Tuesday, January 31, 2006

doctor week

As of Sunday night, the schedule was: Monday morning, dentist for me. Tuesday morning, ENT for me. Wednesday afternoon, allergist for DD -- we'd like to get a kitten (or two) but are concerned about her potential allergy.

Yesterday I woke up in excruciating pain but went to the dentist anyway. It was a teeth-cleaning and pocket-measuring appointment, so it was a little longer than usual. I did my best not to curl up into a ball on the chair, but it wasn't easy -- the abdominal pain was like the worst cramps I've ever had, but up under the ribcage, and nothing was helping.

When I got home from the dentist and it wasn't any better, I called my gp and made an appointment, but the earliest they could see me was 3:45. When I tried to read an op-ed and couldn't because of the pain, I gave up and went to the urgent care center.

Dr. T at the urgent care examined me and agreed that my abdomen was quite tender, probably because I was barely holding back tears when I had to lie down for the exam. He ordered blood work and sent me for an x-ray. The working theory? A gallbladder "attack", which is still possible even though I don't have a gallbladder anymore. The probable cause: absolutely horrible eating on Sunday, DS1's birthday -- I ate about 10x the fat I'd usually eat.

Dr. T recommended I take a Lortab when I got home, and also prescribed extra-strength Zantac to take on top of the Prilosec I'm already taking. The Lortab finally made a dent in the pain and I was able to eat, too. By the end of the day I was nearly normal.

Woke up this morning to the remnants of a dull ache under the ribs, but it's not debilitating, the way it was yesterday. Saw Dr 0, the ENT, and he recommends a swallowing study for the problems I'm having there (a "stuck" feeling, it's icky), and also a visit to the g/e doc to see about that attack.

Amazingly enough, the g/e doctor had a cancellation on Thursday, so that's been added to the schedule. 6 doctors/procedures in 4 days. That's definitely the local record.

I think I'd have good reason to be depressed about something else going haywire in my body, but the reality is I don't feel particularly bad about it (yet). I think I'm just happy to be feeling well enough to function pretty much as usual today. It's bad enough being sick, it totally sucks to be sick and have to get everyone around you to take care of the stuff you would normally do. Here's hoping to further improvements tomorrow.

(My finger is still killing me, but it has improved somewhat, too.)

Sunday, January 29, 2006

hold out

I don't believe in holding grudges. If something happens that makes me angry, I try to address it right away. Sometimes I'm justified in being upset, sometimes I'm not. If I'm not, I can usually talk myself out of whatever snit I'm in, applying the These things happen explanation, or some such acknowledgement that sometimes things don't go the way we'd like them to.

If I'm annoyed with someone, I decide whether or not it's worth it to say something about whatever it was that annoyed me -- most of the time it's not, so I just let it go. (Really and truly, too; I don't stash stuff in a 'war chest' that I can open when I'm well and truly pissed.) But if I decide I need to say something, I try to do it right away, and I try to approach the person as gently as possible, because no one likes to be criticized, right?

Over time I've learned to let more and more things go. I've realized that most people aren't important enough to me to let whatever they say or do have much of an impact on me, so there's no point in me figuring out how to say something, or agonizing over what to say. (This relates tangentially to the dust-up on the TWoP board recently; I really didn't put all that much thought into the way I said my piece because in all honesty, I don't really care that much. If I had thought for an even a moment that I might hurt someone's feelings I would've written with a much different tone -- but over on TWoP, there's generally very little consideration for feelings... except when there's lots.)

I try not to stay angry, and generally succeed, but this week I realized that I am still capable of holding a grudge. Right now, the person I'm needlessly mad at is myself, and no matter what I do, I keep slamming right back into this huge wall of anger.

Why? Well, I cut off the tip of my left index finger the other day, and since I happen to be left-handed, the consequences of that are myriad. I've become adept at 9-finger typing, but there are a host of things I can't do easily now: eat with utensils, write, floss my teeth, wash dishes... the list is endless. Worse, holding my arm and hand down by my side for more than 5 seconds causes excruciating throbbing in the finger. I've had 4 major (major!) surgeries in the past 4 years and a host of minor procedures, and this is by far the most painful injury I've ever sustained.

Another one of this week's lessons: constant pain impairs my ability to think, and obliterates my capacity to empathize.

I inflicted this pain on myself, carelessly, thoughtlessly. I have enough pain in my life, I do not need more. I certainly don't need pain of this level for this duration. On Thursday, I took the good drugs (prescription painkillers are so cheap!) and they do work on the pain, but I can't drive when I'm taking that stuff. So, none during the day. I also don't sleep well on it, either -- so none at night. I'm making do with extra-strength Tylenol, and it works pretty well, as long as I keep my hand elevated. (Even keeping the hand at keyboard height starts to get painful after 10 or 15 minutes.)

I'm assured by various relatives that the mangled finger will grow back, but I don't care. As long as I have a functional hand, I'll be fine. I'm looking forward to the time with the pain subsides from excruciating to the point of requiring drugs to merely annoying and easily ignored. I know it will happen eventually... it just seems as if it's taking forever to get there.

In the meantime, every time the finger inadvertently brushes up against something, my anger at my own stupidity is renewed. With interpersonal grudges, I've always run out of fuel after a while; it's hard to stay pissed at someone you're not seeing or talking to. With dozens of reminders of my own idiocy every day, my anger is staying fresh and hot. So far my attempts to get out of the cycle have been useless: It has happened to a lot of people, it's not so bad, etc, hold no comfort. I did a stupid thing and now I am really suffering, and I deserve it because I was so careless.

I tired of this pain and this anger, both. But I do not think I will be rid of either while the other remains.

Saturday, January 28, 2006

sometimes

I'd be better off reading a book.

(The latest in the series of things I'm learning about myself.)

Friday, January 27, 2006

bad grrl

Oh, no! My posting privileges have been revoked at TWoP! (cue ominous music)

So, what horrible thing did I do to get the boot? Well, I commented on the most recent recap of Battlestar Galactica, in which Jacob did a really amazing job of bringing in all sorts of literary references, but which (to my reading) stumbled badly with the inclusion of this line:
What's it like to live in a country where the government doesn't legislate its temporary religious values?

What threw me, specifically, about this line:

First, it comes immediately after a description of the scene in which Adama asks the believers in the fleet to pray for Roslin, and those like him, who are atheists, to keep her in their thoughts. The scene had nothing to do with legislation, it had to do with honoring the dying president with a moment of silence, more or less. Yes, the scene acknowledged that not everyone in the fleet has the same beliefs, but I think you'd be hard pressed to find a real politician who doesn't understand that situation in reality.

Second, the political situation on BSG is basically that there is no legislative body, as far as I can tell; they were all wiped out in the initial Cylon attack, and the survivors are living under military rule. Yes, the President is the Commander in Chief, but that's just because the military allows her to be. You can be certain that if Roslin had actually died and Baltar had become the President, the courtesies that the military had previously shown to the Office would rapidly fall away.

Third, notwithstanding the lack of a legislature, Roslin herself forced her own religious views on the fleet, believing herself to be the fulfillment of a prophecy. This belief led her to make a number of questionable decisions, and they were certainly decisions which the civilian population of the fleet had no means to protest. So the society portrayed by BSG is actually one in which the government's religious beliefs dictate policy!

Now, in the US, the legislature is elected at all levels, and the legislature drafts the laws that the executive branch must sign, and I can't think of a single "temporary religious value" that has been "legislated." One possible exception could be the attempts by Congress and the President to save Terri Schiavo's life, but I'm not seeing how respect for life qualifies as a "temporary religious value."

What I do know, though, is that courts in several states have declared by fiat that same-sex marriage is legal, expressly against the wishes of the states' populations.

