Change is good

This week, I made a big decision. It will take along time to put into action, but in my gut it feels right. I'm going to let go of a dream that has been dead for a long time now. I'm very fortunate that the change I'm going to make can be done slowly, and in a way that shelters me from uncertainty, but it will be a big change. Looking back, I realize that I have been working hard in the last few years to make positive changes, but the paths I followed were dead ends. It's time to cut it all loose.

No more gnashing of teeth, no more chasing my tail, no more struggling, mired in the Slough of Despond. It exhausts me; it is dreary, and boring, and it could go on forever while I sink in over my head, every semester, and gasp and drown and flail.

I hereby declare that my war on reality is over. I surrender, and I'm going to move on. I have tried valiantly, and then foolishly, to change things I cannot change. (Because it wasn't FAIR!) They are not going to change. I, on the other hand, have changed, and need to make change, for the better. I'm must try to move forward  from possibility instead of fear. The fears have not gone away, but now I also feel a sense of certainty that I have always trusted in the past. This feels right.

Already, I am flooded with relief and eagerness for the future. At the same time, I'm humbled to recognize that I have choices that most people won't have. I can't, I won't let fear prevent me from making them.

Small steps.
I'm taking a medical leave to regroup, rest, recover. I'm leaning on my medical team: changing medications, working to find the right therapist, doing my spiritual homework.
So much clutter. It's time to cut it loose.

Argle Bargle

One step out the door. I'm requested a medical leave today, something I should probably have done two months ago when I fell into the Slough of Despond *shudder*

Maybe I put it off because the round of paperwork, phone calls, and permission is so daunting,  argle bargle. I have been waiting two months  (TWO MONTHS) for a medical appointment with a specialist because the only way to be seen any sooner would have been to check myself into a hospital. Which I very seriously considered, but then I decided to hold out as long as I could.

Is it an omen that when I got home the cat had barfed on the bathmat and peed on a blanket in his basket on the porch? I think I need to take him to the vet, poor baby.

Resaca

After a year of relentless psychic brutality, the campaigns are over. I'm feeling physically and mentally battered. I need to do some kind of cleansing ritual.

Changing eating habits, or, remembering what I know

The temptation of turrón

One of my favorite Wellness resources starts off with the step "Remember what you know."  So much of making positive changes is not about learning something new, but remembering and applying knowledge you already have, often by overcoming the inertia or other obstacles that have arisen around patterns of behavior. Until I had a child, I never had to diet to keep to a sensible weight, nor did I own a car until I was 34 so I was in reasonable shape just form walking and biking, even after I stopped playing sports like volleyball or softball in college.

After last two weeks of truly heroic holiday feasting (Spanish food is so good!) I was--am-- more than ready to make some changes. I crave salads, greens, vegetables, and feel no appetite for sweets. My new year's resolve to try new recipes and start dancing again are a good start to getting back into my previous good eating habits. From experience, I know that I have to find a new set of habits to latch on to so I don't drift back into bad habits.

The U is on a big Wellness campaign, and has provided some serious incentives this year: if you accumulate 300 points by carrying out a set of wellness activities from their offerings, you can get $300 of your health care plan costs next year.
Comparing my responses to the annual Wellness survey, from over the past few years, I see I have done better at managing the symptoms of my depression AND my back pain.  But I have gained weight and become more sedentary, and I don't like having a menopot. I'm also having a recurrence of the frozen shoulder on the left side, so I need to do some active pain management: this was an incentive to sign up for the phone health coach, and I know that exercise (the right kind) will be key.

My two downfalls, ever since I started taking anti-depressants, have been nervous impulse eating, especially right before bed, and portion control.  I also eat too fast. So, remember what I know: don't skip breakfast; protein with every meal; no refined carbs or empty sugar (no pastries or alcohol); five small meals a day works better for me than three big ones.  In fact, I know that if I plan my food buying, prepare food on Sunday, pack my Mr. Bento, and record my eating for a month or two, I'll be back on track. I also know that returning to my former level of physical activity is possible, but I'll have to take is slowly to not go into a fibro flare.

The "MyFitnessPal" app gives me a way to record what I'm eating and get fairly quick calorie/nutritional information because it draws on a huge database of both commercial products and home-made recipes entered by users. I set a weight goal, get a calorie threshold that will allow me to lose weight slowly and steadily, and then record what I eat and my exercise; it shows me the calorie readouts combining calories eaten and calories burned, and makes predictions as to what I will weigh if keep up with a given day's pattern. So far, it has not been hard to use, either on my phone or on my laptop, and it was free. I want to see how well I can do with this for the Spring semester.

