Wednesday, October 19, 2005

Illness & Food

Had one of those moments of crystal-clear realization tonight...regarding just how sick I am & how it came about. Funny, you don't really look at something when you're in it, living it all the time. But tonight it sort of became clear for me all of a sudden as I was thinking back on some friends of mine that passed away a few years ago. I was thinking back to a time when we were all together in the adjunct instructors office at the college & we were talking about things without any possible realization that in very few months 2 out of the 3 of us would be alive no more. (I still can't believe they're gone, if you want to know that truth.) That I'm alive & they're gone amazes me, sometimes.

This was back in about 2000. I was already showing signs that all was not right with my heart. I had felt increasingly out of breath until once when I was in the hospital for an overnight stay to check on my sleep apnea that my lack of O2 showed up on one of their measuring instruments. I was down about 86% O2 saturation. anything over, say 96%, is considered normal. I think my doctor was stunned by this discovery, although I had been telling him that I felt out of breath all the time. He had thought it was just part of my weight issues, & never put me on a meter in the office to find out.

I was having problems with the Achilles tendon in my left leg, so I was already walking very guardedly to protect it, as I was afraid it was going to snap & I would be forced to have surgery to repair it. So I walked a little more carefully. Going up stair were a problem, so I always tried to use the elevator to avoid this extra strain. I was teaching classes--up to 4 a semester, part-time--and also working part-time at the credit union. I had just divorced a few years ago & had no safety net. I had to work, & so I juggled all I could in my life just to keep things going.

From that time on, my heart steadily declined, until I am where I am today. I had to quit teaching in 2002. Now I'm at home, living on disability, & quite limited in what I can & can't do. Mostly, I feel really wretched...body-wise. I must take many medications & the side effects are formidable. I feel like awful. Now I'm not telling you all this, dear reader, to garner your sympathy or anything like that. Actually, tonight I am mainly trying to work out the chronology of how I came to be like this. Like I said, it's difficult to be able to assess a situation when you're living it.

Next, to add to my list of health problems came the diabetes, & then the muscle problems in my legs. At first, I didn't pay much attention to the lack of strength I was feeling...I thought that this was part of the problems with my heart, that it limited my muscular strength as well. And to a certain point I'm sure that's true. But as this weakness increased, I was forced to examine it more & more. So I underwent a battery of tests & diagnosed a form of muscular dystrophy: inclusion-body myositis. Well. Ok. Now what? Not much I can do. It's slow-moving, thankfully, & I'm trying to exercise to, first, aid my heart, but also to work those thigh muscles daily. I suffer some muscular pain that I assume is connected to this, but this is no where as great a problem to me as the arthritis that I now suffer in my hips & knees. Sometimes, quite regularly, actually, it will wake me up from a sound sleep until I must wake up & change positions or take some acetominophen. This arthritis comes as part of the aging process, but certainly more because of the extra weight that I carry & have carried for most of my adult life. I've done this to myself.

But for the first time in my life, I am exercising on a regular basis. At least 5 days out of the week, 20 minutes on the treadmill. 20 minutes seem like nothing to you? Hoo-hoo!! It took me ages to get past 15 minutes! And it is helping. My legs hurt less often & I can feel a gradual lessening of my belly fat (something that is very important to heart health, actually). I've even lost a few pounds. And it's funny, you know, because I feel so guilty if I miss a day. Drives me crazy with guilt! I get up in the morning (or P.M., sometimes), drink some tea & head downstairs to walk, most days. Having the TV right there makes it great because I don't think I'd be able to keep this up without something to put my mind on while walking. It IS boring! But it is also good for my heart, & that's a huge criteria for me in what I can accept & keep in my life these days. I'm on a mission of survival.

This is what what I eat is so important as well. Food as medicine. It IS! And if you think it isn't, have another 64 oz. slurpy & let's have this talk again in 15 years. I am wracked with guilt about eating foods containing white flour or sugar, these days. I try to counter-balance this by eating the RIGHT foods most of the time. But it is hard. Especially for me, as an acknowledged food addict. Being a foodie aside, I also have a definite addiction here. And one that I won't be able to stop! So I have t0 learn to deal with food. And right now I'm coming to recognize--through keeping a food journal--my problems lie mainly in portion control. Of course, I could watch what goes through my lips a little better, but all in all, I have a pretty good handle on what I eat. Now if I could just do with less of it. But keeping the journal helps me to stay real (although sometimes I get sloppy & lapse a few days).