So, with all this stuff percolating through my brain, I posted on the "recapper" thread. My language is more forceful than it would be in other forums, and is indeed more forceful than I usually am around here. There's a lot of attitude at TWoP, and at the time I didn't feel as if I was crossing any lines. I knew I was outing myself as a conservative. No need to pussyfoot around the issue, then. Here's what I wrote:
This was without a doubt one of the best recaps I've ever read on TWoP, and since I've been hanging around here since the Dawn of Time, that's really saying something. Therefore it was especially painful to run across this gratuitous and particularly cheap shot mid-way through:
What's it like to live in a country where the government doesn't legislate its temporary religious values?
See, you say something asinine like that and all the good stuff gets shoved aside, and it takes a while to get back into the flow of the recap again. Why do you do this sh!t? If you're going to talk politics, talk politics -- Lord knows there's plenty of it in the show, which for the most part you conveniently fail to parallel with current events. But then you throw in a line like the one above, and it comes off as weirdly childish and inappropriate.

Snark is most effective when it has its basis in reality... if you want to snark on "the government" imposing religious values, you'd best look to the judicial branch and see which side it is that is doing the imposing. Honestly, I'd prefer you to reserve your snark (and analysis) for what's on-screen. You're brilliant at it.
Then I went to pick up the kids at school, and we went out for our usual Friday-at-Borders jaunt. We came home, had dinner, and I get around to checking back on the boards to see that Jacob has edited my post to add:
I'm sorry that my opinion differs from yours, and that it caused a mental disconnect, but I don't see the effect that a difference of opinion has on the writing itself, which you seem to imply. Should I alter my personal response to the episode in order to more closely approximate your political feelings? Can you accept the fact that not everyone agrees with you, or is it just a problem for you when they express it?
I've got a warning on my account, too, but it wasn't until I tried to post a reply to Jacob's questions that I realized my posting privileges had been suspended.

This, I don't get. In retrospect, I skirted the line between "personal attack" and "expressing my opinion" by my harsh language. If I had asked simply, "why do you do this?" instead of "why do you do this sh!t?," I probably wouldn't be banned. But I've seen others post far worse stuff with nary a ripple of protest. I admit that it never occurred to me that I'd get banned.

I've written an email to Jacob to ask why I was cut off, but I'm not expecting a reply. The TWoP environment has become increasingly hostile to conservatives over the past couple of years, and it's really too bad. One of the nice things about the BSG recaps is that there wasn't a lot of gratuitous politics thrown in, but I guess now that I've brought up the subject, that'll be out the window.

It's pretty sad, though, that even a forum that's supposedly about television -- specifically criticism of television -- is populated with people whose views are so fragile that if a single voice pipes up and says, "what's with the out-of-nowhere (and completely unrealistic) political comment?," the moderator suspends my privileges and the other forum members tell me I'm the one whose nuts. And the recapper himself, who has shown himself to be an intelligent and perceptive guy, doesn't consider for a minute the merits of my question -- why did he include that single comment? -- but immediately assumes I asked it because I have a problem when people express opinions which don't agree with mine.

Stuff like this is exactly why I generally avoid making political comments. I confess, the stupid finger injury is making me grumpy, and I haven't been using my usual restraint. Still, it's kind of good to know just how bad things have become over there.

Later: This is classic. I went back over to TWoP to see if my ban had been lifted and also to see what had happened in the thread -- interestingly, someone has already asked what was meant by "temporary religious values", but there is no reply yet -- and I read the ban-specific FAQ (earlier I had missed the fact that the headers were links to their own pages: D'oh, me.) It turns out that when you get banned, the mod who bans you posts a message to you to let you know why; the "ban percentage" is another link I'd failed to notice earlier. (Damn, I guess having this throbbing digit is more of an impediment than I thought.) So I clicked on my warning percentage to see the message left for me by Jacob:
You had to know you were getting banned for that, right?
No, Jacob, I didn't. I thought it was a legitimate question and a legitimate criticism: that political comment was out-of-place and frankly, off the wall. TWoP's own FAQ page on banning says:
A troll is not[ ]someone who -- in the course of a real debate or discussion -- pisses you off with a [sic] opinion that is different from yours[.]

Riiiiight.

Thursday, January 26, 2006

group hug

Last week's Grand Rounds included OverMyMedBody's excellent post on Google diagnosing. Grahamazon gives a great rundown on the pros and cons of looking for medical advice on the web, but since his focus was mainly on the utility of search engine results, he barely touched on one of the most important sources of online medical information and disinformation: the forum.

Forums, also known as discussion groups, bulletin boards, or message boards, allow registered users to post messages, asking questions or looking for support. Messages are generally arranged so replies can be easily read, and so that new replies can be added. The idea is to allow each member to share his knowledge and experience with the other members of the community, so all can benefit. The realization of that idea, you can imagine, varies from forum to forum.

For every medical condition out there, you'll find at least one USENET discussion group.* You'll also find a Yahoo! group or two or three, and perhaps an About.com site with support forums as well. And those are just the health-related topics at general sites; major medical sites run message boards, blogs, and forums, too. WebMD has them; so does The American Cancer Society. Its a good bet that other national health advocacy related websites also offer support forums.

So, what's the problem with online health forums? Isn't it a good thing that there's all this expertise out there? Isn't it great that you can ask a specific question about your own problems, and get a specific answer?

Briefly: yes, it's good, but it's not all good.

Specifically, yes, it is possible to get good advice in an online forum. However, there are some things you should keep in mind if you're active in such a forum, and considering following medical advice you read in one.

If you're just jumping in, moderated forums are greatly preferable to unmoderated forums, if only because spammers and flamers will be kept at bay. But just because a forum is moderated doesn't mean everything you read there will be medically accurate, or pertinent to you. A moderator could be medically knowledgeable, but it's just as likely that a moderator is someone who has a personal interest in the health issue that the forum covers, and who also has the time to spend keeping the forum civil. Moderating is not for the faint of heart, and I have a lot of admiration for mods, but being good at keeping the inmates calm doesn't automatically translate into being an expert on your condition.

Another problem with forums is that very often, the forum regulars won't have the answers you're looking for. Forums can be great for general information, but if you need more in-depth information or advice about an unusual symptom, chances are you'll be out of luck.

In the same category, there's no telling when you'll get a reply to that urgent question you just posted, so don't rely on a forum to give you an answer to a question that is pressing. Some forums have constant traffic, others sporadic, but even in the busiest forums there is no guarantee that someone will be willing or able to answer your question.

When you do get an answer, take into account what you know about the respondent. In some forums, actual doctors take the time to participate; you can easily identify their posts by the lengthy disclaimers they attach to each and every one of their replies. Still, you can usually trust what a doctor's telling you. With the patients, though, they're reporting based on their own experiences and the knowledge they've gained as patients -- and while that is useful, it might not be something you want to rely on.

One of the best things that online forums can do for patients is reduce their sense of isolation. It can be so helpful to be able to express frustrations to people who have been through all the same tests and procedures, who've had to endure the same tedious recoveries. It's certainly helpful to hear about other's experiences with particular medications or therapies -- it's great just knowing that someone else really understands. An additional benefit is that forums allow a patient to vent without having to dump everything on immediate friends and family. (The best thing about online friends is you deal with them strictly on your own time, and your own terms.)

Even with all the above caveats, it would seem that the benefits of emotional support would outweigh all those negatives. That brings me to my final point: be aware that the members of these forums are self-selected. In any forum, the most active participants dictate the tone, and in medical forums, the most active participants are often the ones who have the most difficult or advanced cases.

In general, there are three types of medical forum participants. The newly diagnosed member ("newbie") comes in looking for basic information and support, and participates until he has reached his own level of psychological comfort with his condition, or at least his knowledge of his condition. This type of member drifts in and out, but typically doesn't actively participate much after all of his questions are answered.

Long-term message board posters fall into two categories: the helpful expert, and the hard case. Helpful experts are godsends, and they shepherd the newbies to the appropriate links and articles to get them through their initiation (to the condition, but also often to forums.) The hard cases are sometimes difficult to distinguish from the helpful experts, because their input can often be helpful, too. They are experts because they've been through it all. But they also remind everyone just how bad the condition can be -- and that can leave a newbie with a skewed perception of what he's in for.

Reading some support forums, you can easily get the impression that everyone who has the condition is struggling with their meds, suffering a host of associated symptoms, and dealing with an intractable medical system. If you're newly diagnosed and looking for support, a forum that's filled with hard cases might give you the impression that you're doomed.