It also warned me on the first day that I was eating too few calories, which might prompt my body to go into "starvation"mode and defeat the slow weight loss purpose. I want to become more fit, not lose weight fast. So I could have had that second piece of 12-grain toast with peanut butter for breakfast, and still kept to my calorie goal.

Paying attention to health eating goes very well with saving money (don't eat out or sit around in coffee shops), so I get to pat myself on the back.

re: plans

Amanda Palmer and her ukelele: "In My Mind." Read the story of the making of the video here.
(via The Bloggess)

Vitamin D deficiency: do you have it?

About 3 month agos, I discovered that I was severely deficient in Vitamin D. I had gone in to see my back doctor because my chronic pain and fatigue symptoms of fibromyalgia had gotten worse, and I had new pain associated with back problems. The doctor ordered some blood work to rule out rheumatoid arthritis (which a family member has) and a few other things. The results were surprising.

One of the blood tests they did is called VITAMIN D, 25-OH. What one hopes to see is  a blood level within the standard range: 30 - 80 ng/mL (Over 80 can be toxic).

The Optimum Level: 30-80 ng/mL
Insufficiency: 20-29 ng/mL
Deficiency: <20 ng/mL

My results? 19 ng/mL, or "severe deficiency." No wonder I felt like crap! I have no idea how long I have been this way.

My primary care doctor put me on a regimen of megadoses, once a week for 12 weeks, to replenish the supply in my body. Since Vitamin D is a fat-soluble vitamin, it is not enough to just take a daily dose in order to recover; one has to build up the stores in the body. This is why you should get your blood tested to find out what your levels are, rather than just popping supplements. In addition, you can get too much Vitamin D, and this can cause significant problems.

After the 12 weekly doses, I was retested, and my level is now up to 40 (yay!) but I'll need to continue to take daily supplements, because even sun exposure and drinking milk are not enough at these northern latitudes.

One thing I noticed after four weeks of treatment was that I started to remember my dreams, to the point where I wondered if I was metabolizing my anti-depressants differently (they suppress my dream memory). I also noticed a huge improvement in my digestion and regularity (ahem), a major life improvement. Most significant is a noticeable improvement in   levels of daily pain, fatigue and inability to focus. The more I read about recent research on Vitamin D's role in metabolism, the more I believe that everyone can benefit from finding out what their levels are, just as we do for cholesterol, iron, or other important metabolic factors. Research is showing links between adequate Vitamin D levels and protection against skin cancer, Crohn's disease, colon cancer, autoimmune disorders such as rheumatoid arthritis, and other conditions.

My mother, who is recovering from chemotherapy, has been having excellent results from her treatment, but also was tested and discovered she was Vitamin D deficient. I'm hoping her treatment will also mean less fatigue and pain for her.

Personal Trainer for "porky kookaburra"

From the comments to my post about fitness:

Poor baby! fed so many sausages she got overweight and unable to fly away from the dogs.

And here is what they sound like!

How a flu virus reproduces (NPR story)

Using animation tools from Zirus. My poor baby has the flu, so miserable!

Al Franken makes a point about health care coverage

I'm so proud Sen. Al Franken is representing me! (via Post-Bourgie)

Celeriac is in season

One of the treasures last week in my CSA box from Featherstone Farms was celeriac (also called celery root, or céléri rave in French). It's a round root vegetable, about the size of a softball, maybe a little bigger.
The surface is brown, warty and tough, rugged with rooty knobs. For some reason, it inspires people to think of trolls! The Dutch use it in their hearty soup stammpot, while the French make céléri rémoulade with a dressing that combines mayonnaise and mustard, and maybe capers or cornichons, depending on your taste.

You can boil it whole in the skin, which takes about 45 minutes, but I'm much too impatient for that, so I like to peel it and boil the pieces. Instead of trying to peel it with a paring knife, it's best to remove the tough peel like a pineapple, by slicing from the top down along the sides. Take your sharpest chef's knife, or even better, a long serrated bread knife (I use my Ginzu knife that I bought at the State Fair from that one guy whose sales patter is a tour-de-force of performance art).

Slice off the top and bottom ends so you can sit it flat and it won't slip. Then, slice from the top down along the side to remove the tough outer layer, revealing the pale fragrant flesh underneath. I love the smell!

