First, she got that clogged, muffled hearing feeling in her right ear, where she can’t hear so well out of that ear, like when you have a cold.

Dan Pashman: Then the tinnitus came on, a faint ringing sound. She waited a couple days for the full blown attack. Then it was a couple weeks. Then a month. 

Abigail Keel: I just never had an attack and I never got the hearing back.

Dan Pashman: It’s now been over a year. Abigail hasn’t had a single issue with vertigo. But she also hasn’t regained full hearing in her right ear. This sort of progression of symptoms, including permanent hearing loss does happen to some people with Meniere’s disease. 

Abigail Keel: It can go into remission, is what they say. So I assume that's what's happening for me.

Dan Pashman: Just as suddenly as all her symptoms started, they changed. Right now, though, Abigail is very grateful she hasn’t had any vertigo attacks in so long.

Abigail Keel: I'm really just at the mercy of nature. And right now, I happen to be in a period where nature has blessed me. [LAUGHS] And I could be good for life. It could never happen again. I might just be in a period of time where it's not happening. They don't really know.

Dan Pashman: So how has it felt all these months now, on one hand, not having your full hearing but also not having an attack?

Abigail Keel: Honestly, it's a trade I'd make. If I could ensure the certainty, like if I could like Ariel from The Little Mermaid, [LAUGHS] if I could, like, sell my voice to Ursula to be able to walk, and I knew that trade was going to last forever, I would make it with the hearing. Like I would lose hearing in the right ear to never have the vertigo again. And it would be an easy trade for me. It definitely sucks. Like at a bar, it's loud and I can't hear people very well. And, you know, like, if I'm sitting next to my partner in bed and he's speaking softly, I have to be like, "What?!", you know?

Dan Pashman: I see. Why don't you switch sides in the bed?

Abigail Keel: You know, [LAUGHS] we really need to.

Dan Pashman: Abigail!  This is ... Of all the solutions that you tried for this issue ...

Abigail Keel: I know!

[LAUGHING]

Dan Pashman: Put him on the side of a good ear.

Abigail Keel: Yeah, we got to do that. 

Dan Pashman: Maybe you'd like it? But I think you might like it better to have him on the ear that doesn't work ...  [LAUGHS]

Abigail Keel: Maybe ...

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Dan Pashman: And where are you at right now with what you're eating? 

Abigail Keel: I eat whatever I want. [LAUGHS]

Dan Pashman: So you're back to the old Abigail?

Abigail Keel: I'm back. Yeah, I'm back.

Dan Pashman: No restrictions?

Abigail Keel: No restrictions. 

Abigail Keel: Yeah. And it's — I mean, I feel honestly just lucky. I think it's made me really, a lot more sensitive to the people in my life who do have dietary restrictions, whether they're allergies or health-related or whatever. And I feel like I can relate to those people in my life a lot better. And I don't know. I know that what they're going through is more than just like what they're picking at the table. It's affecting the rest of their lives, too.

Dan Pashman: Wait, was there a moment where you realized you had fully stopped caring?

Abigail Keel: [LAUGHS]

Dan Pashman: Stopped worrying about it?

Abigail Keel: I think it was probably, like, when I went to the cabinet and there was like low-sodium soy sauce and regular soy sauce, and I was like, "Nah, I'm just going for the regular," you know?

[LAUGHING]

Abigail Keel: It's all got sodium.

Dan Pashman: I imagine you grabbing the low sodium, like throwing it under the garbage, triumphantly ...

Abigail Keel: I did actually buy some no sodium, like, hot sauce. Hot sauce is a strong word for what this was. I don't really know what it was.

Dan Pashman: [LAUGHS]

Abigail Keel: It was not good. It was like tang sauce or something — I don't know. It was ... anyway ...

Dan Pashman: Right. [LAUGHS]

Abigail Keel: I bought some sort of, like, hot sauce replacement thing and I did throw that away and that felt really good. I was like, "I'm never gonna use this ever again."

[LAUGHING]

Abigail Keel: Goodbye!

Dan Pashman: Right. Do you feel like you get more enjoyment from food now than you did before?

Abigail Keel: Hmmm. Definitely, I like, appreciate and respect the, like, salty ingredients way more. I'm like, "Yes, the olives are bringing a lot to this sandwich!" [DAN PASHMAN LAUGHING] You know? Like, for sure.

Dan Pashman: How are you incorporating olives into a sandwich? Because they can fall out depending on your technique. 

Abigail Keel: Oh, you got to chop it up into, like, a little relish ... olive relish.  

Dan Pashman: Like a tapenade situation.

Abigail Keel: Yeah. Mm-hmm.

Dan Pashman: Got it. Okay. All right. 

Abigail Keel: Don't worry. [LAUGHS]

Dan Pashman: I got a little concerned.

Abigail Keel: [LAUGHS]

Dan Pashman: I pictured you picking up this sandwich, taking a — getting ready to take a triumphant salty bite, and then all the olives fall out the back ...

Abigail Keel: Pops out the back? Yeah.

Dan Pashman: Yeah.

[LAUGHING]

Abigail Keel: No, no. They're in there. They’re flattened. 

Dan Pashman: I should have known. I should have given you more credit, Abigail.

Abigail Keel: It's okay.

[LAUGHING]

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Dan Pashman: That’s Abigail Keel. She’s an audio producer and reporter and she’s currently working on a big project about the Colorado River. Find more info at her website, miragepodcast.com. And for more about Jessica Jones and what dieticians like her do, check out diabetesdigital.co.

Dan Pashman: Next week on the show, I’m talking with comic and actor Fortune Feimster, one of the hosts of the hit podcast Handsome. Fortune’s first special, Sweet and Salty, got into some of her favorite foods, from Hooters wings to Fun Dip. We'll talk about that, but we'll also get serious about how her relationship to her body has changed over the course of her career, and why her grandmother was such a big influence on who she is today. That’s next week.

Dan Pashman: While you’re waiting for that one, check out last week’s show about the legendary cookbook editor Judith Jones, who was largely responsible for the publication of both The Diary of Anne Frank and Julia Child’s first cookbook. That one's up now.

Dan Pashman: And hey, did you know that you can listen to The Sporkful on the SiriusXM app? Yes, the SiriusXM app, it has all your favorite podcasts, plus over 200 ad-free music channels curated by genre and era, plus live sports coverage. Does your podcasting app have that? Then there's interviews with A-list stars and so much more. It's everything you want in a podcast app and music app all rolled into one. And right now, Sporkful listeners can get three months free of the SiriusXM app by going to SiriusXM.com/sporkful.

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Dan Pashman: Thank you to our presenting sponsor American Express. AmEx Gold makes your dining experiences more rewarding so you can discover more, connect more, and experience more dining moments. Elevate every meal with the benefits that come with American Express Gold. For terms and to learn more, visit AmericanExpress.com/withamex.