Online forums have been helpful to me personally, but I'm a hard case. After participating over an extended period, I could see that my attitudes were being affected by all the hard cases I was reading about every day. Even though I'm not a typical thyca patient, my prospects aren't bad at all -- but reading messages from patients who had had multiple surgeries and treatments became unsettling to me. Once I stepped away from the forum, I was able to leave most of my fears behind, too.

I'd like to think most people are aware of the usual caveats that attend getting advice online: On the internet, nobody knows you're a dog goes all the way back to 1993. So most people will be cautious about specific advice -- I know I was. But the effect of the disproportionate number of hard cases that are represented in forums was a lot more subtle, and something it took me a long time to recognize.

This self-selection effect is something I think doctors need to add to their warning list when they are counseling patients about seeking advice and support online.

-----
(*) A USENET group is actually a mailing list, but web interfaces are available to make it essentially indistinguishable from an online forum. USENET is, in online terms, practically prehistoric.

9-finger typing

It was a lovely day, not too hot, not too cold. The perfect day for harvesting the oranges and lemons that have been burdening our citrus trees for weeks now. We're skirting the edge of "ripe", approaching "falling off the tree" and "rotting" -- it is time for the fruit to come off!

I picked about 98 percent of the oranges without incident before lunch; we have a box that formerly held copy paper that's overflowing now.

After lunch, DS2 traipsed out with me to help harvest the lemons. The thorns on the lemon tree are larger and more plentiful than the ones on the orange tree, which can mostly be ignored. You don't want to ignore lemon thorns -- I've several nasty scratches to testify to that. So instead of relying on brute force to pull the lemons off their stems, I took my kichen shears out with me so I could snip them off.
The harvest

DS2 and I had a good rhythm going; I'd snip off 3 or 4 lemons, hand them to him, and he'd put them in the box. The big box (much bigger than the copy paper box) was nearly full when I reached up to cut a lemon overhead and... snipped off the tip of my finger.

A triangular chunk of flesh, about a quarter inch along the longest side, was clinging to the blade of the scissor. Yikes I thought (really!), but it didn't hurt all that much, so I looked at my finger to see how bad it was... and I immediately knew it was pretty bad, so I put pressure on it right away (thumb to fingertip -- I looked like I was holding on to something tiny) and walked into the house to ask for my mother's opinion. She concurred: a doctor should look at it.

I called DH to come and take me (Mom doesn't drive), and an hour later, we were home from the urgent care center. My finger has a ridiculous bandage on it, but at least it's not throbbing anymore. The doctor wrote me a prescription for Lortab, and even though it makes me feel spacey, it really did work for the pain.

Typing with nine fingers is very strange, but still a lot easier than the one-handed typing I did when I used to type and nurse an infant at the same time. The only words that are really difficult now are the ones with lots of "R"s.
Handle with care


The big bandage comes off in two days, and then I'll just need to keep the wound clean, smeared with anti-bacterial ointment, and covered until it heals. The urgent care doc didn't give me any stitches -- there was nothing to suture. He stopped the bleeding with silver nitrate (which hurt like all get-out), bandaged me up, and sent me on my way. Only after we got home again did we realize that I had forgotten to get a tetanus booster -- fortunately the care center took care of that in less than five minutes when DH swung me by later.

So now I'm incapacited in a new and different way, due to my own carelessness. There aren't many positives to squeeze out of this situation, but at least the Lortab was a cheap prescription, and I'll only have to wear this stupid bandage for a couple of days.

February's column at LCL

The February issue of the Low Carb Luxury Online Magazine has been posted; my column, Persistance Pays Off, featuring a recipe for low carb lemon squares, is included.

The "research and development" for this column was a lot of fun, even if it did keep me in the kitchen for several days running!

Wednesday, January 25, 2006

compensating

Sometimes when we have leftovers for dinner, I like to make a more special or unusual side dish to make up for it. Sometimes I make bread, but last night, since I had a batch of chicken stock in the fridge, I decided to make rice pilaf.

If you're in the habit of eating rice pilaf from a box mix, I implore you to stop. You're not saving yourself any time and you're certainly not saving yourself any money, either. What you are doing is giving yourself a lot more chemicals and salt than are good for you, or for your taste buds. If you like rice pilaf, give this a try and see if you don't agree that this is better.

Easiest Rice Pilaf
4-6 servings

1/4 C orzo pasta
1 C long-grain rice (basmati is very nice)
1+1/2 C chicken stock (if you're not going to make your own -- entirely understandable! -- I recommend Swanson's Natural Goodness)
1 T olive oil
1 T butter

First, rinse the rice. Measure out your rice into a medium-sized bowl, and rinse two or three times: fill up the bowl with cool water, agitate the rice to wash it, then carefully pour off the milky water, keeping the rice in the bowl. Repeat until the water is clean; pour off as much water as possible.

Put the olive oil, butter, and orzo in a medium-size saucepan with a tight-fitting lid over medium-low heat. Cook, stirring occasionally, until the pasta is nicely browned. Add the rice to pan, and stir to coat it with the butter/oil mixture.

Add the chicken stock and stir. Increase the heat to high and allow the stock to come to the boil. Immediately cover the pot and reduce the heat to low. Let the pot sit undisturbed for about 15 minutes. Check and see if all the liquid is absorbed; if some remains, cover and leave on the heat a few more minutes. Once all the liquid is absorbed, fluff with a fork, but keep covered in the pan until you're ready to serve it.

This is the simplest pilaf -- you can easily add things like sauteed vegetables (mushrooms are good) in at the beginning stage, when you're browning the orzo, if you'd like to dress it up a bit. This is a lot less complicated than risotto, but it still tastes really good.

the difference between girls & boys, first grade edition

All year, we've been struggling to get DD to read on her own. She's a brilliant reader, but very few books held her interest. She kept going back to her favorite "read to me" books, like David Shannon's A Bad Case of Stripes, which is simply brilliant, but not a book she could read on her own.

This week, we've made a breakthrough. Over the weekend, she picked up My Secret Unicorn by Linda Chapman, and is she ever hooked! She is barely content with two chapters a day. She reads several pages, and then I take over and read the rest. (Apparently, we're ahead of the curve, here; a quick googling shows that this book is not generally available in the US. I believe we ordered it from Scholastic through the kids' school, but it's not even available on their website.)

DS1 always liked to read, but back in first grade, his choice of books was The Magic Tree House series by Mary Pope Osborne. We own all 34 books chronicling the adventures of brother and sister Jack and Annie, and their adventures through history. The point of these stories is quite clearly to learn something about the past, and while they do have an element of fantasy, there isn't any character development to speak of. DS1 enjoyed the fact-based adventures, and enjoyed the appendices as much as the stories themselves.

DD, too, likes non-fiction material, but her current choices are outside of her reading ability: The Magic School Bus series, in which Ms. Frizzle takes her class on very unorthodox, and educational, field trips. These books are excellent, but the vocabulary is generally third or fourth grade level, making them better "read to me" books.

The unicorn book has pretty hefty vocabulary and complex sentence structure, too, but DD remains undaunted. What has her hooked is the characters. Readers never learn much about what Jack and Annie are thinking or feeling, aside from their fears and frustrations relating to each story's theme. The "Unicorn" books are different in that Chapman opens up her characters' thoughts and emotions.

I can see that having more fully developed characters is very appealing to my daughter, who is more interested in the people than their surroundings. I'm not saying my son wouldn't enjoy these stories, but I do think they are not something he would choose for himself. Obviously, he hasn't chosen them, or anything like them, yet. He sticks to action/adventure (Bionicle adventures and chronicles), ghost stories (Goosebumps and others), and non-fiction (The Way Things Work, Walking with Dinosaurs.)

My philosophy here is to encourage pretty much any and all reading. We have books in every room in the house, with non-fiction and fiction in many genres for the kids to choose from. My bookcase is stuffed with roughly half science fiction and fantasy and half non-fiction books on history, economics, politics, and religion. (The cookbooks have their own bookcase.) So far, DS1 leans towards action-oriented fantasy and non-fiction, whereas DD has now shown a preference for character-driven fantasy, although she did really like Little House in the Big Woods, which is also character-driven.