The texture is not quite like that of a potato or a jicama, and not quite the same as a turnip's. The odor is between that of fresh celery stalks and celery seed. If you use a knife that is not stainless steel, it will discolor faster and maybe take on a metallic taste, so avoid that. If you're not going to cook it right away, or if you are using matchstick sized pieces raw in a salad, in the French style, put the pieces in a bowl of water with a splash of lemon juice or vinegar to keep them from discoloring.

I just chopped it into chunks and put it in a pot of boiling water immediately. It takes about 8-10 minutes to cook through, or, you can wait until the water comes back to a boil, put a lid on the pot and turn off the heat, and let it sit until cooked through while you do something else.

The cooked pieces can be eaten plain, speared out of the pot, but it's commonly dressed with mustardy vinaigrette, mashed with potatoes or carrots, or used just about any way you'd use a potato. Save the broth for vegetable stock or use in a soup for a subtle flavor.

This NPR story by Jack Staub (from the series Kitchen Window) is a loving ode to celeriac, and has a recipe for celeriac french fries! But these recipes look more my style (I'm deathly afraid of frying things in oil), especially the hearty soups. Celeriac also pairs well with green apples or pears. I think I'll use it with some of the fresh tarragon Loren gave me.

A civil conversation about health care reform

Senator Franken talking to folks at the State Fair, in a calm and rational way, and people respond in a calm and rational way. Intense? yes. But this is a model of how we can do it right.

Mustard greens

In my CSA box from Featherstone Farms today, there were four kinds of tomatoes (little yellow ones shaped like pears, orange sweeties, a greenish-red heirloom, and several roma style cooking tomatoes), summer squash, bell peppers, basil, red onions, green beans, salad greens, cucumbers, and a bunch of mustard greens. I love my CSA deliveries! Opening the box is like opening a gift every week.
I often crave greens, any and all of them, especially bitter greens. I washed and ripped the leaves off the coarse stems, and cooked them down in the water left over from steaming the beans. I ate some with my salad, and put the rest in a container for later. There was almost a cup of broth left over, and I'm drinking it now. I like the flavor, and mustard greens have a huge amount of vitamins A and C, as well as other nutrients.
Nutrition has always fascinated me, and I just discovered asite called Nutrition Data, a good source of basic information presesented in the familiar USDA label format. An even better site is World's Healthiest Foods because it gives detailed explanations of the health benefits associated with the nutrients in specific foods. The entry on mustard greens explains why mustard greens might be particularly good for the lungs, the liver, and the joints, but not so great for people who have kidney or gall-bladder problems (because of the presence of oxalates). It reminds me of the kind of information that fascinated me when I started using Laurel's Kitchen to cook with, many years ago. The New Laurel's Kitchen is practically a textbook of nutrition as well as a cookbook.

Here is their list of the "worlds healthiest foods," (129) of them, according to these criteria: nutrient dense, whole foods, that are familiar, available, affordable and taste good.

Anatomy lessons the hard way

My poor sweet baby took a tumble yesterday and hurt her ankle (she may be taller than I am now, but she'll always be my baby girl). When I saw how swollen it was, I flashed on when I broke a bone in my foot a few years ago and was afraid she might have done the same, but it's a painful, nasty sprain (a Grade II eversion sprain, if you want to get technical) nothing more. I'm glad nothing is broken, but it will be a few weeks wearing an ankle brace and an ace bandage, probably a week at least of evil crutches, and a month for full recovery. What a bummer. We are so fortunate that we have good medical care. Every single person who helped us at urgent care was wonderful to her. She even got to ride in a wheelchair for a little, which is sometimes the only highlight of the tedium of waiting around in a clinic on a beautiful Saturday afternoon instead of going for a walk. It was very cool that the doctor let me look at the X-rays on the computer with him (being the physiology geek that I am). They can see so much more know because they can zoom in. My daughter has lovely bones!

When I was six, I had my first of what would be four ankle sprains, and two twisted knees. The treatment then was a plaster cast for six weeks (and apparently there continue to be arguments about the best form of treatment for sprains!) prolonged immobility is no longer the fashion, but there are arguments to be made for "giving the foot a holiday" for the first phase of treatment. I spent so much time in those freakin' casts. A plaster cast is still the best for a complete ligament rupture (Grade III) but I'm sure mine weren't that bad, and I know that at least two of the sprains were re-injuries because of atrophied muscles and no rehab. I got very good on crutches and also enjoyed a lot of plaster cast artwork. But now, the emphasis is on evaluating each injury and beginning to strengthen the ankle and leg muscles (without pain) as soon as possible so as to prevent further injury. For now, she is doing homework, drawing, reading, and listening to music while I dose her with smoothies!

