Tenhaken lives with Celiac disease, an autoimmune disorder that affects the digestive organs. It affects nearly one in 133 Americans. Tenhaken, like other patients with this disorder, cannot tolerate foods that contain gluten. This includes any product made with wheat, barley or rye -- the main ingredient for most bread, pasta and other carbohydrates.
"I've had digestive problems all my life, but wasn't diagnosed with Celiac disease until 1999, after all other testing was exhausted," said Tenhaken. It is considered a genetic disease, but "I'm the only one in my family who has tested positive," she said.
The symptoms of Celiac are similar to those of irritable bowel syndrome and other intestinal infections. According to Nurse Practitioner Valerie Savina of Holland Hospital, patients usually suffer from "chronic diarrhea, malabsorption, weight loss and abdominal distention."
This is in sync with Tenhaken's diagnosis. She underwent blood tests and a "small bowel biopsy" to diagnose the disease.
There is no cure or pill to treat Celiac disease; it's all about management.
"The cornerstone of treatment of Celiac disease is the elimination of gluten in the diet," said Savina.
The risks of not following a gluten-free diet can be dangerous. Even though patients may feel "clinically well," they may have a variety of "deficiencies that may ultimately have clinical consequences," Savina said.
Because Celiac disease interferes with the body's ability to absorb nutrients, left untreated, it can cause cancers of the small intestine, bone loss, short stature or miscarriage or congenital malformation in the unborn baby of pregnant women.
Tenhaken describes her diagnosis as a "tough and challenging transition."
The first thing she did was to educate herself.
"I read everything I could get my hands on," she said.
Becoming gluten-free is difficult and can be life-changing, said Tenhaken.
"I love bread and pastas; they're my comfort foods," she said.
Health-food stores are where she first went, but the conventional grocery chain Meijer also has a gluten-free aisle, and she was "pleasantly surprised" with the variety of foods available.
"I found bread made from rice, soy or arrowroot; pasta made from rice, corn or bean flour; whole-grain corn and rice cereal; crackers made from rice and nut flours," she said.
She incorporated those products in with a diet of fruits, vegetables and fresh meats.
"I tend to stay away from any processed foods," she said, because there could be hidden glutens in the ingredients.
Sticking to a gluten-free diet while on-the-go can be tough. For Tenhaken, going out for a meal can be challenging. She avoids Italian restaurants.
"I have yet to find a restaurant in this area that offers gluten-free choices," she said.
Normally she sticks to fresh foods without sauces or gravies, "since those are usually thickened with flour," she said.
Dessert is another difficult area. She can't have any traditional pastries or cookies, but she has found some good alternatives -- gluten-free mixes for cakes, cookies and brownies all available at local grocery stores and health-food stores.
"They taste great. You can't even tell they're gluten-free," she said.
Some local restaurants offer a flourless chocolate torte that is "really rich, delicious and satisfying," she said.
Tenhaken didn't always have such a positive outlook on her disease.
"I felt a little sorry for myself, having to give up foods that I really enjoyed," she said. However, after making the transition to the gluten-free diet, "I discovered that I wasn't missing much at all, and the health benefits have been huge."
Tenhaken admits that she occasionally strays.
"I go off my diet when I get a craving for some really good thin-crust pizza or a fresh bagel," she said.
When this happens, she usually pays for it the next day with a relapse of symptoms. Sometimes she gets lucky and there aren't any symptoms from her divergence, but "that doesn't mean it's not hurting me," she said. "Even small amounts can be damaging."
For more information on Celiac disease, go to the National Digestive Diseases Informational Clearinghouse at http://digestive.niddk.nih.gov/index.htm or talk to local health professionals.