I make suggestions all the time, of course, but I don't force them to read anything they don't like. DS1 has tried any number of books of mine and then put them down again. I'm curious to see what kind of reader DD turns out to be.

As for DS2, his favorite author by far is Robert Sabuda. The kid has a stunning collection of Sabuda's work, aka "paper sculpture/art in book delivery form," and we're doing the best we can to preserve it so it survives his childhood.

Tuesday, January 24, 2006

Grand Rounds

The latest Grand Rounds is up over at Kevin, M.D., a pioneer in medblogging.

I was amused by his intro to my this does not inspire confidence post, because he said what I was thinking: my pediatrician has gone "over to the dark side."

every now and then

It doesn't happen too often, but occasionally I participate in comment threads on controversial topics. This one started out calmly but then took a sharp turn into the surreal.

It has been interesting.

Monday, January 23, 2006

depleted

I admit, going through everything here and pulling out posts to include in the "Cancer, Health, Medicine" index has sucked the wind right out of my sails.

You know, when you're in the middle of something, you're only directly experiencing the part you're in. You can conveniently forget the past (more or less) and try as much as possible to remain blithely unaware of the future. That way it seems as if the path you're on may be a bit treacherous that day, but you don't perceive it as having been fraught with peril from, say, the very day you set out.

So when you finally turn around and look back at everything you've been through, it can really throw you for a loop.

I want to be done with all that and get on with cooking, writing, and being with my family. I'm on hold for a little while more -- just about a month -- and then we'll see.

Sunday, January 22, 2006

best of...

The Cancer, Health, Medicine link on the right there has now been updated with links to many of my health-related posts, plus all of my Grand Rounds entries.

The process was not uplifting. I really have been through an awful lot the past few years.

I wish my throat would stop hurting now, and I wish the fact that it is hurting would not make me think that I have more cancer. It would be nice if a sore throat could just be a sore throat caused by a virus that will go away on its own. My recent history makes me think, Oh no! More surgery...

Yeah, I know it's stupid, but I can't help it. Two things I will try to keep in mind: first, my Tg was undetectable a month ago, and second: I have gained weight recently.

Both of those are very good things.

get cookin'

The latest Carnival of Recipes is up at the Morning Coffee & Afternoon Tea. This week's host had requested recipes using coffee and tea as ingredients; I submitted my low carb apple orange bread. (I just ate a piece of it, and it is just awesome.) The espresso and chocolate swirl cheesecake looks particular enticing, but for next month's column I will soon begin work on Sachertorte cookies, so the cheesecake will have to wait. Fortunately, I've got the link right here!

progress report: 3 months post-op

Neck dissection scar at 3 months post-op
Compare to 3-week photo


Overall, I'm doing very well. The scar is not healing uniformly, and it is somewhat annoying (if predictable) that the part that is least visible (around the right side of my neck, usually covered by my hair) is healing best, and the part that is most visible (center-left) still looks like a bright red gash. OK, slightly less bright than a fresh gash, but still. Mom commented this morning: Part of your scar looks irritated, but I think she only noticed it because I've been wearing turtlenecks a lot recently, so she hasn't seen it in a while.

Moving to the more important aspects of recovery (looks aren't everything, after all), I'm happy to report that my strength and mobility are both doing very well, although I have lost strength since I quit doing my physical therapy. I am a slug these days, and it's not helping my overall fitness, of which I have none. I'm working on getting up the motivation to get back to the Y -- which also requires coordinating with my mom. It will happen.

The surface-level nerve damage is slowly, slowly healing. I note that normal sensation has returned around the right margin of the affected area, and that my jaw line is entirely free of numbness now, although it is sore and tender underneath the surface. My ear, too, finally feels normal now. There is still an area of numbness starting at the midline under my chin, extending about 3-4 inches to the right, and all the way down to just above the incision scar.

I continue to massage the scar once or twice daily, and to massage the affected area and my right neck in general; there was a lot of dissection in there, and it helps to get things loosened up in there. Even gentle massage is very uncomfortable. I frequently feel stabbing pains in and around the affected area, as well as the unpleasant tingly feelings and electric shock-like feelings. All of these are good, I know, because that means that nerve function is returning. But it still hurts and there isn't much I can do about it, except wait for it to go away. The one good thing about these random sensations is that they seldom last more than 5 or 10 minutes.

I have a big lump in my right neck which of course freaks me out: I'm sure it's a lymph node (they were not nearly all removed, after all). I'm not sure it's cancer. DH was reassuring: Maybe you just have a little cold, he said. It's true there's all sorts of respiratory-type junk floating around this house, so I could, indeed have a cold. I have been having more trouble swallowing lately, though... but that could also be from having a post-nasal drip.

I've noticed that the deep-breath/out of breath feeling I was having, which was related to aspirating stomach acid (ew), has not been bothering me lately at all, so perhaps the Prilosec is actually working. I need to follow-up with my ENT to see if I should be getting speech therapy for my slightly paralyzed vocal folds -- my voice control seems better lately, but maybe that's just because the kids are back in school and so I'm not having to talk so much or raise my voice much.

My RA is kicking my butt these days, literally -- major problems with the tailbone on waking, as well as hands, hips, feet, and shoulders. This is definitely the worst I can remember feeling on waking, ever: the pain is bad enough to get whimpers out of me even though I hate it when I do that, and I try my damnedest not to squeak just because it hurts so much. (I would describe these sounds as sighs that suddenly betray me and turn into squeaky almost-sobs; it sucks.) There are any number of reasons I could be feeling so crummy, including changes in my thyroid meds and lack of exercise (biggest culprit, I think), but one thing I have been good about is going to bed at a decent hour. I'm disappointed that's not helping more. Fortunately I'm off to the rheumatologist in early February; we'll see what she has to say.

I hate writing these things because they come out sounding so negative when really, things are going pretty well. The kids are all healthy for once, there's nothing stressful hanging over my head, and Life is more or less on cruise control so we can, you know, enjoy the scenery.

I'm itching to make our summer plans but we've decided to wait until I get back from Houston. I'll feel a lot better about things if that node in my neck goes away before I get there.

Thursday, January 19, 2006

the USOs

In the Greater World of Knitting (and crafts in general, I suppose), the abbreviation UFO has non-standard meaning: Un-Finished Object. All knitters are faced with dreadful UFOs from time to time, and many serious knitters juggle several UFOs simultaneously.

The problem with UFOs, you see, is that once they've earned themselves a place in that category, rarely do they ever escape it. You'll note a rueful tone of voice when a knitter mentions her UFOs. There's regret and embarrassment, sometimes a kind of wistful nostalgia for the enthusiasm that accompanied the start of the project, but discussion of UFOs is more akin to the confession of sins than anything else. Yes, it feels good to admit that we've screwed up, and doesn't misery love company, especially over something, in the end, as inconsequential as shared projects-off-the-rails guilt?

For some, just admitting that the UFO exists provides enough impetus to get started on it again.

Which brings me, finally, to the purpose of this post: not taking up UFOs, but finally getting off my butt to do the USOs: the Un-Started Objects. These are not projects that are mere wisps of daydreams -- these are projects for which I have purchased all the supplies and materials, and yet I still haven't done a single bit of work on them.

Starting with the longest pending to most recent, here they are:

1. DS2's baby quilt.
DD's baby quilt, unfolded 4'x4'

I made baby quilts for his big brother and sister, and when I was pregnant with him, I bought the fabric and the batting to make his quilt. (It's in my closet.) Then I had pre-term labor and was put on "restricted activity": lie down as much as possible. It's impossible to use a sewing machine when lying down, you know. When he was finally born -- five years ago, I had the usual infant-in-the-house stuff to deal with, and then when he was older and you'd think I'd have more time, my medical nightmares started up. He wasn't entirely deprived; his auntie made him a beautiful baby quilt. But it's not the same as one made-by-Mom. I owe it to him. Expected time to complete the project: about 10-12 hours, can usually be done if focussed over 2 days. This isn't the kind of thing that you leave lying around.