Coincidentally, my daughter also just found an amazing T-shirt that has a drawing of internal organs on it (yep, she's my daughter). And I just found this great blog Street Anatomy, where artists combine medical illustration with all the ways people (not just artists) are using anatomical drawings, for art, fashion, furniture and more.

Atul Gawande

Dr Atul Gawande is a physician, a teacher, an public policy leader, and a writer. His columns in The New Yorker magazine have been some of my favorites pieces of the last few years: filed under "Annals of Public Policy" or "Annals of Medicine" but also "Annals of Human Rights," they talk about subjects ranging from blushing or nausea to solitary confinement as a form of torture. His books on being a surgeon have won awards, and his research and work on improving the safety of health care, among other topics, are important contributions to public health and safety worldwide. Having read his work now for a number of years, I have trust in his ability to communicate complex scientific and social issues in clear, compassionate terms to the general public, but in ways that avoid oversimplification.

His article on how Obama's administration should approach the urgent need to reform our system of health care does something important: it gives us the historical context for understanding how the variety of European national health care systems emerged as responses to particular local arrangements and needs, rather than as ideological master plans; it places the pragmatic approach as an alternative to the idealist (but potentially dangerous) or the free-market (and ineffective) approaches. And it talks about how Massachussets' recent state-wide reforms give us a glimpse of how a national health care reform might work. Here's a bit of an interview with him on Charlie Rose's show:

He reads from his book at a talk he gave for Google employees here. I'm not embedding it because they chose to film him against a hideous yellow background, and positioned an icon of a book right in the back of someone's head. But the story he tells about his medical training as a resident is fascinating: he is fascinated by the intersection of intelligence, competence and those other less well-understood elements of performance that make one doctor better than another. One of his strengths as an intellect is in his ability to think from the local and the material to the level of the global and the systematic.

A tiny bit of wisdom, after all these years.

I had my wisdom teeth taken out when I was about 22-23. I only had the two in my lower jaw, so I was lucky that it wasn't more painful. In the past month or so, I've had terrible toothache and jaw pain on my left side. It felt as if a tooth was cutting through the gum on the inner part of my jaw, below the place where the wisdom tooth would have been. Was it possible to have another wisdom tooth? Why could I feel this hard bony or toothy protrusion, cutting through the gum when I touched it with my fingernail? My dentist said it was possible that a tooth fragment from the original wisdom tooth removal had worked its way to the surface over the past few decades. I am about to go to an appointment to see if there is anything else wrong, but yesterday, it hurt so much that I clawed at the little bony bump, and it came out!!! It was exactly like a grain of sand. Tooth? bone? whatever. It still hurts, but not as much.

So, here I am at almost 50, and this little bit of the past has worked its way to the surface and broken free. I'd like to think of this as a sign. Of something or other.

Grateful

Today Blas came home from the hospital, a day early, with some dramatic stitches but a clean bill of health from the neurosurgeons. He was admitted for emergency surgery last Wednesday to have a blood clot removed from the space between his skull and the membrane surrounding the brain (to be technical, a sub-acute subdural hematoma). He received the best of care. We are so grateful for the skill and kindness of all the people who took care of him, to our friends and family for their support and good wishes, to the amazing power of the human body to heal. We have always been keenly aware of our good fortune as a family. Even more so today, I am grateful to have Blas in my life.

Limits

Yesterday I had a piano lesson. I love my piano lessons, but yesterday's was tough.
I have been diagnosed with "rotator cuff impingement" syndrome which means, for the moment, that the left side of my upper body hurts like the dickens. I'm getting physical therapy, but I have been told not to do certain movements, and that I must collaborate in my healing by faithfully doing what the Physical Therapist recommends! So piano practice has been limited to right hand only, and I am working on observing how I sit, move, breathe and perform all kinds of basic actions in order to begin healing. As this situation is a result of an underlying chronic pain condition, I know there will be no quick fix, but I also know that healing is possible.

So I will have to seek inspiration in the playing of others for the moment.Hhere is a wonderful story about the "Mozart Project" that I heard on NPR yesterday while I was driving home, wondering if I'd have to give up my dream of playing the piano again. It was so inspiring to hear these two musicians converse about the experience of playing together and working together on this wonderful music.

Then, of course, I could learn to play Mozart by other means:

"Dos formas del insomnio"

A friend told me that lately she is having trouble sleeping. Then she recited this poem by Jorge Luis Borges to me.