More about food choices later...

Wednesday, October 05, 2005

The Holidays

I'm already thinking about the menus coming up. We've got my cousin from CA & her family coming for Thanksgiving, & I'm already formulating the perfect feast for that. But an Instant Message conversation that I just had with my nephew in Japan brought me back to holidays with my family when I was a little girl. Even though my parents were both avowed atheists (they had both gone through Catholic grade school), Christmas was a big deal -- food wise. And my father's Italian traditions were duplicated as well as could be expected in our big, new suburban home. After all, this was probably the first generation of his family ever to break the cycle of real poverty and to make it to the middle class, so even if our holidays lacked a religious context, they tried to compensate by going overboard with the food. And it was something incredible to behold!

Christmas Eve (La Vigilia to some Italians) was a non-meat designated day, & by God, even my atheist parents followed it. So all the courses had to be fish-based. My dad would prepare for this the week before by going around from store to store where he knew the freshest fish & seafood could be found, & sometimes I came along for the ride. There was always a "white" pasta course -- spaghetti al'olio -- a simple pasta dish dressed with olive oil & garlic & parsley. And then came the seafood. Baccala -- dried codfish -- which had to be soaked for days, changing the water several times. Then came the octopus & squid. This took a lot of time to clean as they often came frozen in a solid block of ice. I remember helping to strip the membrane-like skin from the squid, pull out a "plastic"-looking piece & cutting them into rings & tentacles. Then there were the shrimp & lobsters. (Funny thing: days after cleaning these, the top layer of skin on my hands would begin to peel off!) Again, labor-intensive, with the vein that runs along the back of the shrimp having to be cut out. There might be some oysters, clams or mussels, depending on what was available at the fish store. And I remember one Christmas where he had bought a box or bag full of snails & put them into the refrigerator, only to discover later that they had somehow gotten out & were climbing all over the interior, to my mother's chagrin. Then came the courses of various types of swimming fish -- whatever looked good & caught my father's eye at the time.

Generally, it was agreed that there had to be at least 7 fish courses among the Italian Catholics (or maybe 9), but my dad didn't feel pressed to observe this. He just wanted to present a bounty to his family & friends on that day. Late in his life I remember that he had discovered a recipe for a new fish stew that was creating a sensation in San Francisco at that time -- Cioppino. It was a bouillabaisse-like creation full of all sorts of seafood, & he was years ahead of anyone around here in finding it.

Now you might think that I was enjoying all these dishes too, but nothing could be farther from the truth. At the time, I complained bitterly that we weren't eating what "normal" people would eat for Christmas, and why couldn't I have a hot dog or something? I wasn't eating that weird stuff! All I would eat was the spaghetti, & maybe a shrimp or two, or a little fish. That was it. Later, when I was 16 & in Spain with my mother, I had some mussels & got deathly ill in a hotel room overnight, & we had to call in a doctor. From that point on, I determined never to eat any sort of mussel, clam or oyster because it seemed that I might have some food allergy to them. As I look back on this now, it's probably more likely that I just had a bad mussel in that stew, & got sick from that. But I'm not really willing to try again at this late date because I really, really hate to be sick to my stomach.

Christmas Day was better, in my eyes. There'd be a flashy pasta dish -- something with tomato "gravy" (as my father always called the sauce) -- maybe lasagna, ravioli of ricotta & spinach, or potato gnocchi. This was served with whatever meats went into the making of the gravy (which was a 2-day affair, by the way), usually pork neckbones, or meatballs, Italian sausage, a piece of beef, bracciole, a chicken, etc. Then the main meat course, which might be a large beef roast, roasted cornish hens or chickens, or something like that. Something flashy. Then came the side dishes, always including a salad dressed as my father always did, with olive oil, red wine vinegar, garlic, salt & a little oregano. These would also include roast potatoes and other vegetable dishes. There would be Italian bread & a gallon of good, basic red wine which was served in small juice glasses rather than in wine glasses (In fact, I remember we used the glasses that small shrimp cocktails came in). My step-grandfather's glass kept getting refilled a lot, as I recall.