2. DD's cushions. A year and a half ago, I did major work refinishing our old bedroom furniture for her use. One of the things I did was take the legs off our old nightstands and put them on casters, and fit the tops with moldings to hold a cushion, so they became movable seats/footrests. I've got the foam, batting, and fabric, (they're all in the closet), but what I'm lacking entirely is the experience. I have the feeling once I get into it, it won't be that bad, but there's a steep curve to climb before I start. Expected time to complete: I have no idea! Probably 3 or 4 hours, but that uncertainty is one of the big factors holding me back.

3. Back in August, I thought it would be cool to make myself a new sweater/coat. I decided on this one:
Fall 2005, Vogue Knitting

I bought the yarn. I have the needles. The yarn sat around in the living room for a couple of months, then I moved it upstairs to my closet. It's still in my closet. Time to complete: irrelevant, really, as it would be knitting-while-TV-watching. It would work up fast, though, so probably about a month.

4. In September, my nephew became a father. When his big sister, the first of my mom's grandchildren, was born, I started the tradition of making each baby in the family a teddy bear.
DS2's baby bear, about 6" tall

When I heard there was a baby on the way, I started a bear for the new baby -- and then realized I had never made one for DS2. (I finally made DS1 and DD their bears after DS2 was born. Pathetic, I know.) Of course, DS2 loved the little bear and wanted it for his own, and he did have a prior claim, so I gave it to him. That left me without enough fake fur to make another bear. Then the whole going-to-Houston-for-surgery stuff surfaced, and I got distracted. I did, finally, at some point buy some more fur. It's upstairs... in the closet. Time to complete: about 4 hours, start to finish -- the kind of thing I have easily done on a single weekend day.

I should work on these projects. I will work on these projects, eventually. The question is, which one should I do first? DD's cushions, she could use the seats at her new desk -- but of course this holds the least appeal for me! The one I want to do? The sweater coat, of course. But my arthritis is kicking up so maybe knitting would just hurt.

Here's hoping that this incents me to actually do something about these USOs. Because what I really, really want to do is start a new counted cross-stitch, but I refuse to even look at materials for that until I've cleared the decks!
"Map of Discovery", approx 22"x15"
My last counted cross-stitch project
It only took me 6 years...

emergency measures

I had to bake last night. Mom and DS2 made brownies in the afternoon, and if my jeans weren't getting tight, I wouldn't care. But the jeans are getting tight, and the scale has not crept back down from its holiday-indulgenced height, so I do care. No way am I eating brownies.

Of course, if I'm not eating brownies, I have to eat something else, so I low-carbed Virginia's Apple Orange Bread, which I found in last week's Carnival of Recipes. The original recipe uses orange juice, but I knew that my favorite herbal tea ever, Tazo Wild Sweet Orange, would be the perfect substitute.

We always have apples in the fridge -- Granny Smiths are the kids' favorite. I have a tree full of oranges outside, and so off I went:

Low-Carb Apple Orange Bread
2 standard loaves, or 24 muffins

wet ingredients:
1/2 C oil
1 Tazo Wild Sweet Orange teabag
1 C erythritol
1/2 C Splenda granular
2 apples, cored, not peeled, cut into chunks
1 orange, with rind, cut into chunks, seeds removed
2 eggs
1/4 C golden raisins, each snipped into 2 or 3 pieces (see note below)
1/2 C chopped walnuts

dry ingredients:
1+1/2 C almond meal
1 C Designer Whey French Vanilla whey protein powder
1/4 C oat flour
1/4 C vital wheat gluten flour
1 tsp salt
2 tsp baking powder

You'll need a food processor for this recipe, although the Headmistress/Zookeeper at The Common Room used a blender in her version. There is a blender somewhere in this house, but it belongs to DH and I don't think anyone has used it in the past 10 years. My food processor, on the other hand, has been with me longer than my husband and is one of my best kitchen friends. I trusted it for this job and it came through just fine.

Preheat the oven to 325 degrees. Prepare two standard loaf pans by lining them with foil and then spraying the foil with no-stick spray. You really don't want to skip the lining step. Breads like this can be very tenacious. Use paper liners if you're making muffins, although you'll probably do well with a silicone muffin pan. Use no-stick spray no matter what!

Before you start, pop the teabag into 8 ounces of boiling water, and let it sit until you're ready for it.

Measure the dry ingredients into your food processor. Yes, that's right, I said the dry ones. I usually recommend sifting the ingredients together to make sure that everything is well-mixed, but thought I'd see how this works out. Pulse-process until the mixture is uniform. My almond meal was a little moist so these ingredients almost formed a dough, and I had to keep breaking up lumps of stuff, but this was still way easier and faster than having to sift everything together. Dump the combined ingredients into a large mixing bowl.

Put the apples and oranges into the workbowl (no need to wash it out first), and process for a minute or so until all the big chunks are gone. Add the oil, sweeteners, eggs, 1/2 C of the orange tea (drink the rest), and process until
smooth. Add the raisins and nuts and give it one more quick whirl.

At this point, my food processor's workbowl was filled to capacity, so it's a good thing there aren't any more liquid ingredients...

Pour the contents of the workbowl into the dry ingredients, being sure to scrape it out. Mix quickly but thoroughly -- don't overbeat, but do make sure there are no big lumps of dry stuff. Pour the batter, which is quite liquid, into the two loaf pans, making your best effort to keep them even.

Bake at 325 degrees for about an hour, until the tops are deep golden brown and a toothpick inserted into the center comes out clean. These are incredibly moist, so don't worry as you normally might with a low-carb bread that it will be too dry if you overbake -- err on the side of baking longer. Muffins will probably need about 20-25 minutes.

Yields 2 loaves, each loaf yeilding 12 slices -- or 24 muffins.
Approximate nutrition information, per slice/muffin: 139 calories, 5 g fat, 7 g carbs, 2 g fiber, 2 g sugar alcohols.

As the Headmistress/Zookeeper noted of the original version, these are awesome plain or with butter. All the fresh flavors of the fruit shine through since there are no spices to compete with them. Yum!

Notes: You don't have to snip the raisins, and it is incredibly tedious job. But if you do, you will be rewarded with a more even distribution of raisin bits throughout the bread. Raisins are lovely, but quite high carb. I couldn't bear to leave them out altogether, but a whole cup of raisins is 115 g of carbs! Yikes. A quarter-cup, snipped, gives you the flavor without making this bread an unreachable splurge.

You can always pick up a Tazo at your nearest Starbucks, but if you'd rather not, you can use sugar free diet orange soda; Hansen's makes a nice diet Tangerine Lime that would probably work well here. Reduce the Splenda to 1/3 cup if you use this.

You can use all Splenda instead of Erythritol; that will add 1 g of carb per serving but your taste and texture should be fine.

Tuesday, January 17, 2006

learn something new...

I enjoy Neo-neocon's blog very much. She explores all sorts of issues and has lately been exploring the literary depths of Melville's enduring classic, Moby Dick.

While the discussion of Ahab's motivations and intent are fascinating, what I really learned today is that The Enemy Within, a 1966 episode of the original Star Trek series, was based on Talmudic lore (see neo's post linked above for relevant quotes and links).

In this episode, a transporter malfunction separates the components of Kirk's psyche into two physical manifestations, the Good Kirk and the Evil Kirk. While the Evil Kirk is predictably bad, the Good Kirk is disappointingly wimpy, and everyone realizes that without the strength of his "evil" side, Kirk can't be an effective captain -- he can't even be an effective human. As silly as that sounds here, it makes sense within the episode, and as presented, it makes sense in general: there is a lot of "negative" energy/force/what-have-you behind nearly all of our positive accomplishments.

I had no idea of the philosophical underpinnings of this episode. It was written by Richard Matheson, who has such an extensive film resume that I'm embarrassed to admit I didn't know who he was before writing up this post. His 1957 The Incredible Shrinking Man was fantastic, in both senses of the word. Obviously, Matheson knew what he was doing in putting that episode together.

So, the next time you hear someone dis Trek, you can casually point out that this episode managed to examine the duality of human nature and be entertaining at the same time, no small achievement. How much Talmud is Desperate Housewives (audio at link) serving up these days?

this does not inspire confidence

I take my kids to a pediatric practice that has three different offices and dozens of pediatricians. Nevertheless, I have always scheduled the children's "well visits" with Dr W, because we held similar views on nutrition and child development. She had even worked with the founder of my kids' preschool to help develop the curriculum for the parent-toddler interaction class -- which, for those of you rolling your eyes, actually was a lot of fun and has helped many a parent understand what toddlers can and can't do.