Dos formas del insomnio

¿Qué es el insomnio?

La pregunta es retórica; sé demasiado bien la respuesta.

Es temer y contar en la alta noche las duras campanadas fatales, es ensayar con magia inútil una respiración regular, es la carga de un cuerpo que bruscamente cambia de lado, es apretar los párpados, es un estado parecido a la fiebre y que ciertamente no es la vigilia, es pronunciar fragmentos de párrafos leídos hace ya muchos años, es saberse culpable de velar cuando los otros duermen, es querer hundirse en el sueño y no poder hundirse en el sueño, es el horror de ser y de seguir siendo, es el alba dudosa.

¿Qué es la longevidad?

Es el horror de ser en un cuerpo humano cuyas facultades declinan, es un insomnio que se mide por décadas y no con agujas de acero, es el peso de mares y de pirámides, de antiguas bibliotecas y dinastías, de las auroras que vio Adán, es no ignorar que estoy condenado a mi carne, a mi detestada voz, a mi nombre, a una rutina de recuerdos, al castellano, que no sé manejar, a la nostalgia del latín, que no sé, a querer hundirme en la muerte y no poder hundirme en la muerte, a ser y seguir siendo

Fixing School Lunches: How can we make change?

Flea over at One Good Thing reviews the book Lunch Lessons: Changing the Way We Feed Our Children. It sounds like something I have to read. The Nation published this interview with one of the authors, Ann Cooper, in which she describes the major changes she was able to make to the Berkeley School systems school lunch program.

When my daughter was in child care, the children were served wholesome, delicious food, with vegetarian options. The kids loved it. In our (otherwise excellent) public school here in Minneapolis, where most of the kids are eligible for free breakfast and lunch, the food they serve keeps them alive, but it is otherwise dreadful. So we've made her lunch every day since kindergarten, and talked about healthy food choices. When she attends school in Spain, they serve simple but nutritious and delicious food. The idea of serving the kids junk food would simply not occur to them.

I asked my daughter what she thought of the school cafeteria food her friends eat. She made a face and said, "It's packaged and it's usually wet. The french fries are soggy. It would cost the same to have actual chefs preparing the food as to get the packages." When I asked her how she knew that, she said that they learned it in their "Life Skills" class when they saw the movie "Super Size Me." Hah!! I guess I'd better put that in our Netflix queue and see it myself. Clearly at least some of the teachers are trying to educate the kids about nutrition, and that's an important step.

Flea points out that the most famous instances of this kind of change are those driven by chefs like Alice Waters with the Edible Schoolyard program, and occur in large cities. She wonders about whether such efforts can happen in places with fewer resources, and about how poor people can afford to eat organic food when it seems to be so much more expensive. These are a great questions, and it got me thinking about what it would take to make this kind of change in our public school food service right here in the Twin Cities (and especially since there is a public forum tonight for the school board elections coming up).

Is it already happening? It's not as if we don't have celebrity chefs, a thriving sustainable agriculture and co-op movement with a long history, and rich sources of local foods. Here in winterland, we can't have a year-round garden in the backyard the way they do in California, but it wouldn't be hard to make huge improvements right away. But you do have to get parents to organize and lobby for changes in collaboration with the school board and elected officials, break out of the corporate stranglehold on food contracts, and join the movement. I've discovered at least one local school district, in Hopkins, that has made major changes in its school lunch program, with great success. So, not only can it be done here, it has been done here! Looks as if I should register for this "Bioneers" conference coming up Oct 20. because it sounds as if it will combine inspiration, education, and some hands-on pragmatic organizing ideas.

Here are some web resources I intend to explore, when I've finished with work today:
I am a member of a food co-op called The Wedge, which has an organics FAQ and lots of educational links. The Center for Ecoliteracy has a program called Rethinking School Lunch, which has a guide on how to do it. This is linked from Alice Water's site as well.
The Physicians' Committee for Responsible Medicine has an initiative called Health School Lunches for educating legislators and administrators about making school lunches healthier. They also have this great guide to resources for parents. They are dealing with the fact that huge numbers of schoolkids in the U.S. get their lunches through the National School Lunch Program, so change has to happen in partnership with this effort. I am dismayed, but not surprised to find that their 2006 report card gives the Minneapolis School District a D+
Jamie Oliver, another celebrity chef in London, has an ambitious and visionary program called "Feed me better" Let's hear it for celebrities who use their powers for good!