In the midst of all of this, my father was officiating over everything, just like a conductor leads an orchestra. Everything had to be perfect, and he was clearly pleased with himself. I was 10 or less, at the time, & thought this would never end. Within 3 years, he was gone. I think back on those times & remember little bits & snatches of the music he'd have on the hi-fi (Mario Lanza or some Christmas music), the Christmas tree upstairs (which he always decorated like a big kid), my presents (the pink mohair sweater & "ghillies" shoes), my cousins & I running around & playing with Barbies. The colorful Christmas candies filled with some sort of jam, the antipasto which included black olives which us kids would "wear" on our fingers, the bubbling, excited feeling I got for this day & how fast it was over! By the end of the day, I melted into my bed like a blob of warm mozzarella. I had had enough partying for a while.

We don't realize just how much our children are recording all that goes on around them on these important event days. How much they retain! It's important to keep that in mind & try to build on those memories by keeping them happy ones (if possible). Today, my children & our immediate family have started to come together each week at least one day of the weekend to cook & eat together, & it's been really nice for everyone. I'm sick, my mom's 83... who knows how much longer any of us really have here together. It just makes sense to get together as a family. It's not always sweetness & light either -- there's been some arguing (mostly my mom & I), but nothing serious. It comforts me to have my kids around me & I hope these family traditions will live on with them & their kids. We made gnocchi last Saturday together. It was nice. But just wait until Christmas. This year: bigger & better!

Tuesday, October 04, 2005

Food Journal

I've been keeping a food journal on & off since the beginning of August. At first, I missed a lot of days, but later on when I got into the habit of it & realized it was actually good for me to know what I was eating, I've been doing it every day. For one thing, it makes you think before you pop something in your mouth. Even though the doctor who asked me to do this (a cool cardiologist -- if you're reading this, hi!) didn't tell me to change my eating very much--she knows I have a good sense of nutrition -- it DID make me aware of my problems with portion control and what it was that I'm eating. Here, I always prided myself of really knowing about which foods were good for you & which were bad, I have come to see that I'm not following my own rules very well. For one thing, even though I make a concerted effort to get in several servings of fruits every day, there have been long stretches when I don't take in any vegetables other than a sandwich or an ocassional sliced tomato with eggs in the morning. So much for being so smart!

I have also come to realize that it's hard to eat all the things that you're supposed to within a 24-hr. period. And can I say it? It's sometimes boring, too. Yes. Boring. Fruits & vegetables, fruits & vegetables... what do I look like? A squirrel? I want goodies sometimes, and I want carbs & meat most of the time. Sorry, but it's true. I especially crave rare red meat. My Paleolithic genes are kicking in. And carbs? Gnocchi, pastas of all cuts & sizes, Chinese fried rice, Italian bread, flour tortillas... Not much fiber or whole grains there. Aarrgh!!

OK, ok. I know that for me with my myriad health problems, I have better get with the program & eat right, exercise daily & get some of this weight off or I won't be around to enjoy any foods any more. And I do so enjoy food. For so many years I felt guilty about loving food as much as I do. But now that I discovered the Food Network and the many "foodie" blogs online, I know I'm not alone! There's a lot of people like me out there who really love to eat & think about it often (some, very often). So why be ashamed of it? Were the Chinese ashamed of their preoccupation with food as they developed so many wonderful dishes over the centuries? No way! They took food to a new height as an art form -- cutting each bit of vegetable or meat to be exactly mouth-sized so as to maximize the eating pleasure. I have even caught myself dreaming about food on several occasions & even chew (!!) in my sleep. Yes, chewing, & the dentist showed me the wear present on my top front teeth interiors from doing so. So '86' the guilt & let's look at food in a new light -- seeing as we can't go without it.

So, my new plan is to increase the veggies & work on portion control. I'm sure all my problems with food would be enough to spend a few years on a psychiatrist's couch to work out the reasons why I feel I have this "void" to fill within me with food. When it comes to food, I lack objectivity. I have this feeling that it's my god-given right to eat that piece of pie. And if you want to ban it from me, then you don't really love me. Sounds a little like I'm stuck in childhood, doesn't it?