She always seemed to have her head screwed on straight, even though she did make me take DS1 in for a developmental assessment (as in: test for learning disabilities) when he had just turned 5 because he refused to write his name for her. It was annoying that she wouldn't take my word for it that he was just being stubborn. The school counselor who did the assessment said my son was the brightest kid she had ever had to assess.

Still, over five or six years, caring for three different children, we usually saw each other several times a year, and we usually saw eye-to-eye. So, whenever one of my kids needs a doctor for something, I'd always ask for Dr. W first. She was "our" doctor.

I heard the first rumblings that something odd was going on when I took DS2 in for his strep throat back before Christmas -- Dr. W was out on leave and would be back after the first of the year. OK, that's none of my business, we'll just see someone else, I thought.

Now it is after the first of the year, and when I again had to take DS2 in (the ear infection), I learn that Dr. W has left the practice.

Well, now my curiosity is piqued. I really like this practice, so I'm not sure I'd follow Dr. W to another practice, but I would consider it, depending. So I asked the scheduler, Has she joined another practice?

Did you ever learn a single fact about someone that caused you to re-evaluate your entire opinion of them? Well, that's what happened to me here, because the scheduler replied, She's finishing her studies in homeopathy, and she'll be joining a homeopathic practice.

Homeopathy.
Homeopathy?
Homeopathy?!

What makes a board certified pediatrician, a Pediatric Fellow!, abandon all that and go full-tilt into practicing a baseless, thoroughly debunked "science"? The only semi-plausible explanation I can come up with is mid-life crisis, but does that usually entail professional suicide?

I really don't understand this at all -- this woman spent 15 minutes discussing flu vaccines with me last year, trying to convince me to get one because of my status as a cancer patient. (Understand that I'm not anti-vaccine at all, and if there was only one single flu virus, and an effective vaccine against it, I'd be first in line to get that shot. My kids have all their vaccinations, too. But the fact is that the flu vaccine is a best-guess mixture of what some scientists think are going to be this year's big flu virii, and it won't do you a bit of good if you contract a different flu virus. My preferred method of combatting flu is prevention.)

I don't know what happened to Dr. W, and I do wish her well in her new professional life. That said, if she really is becoming a homeopath, I'm profoundly relieved she won't be treating my children anymore.

mothers & daughters

Sunday evening DH and I went out for a low-key dinner at Buca di Beppo. (I've heard Buca criticized for not being "authentic" Italian, but I can taste the freshness of the ingredients, and I love whoever it is who balanced the seasonings in their recipes... it was all delicious.) After dinner we went to B&N and got coffee and cheesecake, and sat in the cafe each reading something interesting and funny, occasionally reading passages aloud for the other's appreciation. It was really lovely.

When we got home, we had a message from Connecticut: our sister-in-law's mother, who had been quite ill for some time, had died. We're 2,500 miles away and there's not much we can do besides offer our condolences and send flowers. That sucks.

Today, when I was driving DS2 home from school, I had an "uh-oh" feeling: Something's wrong with Mom. It was a strong, bad vibe -- there's no other way to explain it. I shook it off, though, sure that I was just feeling the after-effects of my s-i-l's loss, manufacturing worry on this first occasion of my going out without my mom after hearing that sad news.

When I got home, Mom was fine, and I completely forgot about that uh-oh feeling until a few hours later when the phone rang.

It was the youngest of my brothers, calling with news about our Pennsylvania brother's mother-in-law. My sister-in-law has been caring for her mother, who has dementia, at home for several years now. Sometimes the medications seemed to help stop the deterioration, but nothing restored what was lost. Lately, her mom has become completely unmoored, often not knowing who they were or where she was, but at least retaining her own sense of identity.

Today, though, the situation turned in a completely horrifying direction: my s-i-l was attacked by her mother. Fortunately no one was hurt, but her mother had to be hospitalized to calm her down, and now she will have to live in a managed care facility.

I can only imagine my s-i-l's heartbreak. She lived with her mother until she married my brother, but she was always close to her. When my brother first had to move out of state for work, his mother-in-law moved with them to stay close. All of their houses since then have had mother-in-law suites for her, so she could live with them and still have her own space. She was a wonderful, sweet, generous woman, and it has been incredibly difficult for my brother and sister-in-law to watch her decline -- and it has been very hard on their children, too.

By the time I heard the news and finished fetching children and doing homework, the window of opportunity to call had closed, but I will call my s-i-l in the morning. I wish I could do more than that, but again: all the way across the continent, here, I'm stuck.

And somewhere in the back of my mind is that horrid, horrid superstition: Bad things come in threes, but I know that's just what it is, a superstition, and I'm not going looking for any trouble.

Saturday, January 14, 2006

whitewash

Listerine Whitening Pre-Brush Rinse

32 ounces of this product costs about $8.

32 ounces of this product costs about $2.

Let's go back to that first product now. Here's what it will do for you:
Safely Whitens Teeth - Kills the Germs that cause Bad Breath

The Easy Way to a Whiter, More Confident Smile.

* Dynamic foaming action to let you know that it's hard at work whitening your teeth.
* Kills the germs that cause bad breath
* Continue to use every day for whiter, brighter teeth.

How does it accomplish all of these minor miracles? That's easy -- just take a look at the ingredient list: Water, Alcohol 8%, Hydrogen Peroxide, Sodium Phosphate, Poloxamer 407, Sodium Lauryl Sulfate, Sodium Citrate, Flavors, Sodium Saccharin, Sucralose

Hmmm. Well, water's just to dilute it to the proper strength, and alcohol is probably to help shelf-stabilize it. The rest of that stuff is either flavoring or soap (compare to the label of your favorite shampoo!)

Is this the biggest racket ever since Excedrin repackaged itself -- with exactly the same active ingredients -- as "Excedrin Migraine" just so they could charge more? (Interestingly, I note on drugstore.com that the price of the two products is identical there, but that hasn't always been the case.)

Hydrogen peroxide is great stuff. We soak our toothbrushes in it to keep them germ-free, changing out the peroxide once a week. This is especially important during cold and flu season, when germs can thrive on toothbrushes! But I figured out a while ago that just shaking off the brush and brushing with the peroxide, before my regular brushing, keeps stains at bay.

But what about the taste, you say? Well, hydrogen peroxide does "fizz", but it doesn't have much of a taste to speak of. It won't leave your mouth feeling minty-fresh; it's not that much different from brushing with just water. But you should use it as a pre-brush anyway -- brush for a minute, then rinse your brush (not your mouth!), add your regular toothpaste, and proceed as you normally do.

I was concerned that perhaps the straight peroxide brushing might pose a threat to my teeth, so I did some googling around. This dentist assures us that teeth whitening procedures, all of which use hydrogen peroxide, are safe so long as prolonged exposure to the whitening agent is avoided. A few minutes each week of brushing with peroxide won't weaken your enamel, but it will brighten your smile... for a lot less money than you'll spend on that Listerine stuff.

woosh

Today slipped by me so quickly, I have no idea where it went.

I did a little cleaning. I talked to a friend in the morning and my sister in the evening. I did a little cooking: I made some chicken soup for dinner. (The kids had pancakes and bacon.)

I lost a couple of hours in the late afternoon: DS1 had another outburst at school today. The common circumstances I can identify are 1) he was hungry 2) they were out of the normal routine 3) the teacher asked him to do something he did not understand and therefore did not want to do. So: talking to the teachers involved, talking to the boy himself, talking to DH about what to do about this stuff, and then reading through my favorite parenting book for advice; alas, I came up with nothing. The problem is, it's about half temperament and half manipulation, and you deal with these issues in very different ways.

The hunger symptom is one that we can perhaps address, so I made an appointment for him at the pediatrician this week, where we'll explore things like hypoglycemia or other possible metabolic problems (food sensitivies? I don't know.) Other kids can drink Snapple and not turn into raving lunatics; DS1 can't. There's got to be something going on there.