It's hard to make real changes in life. Damn hard, but not impossible. I gave up putting white sugar in my tea when I was diagnosed with Type II Diabetes. Now, I'm super-sensitive to sweet things. Salt, too. I lightened up my use of salt with my high blood pressure & water retention problems. So now I can't eat a normal cracker without it tasting too salty. I've gone to the low-sodium type. And I'm still standing! We drink only 1% milk at home, & I suspect that we could go to skim milk if we really had to, but I have a teenager still in the house who loves cereal & milk & it might be hard for him to adapt.

To add to my problems comes the issue of Metabolic Syndrome. BIG controversy raging over this right now, between the diabetes doctors and the heart specialists. Basically, it's a turf war. Which group has dibs on this condition. The endocrinologists say they do -- after all, it's mainly an issue of blood glucose levels. Cardiologists say, not so fast. This group of health problems can affect the heart & circulatory system without the individual ever knowing what hit him. In fact, they now think this accounts for a large number of heart attacks. But however you want to slice it, this stuff is nasty & everyone who has a problem with a large "middle" ought to google it right now & get informed. You may have it. Or be well on your way to getting it.

Here's what it is: (basically)
1. High blood pressure
2. Type II Diabetes or Insulin Resistence (a whole 'nother story)
3. Abnormal cholesterol -- high triglycerides & low HDL
4. "Trunkal obesity" -- a big stomach (apple-shaped, rather than pear-shaped)
Put them all together & they spell TROUBLE for you. Find out more about it if any of these fit.

What can be done about it? Diet & Exercise. Same ol', same ol'. That's it. That's basically the bottom line. Sure, they've got medications for diabetes & high blood pressure & the newer "statin" drugs for cholesterol reduction, but diet & exercise is the key for really reversing it. And losing weight. Which is what started me off on this direction in the first place. I'm not going to say how much I have to lose, but I'll be happy to report any successes with you. My first goal is 10% of my current body weight. Since I've been food journaling, I've lost 4 lbs. Just for writing it down each day. So it's a start. And don't even think of leaving off that cookie! Tell the truth. You're only cheating yourself.

Thursday, September 29, 2005

Minestrone/Minestra

1. Meat
2. Beans
3. Greens
4. Vegetables
5. Pasta or rice
6. Cheese

What’s not to love about this most famous of Italian soups? Nutritionally speaking, it’s got it all. Frugally speaking, it’s a good way to clean out your refrigerator of all those leftovers & odds & ends that you’d probably wind up throwing away in a week. And it goes to a very good cause. A food that is close to perfect—well, depending on what you put in it. Of course, if you load it up with fatty meats or sausage or bacon, and loads of cheese, then you’ve defeated the purpose. But if you’re careful, and wise, you can produce a food that keeps on giving & evolving as the week goes on. On Sunday, it may be minestrone, but by the week’s end, it may become minestra (sort of a stew) as it thickens & you add things. With a loaf of crusty, whole grain bread and a salad, you’ve got a quick & easy & very healthy meal. Or, it may just be the soup course in a larger meal. See how versatile it is? I love it!

But I have to admit that I didn’t always love minestrone. As a kid, I hated it. It was full of boring vegetables & there were always some big red beans in there to ruin it for me. I just couldn’t see why adults went so gaga over it. But now, as an adult, I understand better & my tastes have changed. I know that this food is good for me. That the sum total of all of its parts has the properties that my body really needs for optimal health. Besides, now that I’m in charge of the kitchen, I can decide what to put in it—and what not. I can avoid the items that I or my family doesn’t like, and be sure to add the things that we do. And I can make sure it tastes good.

I've changed a lot about how I view food over the past few years. Things that I would eat with wonton abandon years ago, I can no longer have, not that I am ill. I have gotten to the point that I feel really guilty when I'm eating things that I know are made with (for example) white flour or white sugar, so that I can't really enjoy them anymore. I know that sounds a little neurotic... After all, it's only food. But I've come to view food as a sort of "therapeutic agent." It not only nourishes, it can also heal. Yes, food as medicine. And when you're ill, you take that pretty seriously, let me tell you.

As for recipes, check out any Italian cookbook for a basic one to follow & then adapt it to your own tastes. You really can't go wrong. (Do you really think all those Italian mamas over in Italy are consulting cookbooks on how to make soup?!) Mario Batali has a good one at the end of his "Holiday Food" book. Make a steaming pot of soup today as the weather is changing & it gets colder. It can really make you feel good!