I don't know why I have this sense there's something I should have done. Whatever it is, it did not get done.

Thursday, January 12, 2006

everybody wins

The final tweaks are in, and the additional egg white had the desired "glue" effect. Here's the recipe I used for the test run, since we had quite enough lemon squares already:

Low Carb Cinnamon Shortbread
16 squares

1/2 C almond meal
1/2 C Designer Whey French vanilla protein powder
1/2 tsp xanthan gum
1/4 C Splenda pourable
2 tsp cinnamon
1/8 tsp nutmeg
1/2 C (1 stick) unsalted butter, softened
1 egg white

Preheat the oven to 325 degrees.
Line an 8x8 baking pan with foil, and spray the bottom of the foil with no-stick cooking spray.
Put the almond meal, protein powder, xanthan gum, Splenda, cinnamon, and nutmeg into the workbowl of your food processor fitted with the "S" blade. Process to combine everything, about 15 seconds.
Cut the butter up into rough chunks and add to the food processor bowl. Pour in the egg white. Process until the mixture forms a smooth, sticky dough, and no lumps of butter are visible.
Scrape the dough out into the pan, and spread it evenly to the sides and corners. This dough is somewhat self-levelling, but do take care that there aren't any thin spots.
Bake in a 325 degree oven for 25-30 minutes, until just starting to brown around the edges. Do not underbake or the texture will be gluey in the middle.
Allow to cool about 5 minutes in the pan, then, using the edges of the foil, lift the shortbread out of the pan onto a cooling rack. Allow to cool completely before cutting. Makes 16 good size squares.

You can use double the ingredients and bake in a 9X13 pan for excellent results. You may want to dial back the cinnamon to 3+1/2 tsp, though. These are super-cinnamon-y; you could probably decrease the cinnamon to just 1 tsp if you're concerned about cinnamon overload.

Approximate nutrition information, per square: 81 calories, 7 g fat, 1.5 g carbohydrate, 0.6 g fiber, 3 g protein

If you want to make the high-carb version of this, use regular flour in place of the protein powder and almond meal, and sugar in place of the Splenda; omit the xanthan gum and egg white. High carb baking is so easy.

almost there

Today's batch of low carb lemon squares was much better than the first batch, which suffered from a pasty crust, most likely the result of undercooking and the combination of ingredients I used. I was going for taste and didn't realize how much the texture would suffer. Mom and DH didn't seem to mind, but to me: Ew! Not as bad as "yuck!" but I'm not about to publish the recipe.

So today I left out the paste-makers and went in a different direction entirely, and the result was very tasty, indeed. I had to add an extra step to improve the texture of the custard top, but overall, these squares got nods of approval from everyone.

I thought I was done tinkering until I started putting them away. The crust is much too crumbly! I ended up leaving about a third of it in the pan. Obviously, some culinary glue (aka egg whites) will be required. Regular high-carb shortbread doesn't have much in it besides butter, flour, and sugar, but regular flour has its own "glue", gluten, that helps it stick together. Low carb ingredients need all the help they can get, and I thought that including xanthan gum would make up for the lack of gluten, but it isn't enough. So tomorrow, one last trip to the kitchen.

I don't need to make another whole batch of lemon squares, though -- I'll just make a little batch of shortbread, and see how it turns out.

If I've piqued your interest, the recipe will be published on the first of the month.

Wednesday, January 11, 2006

Grand Rounds (late entry)

The proprietor of Clinical Cases and Images was kind enough to make my post a late edition to this week's Grand Rounds. Check out the pie chart -- I've a longstanding love of useful graphics, and this one certainly qualifies. Lots of other good stuff as usual.

Tuesday, January 10, 2006

you're not going to throw that out, are you?

I think it drives my mother crazy that I discard the meat and vegetables, etc, from the chicken stock that has been simmering on the stove all day. I'm sure she was horrified to see it all get dumped, but I told her: It has all given up everything it had to the stock, Ma.

Our diet at home was very simple and repetitious, but the food was always fresh, wholesome, real food, not a lot (or any, really) pre-cooked, packaged junk. I learned the basic basics from my mother when I was in junior high and high school. I remained at that proficient but dull level for a number of years until my early 30s, when my whole relationship with food changed: I discovered food as entertainment, and I've never looked back. I started collecting (and reading) cookbooks and trying to reproduce the astounding tastes I was having at the really good restaurants I could finally afford. I discovered I could do it! Wow.

I'm not saying I'm a better cook than my mother. I'm saying I'm a different kind of cook. I don't think my mother ever cooked anything "just for fun," but I could be wrong. She loves to cook and bake for others, when she "knows it will be eaten." That's what food is for, after all. But still -- from my earliest memories of good-smelling kitchens, I remember big pots of soup bubbling on the stove. Surely Mom knew how to make stock? -- No.

Every so often I stumble over something like this that I didn't realize about Mom, and then I have to figure out where it fits in. The no-stock soup makes perfect sense, really: Mom would never use up a passle of vegetables and herbs "just" to make a stock. She would put the meat and the vegetables in water and cook them until they were done, and if the stock was a little thin, she'd punch it up with bouillion. It's part of her essential frugality, that Depression-era "waste not" idea that will always be a part of her, and which lurks, in some way, behind every decision she makes. In retrospect, I should've known, but making stock is an auto-pilot thing for me now, so I didn't even think of it.

At any rate, I made a batch of chicken and rice soup with last week's stock and we both really enjoyed it. She liked it so much that she asked today, as she was cutting up the chicken we ate for dinner, Are you going to make your soup? Yes, another little batch, using the backs and breastbones and all the other bits you wouldn't set on the table. It's just enough for a small batch of soup, or for some gravy, maybe, or as the base for a nice white sauce.

I love that about my mom: even though it's not something she herself would do, she can relax enough about those "wasted" veggies, etc, to still enjoy the soup.

Tiny Batch of Chicken Stock
yield: 3-4 cups flavorful broth

backs and breastbones, plus wingtips and any other bones, skin, or bits of meat, from 2 chickens that you've cut up to use for some other purpose
1/2 onion, cut into quarters
6-8 baby carrots (I don't buy any other kind now)
2 stalks of celery, washed and cut into 2-inch pieces
4 cloves of garlic, peeled
8 peppercorns (more or less)
1 bay leaf
1 tsp dried thyme
1 tsp dried rosemary
water to cover

Put all this in a heavy-bottomed pot and cover with about 6 cups or so of water. Bring it to a boil, then lower the heat and let it simmer for at least 4-6 hours, 8 hours is OK, too, stirring occasionally. The longer it simmers, the more "good stuff" is extracted from the bones and cartilage.
Let cool. Put a strainer over a large bowl set in your sink. (This part can be messy). Pour the contents of the pot into the strainer -- don't forget the bowl underneath, because what you want is the stock, not the stuff! Pick up the strainer and let it drip for a while, but don't bother pressing the contents. (Well, I suppose you could, but I never do.)
Decant your lovely stock into a container that is more suited to its volume, cover tightly, and refrigerate until you're ready to use it.

Easy Chicken Soup
serves 2-3
(It's easy because making the stock is the hard part! Really, it's nearly impossible to screw this up)
3-4 cups chicken stock
boneless skinless chicken breasts, 1 per person you want to serve
baby carrots, about 4-6 per person
celery, 2 stalks per person
potatoes/rice/barley/pasta ... what do you like in your soup? Be careful, these expand! Use a small amount if you're not sure how much to put in!

Put the chicken stock in your pot over medium heat. Cut the chicken into bite-sized pieces and add to the stock. Cut carrots, celery, and any other soup-friendly vegetable you like into bite-sized pieces and add them, too. Let it simmer until the vegetables are tender and the chicken is cooked through. Here, two things are important: first, make sure the vegetables are cut into uniform, small-ish pieces. If you want bigger pieces of vegetables, put them in before the chicken, because otherwise the chicken will turn to mush before the vegetables are cooked. Second, do make sure the chicken is cooked through before eating it.

You can add raw rice/pasta/barley to the stock but it will soak up quite a bit of liquid, and you might end up with something more thick than you like. Leftover takeout Chinese food rice works really well; you can just stir in as much as you like. The rice cooked in the stock tastes fantastic, but for a recipe like this where you're working with a small amount of stock, it's best to be cautious.

seems like old times

(geek alert)
I'm having a problem with the links my blog generates to individual posts. It doesn't attach the ".html" suffix to the URL the way it should, and because the filetype is missing, Firefox and Opera browsers can't access the pages.

Why should I care? Because my latest submission to Grand Rounds was booted because it wasn't viewable under those browsers. This is the third or fourth time I've been shut out of a carnival because there's something wrong with my template.

Since blog carnivals and Grand Rounds are about the only "publishing" (ha) I do these days, it is annoying when I can't -- especially when I've actually written something to submit by the deadline.

So today for the first time in about five years I found myself diving into HTML and CSS and staring with blank eyes at some Java Script, too -- at least that's what I think it was. Damned if I can figure out what's going on.

Fortunately, I found the Blogger Forum and there are knowledgeable people there, and I am hopeful that we (meaning they) can figure this thing out.

I admit, walking through the code was kind of ... exciting. I liked it, and not just because it was familiar. I liked having to dust off my problem-solving gears, even though I still haven't solved the problem. I remember when I used to do this kind of thing 10 hours a day! I thought. Don't want to go there again, but maybe I could get a part-time, flexible-hours gig when DS2 starts kindergarden in the fall. Hmmmmm....

Update: The fix worked! Post URLs from here on out will contain the proper ".html" extension. Old posts are stuck with the URLs they already have, but that's OK, because I don't want everyone's links to my old posts (not that there are so many, but there are a non-zero number out there) to suddenly become invalid. Thanks go to the Blogger Forum moderator redryder52, who immediately identified the problem in my archive settings. YAY!

optimist or realist?

DS2 has a raging ear infection. This has been a very rough winter for him: strep throat ($10 antibiotic) followed by mono (palliative measures only: buy stock in Motrin) followed now by an ear infection ($65 antibiotic.)

He woke up crying in the wee hours this morning, complaining of an earache, and woke again this morning just as his ibuprofen wore off with the same complaint. He was miserable all day, and was especially anxious about having to go to the doctor because the last visit had included a blood test. My assurances to him that he wouldn't have a needle stick today did nothing to calm his fears.

He was glued to me for our entire visit, and only started to perk up as he was choosing his sticker on the way out. (You don't get to choose from the toy box unless you get a shot -- it was probably the happiest he'd ever been to have not picked out a toy.)

As I carried him out of the doctor's office, I said to him, You're having a bad winter, aren't you?

He looked up at me and said, It feels good to me, Mom, then laid his head back down on my shoulder.

Monday, January 09, 2006

culinary technogeek

Back in my single career girl days, I once worked with a product manager who was an admitted, unabashed technophobe. Judith bragged about having a rotary dial on her phone at home, and no TV, either -- never mind a VCR to hook up to the thing. The irony of this situation, of course, is that she worked for a software development company, and the rant was precipitated by a voice mail message. But anyway, she once made this astounding statement: I hate technology. It hasn't done anything to improve people's lives, it has just made them more complicated.

It was pointless arguing anything with Judith, but at the time I thought, "Wow, you couldn't be more wrong: when was the last time you had to take your clothes down to the river to wash them?" I'd go so far as to say I'm the anti-Judith, at least with regard to her feelings about technology.

Today, for example, I spent the day in the kitchen, giving all my appliances a workout. I made my Guinness beef stew in the crockpot, but because I was multi-tasking, I forgot to add the vegetables until just a half-hour before dinner time. This did not precipitate a crisis, because I popped the carrots and potatoes into the microwave and pre-cooked them before adding them to the crockpot for the final 20-25 minutes of simmering, where they nicely absorbed the flavors of the broth.

It was the multi-tasking project that really put my kitchen tech through its paces. I'm working (again) on a low carb version of my Champion Lemon Squares recipe. Lemon squares are labor-intensive, there's no way around it. And so there I was, peeling and juicing lemons. Then the strips of zest went into my mini-chop to be pulverized. With the lemons processed, I could them move onto the actual baking. The crust went together in about 30 seconds in my food processor, and I firmed it up in the freezer before popping it in the oven.

The squares are cooling, we'll try them when they have sufficiently stabilized to cut. Low carb bake goods tend to be more crumbly in general, and even high carb shortbread isn't known for its structural integrity. I may end up having to refrigerate the squares before attempting to cut them, but that would be fine. I just want them to taste good, with the approximate textures of their high carb counterparts. This recipe is becoming my Mount Everest: a goal which will be attainable only after a lot of hard work. Or maybe it won't be attainable; maybe this is one recipe that I will concede needs to stay high carb.

We'll see. I won't get discouraged if this attempt is a failure, too. We still have a tree full of lemons out there.

Carnival of Recipes

The latest Carnival of Recipes is up at TechnoGypsy. I really enjoyed the descriptions of Orthodox Christmas and family traditions, and there are a number of recipes I intend to try -- the Apple/Orange Bread looks very good, and the post that introduces it is wonderful, too.

Sunday, January 08, 2006

did you know you can call?

I believe that everyone should have a doctor, but I know that's not going to happen. So for those of you who don't have a doctor, I'm going to recommend that you either 1) get one if you can, or 2) find the number for a local hospital or medical center's telephone triage call center (something like this).

Why? Because if you're sick and you're not sure you need medical care, the best thing to do is to call (as long as it's not an emergency, obviously). Call your doctor's office or the call center, and a trained professional will ask you about your symptoms, how severe they are, and how long they have been happening. You can get personalized, professional advice; all you have to do is ask. It's amazing how many people don't realize that doctors' offices and hospitals will do this!

Let's do some expectations management up front: during flu season, doctor's offices (and, I imagine, call centers) are very busy, and you may be on hold for a long time, or you may have to leave a message and wait several hours for someone to call back. If you think you're too sick to wait for advice, you should get yourself an appointment asap, or take yourself to an urgent care center. But there are a lot of times when you're just not sure what to do, and those are the times when calling can give you an answer.

Before you call, get your ducks in a row. The doctor on call or the nurse will ask you several questions, and it is very helpful if you are prepared. Sometimes just the exercise of answering these questions for yourself can help you recognize whether or not you need medical help.

1) What is/are the main problem(s)? This should be the symptom that finally drove you to call. It's fine to be aware of other things that are going on, but keep the main point up front.

2) How long has this been going on? Has it been the same, improving, getting worse? This is an important detail. ("I've had a fever and a really sore throat for 3 days now, and it's not getting any better.")

3) Now for the supporting information; report anything different from usual:
- do you look different - pale or flushed? Are your eyes droopy, red, glassy?
- how's your energy level? fatigued or wired?
- are you eating, eliminating, and sleeping the same, more, or less than usual?
- other symptoms like fever, coughing, wheezing, headache, neck pain or stiff neck, stomach pains, sore throat, bad breath -- again, note when they started, how long they've been around, and how bad they've been

4) Tell the doctor or nurse about any treatments you've tried, as well as any medications you take normally

5) If you know you've been exposed to something contagious and you feel you're coming down with the same thing, say that, too: "Two of my co-workers were out with strep throat last week."

6) If you have a pharmacy at which you get your prescriptions filled, have the number on hand in case the doctor wants to call in a prescription for you. This doesn't happen often, but it was a life saver one night when DD had an ear infection, and the pediatrician called in a prescription for some painkilling ear drops.

7) Last but not least, have a paper and pencil with you so you can take notes. Write down what the doctor or nurse tells you to do; don't rely on your not-well brain to remember everything.

When you get off the phone, do what you're told! The nurse or doctor won't tell you to come in if you're going to be fine, so if he wants to see you, or he wants you to go to an urgent care center, GO.

If he tells you to stay home and take care of yourself, do that, too. And if that's what you're told, won't you be happy you didn't drag your aching body down to the office?

Narnia

First impression: Nicely done, good for the kids, an excellent balance of suspense, violence, love, and beauty. I particularly liked the portrayals of sacrifice: everyone talks about Aslan, but I was struck more by Peter's general, the Centaur, who, upon seeing Peter struck from his horse, turns back and single-handedly tries to beat back the White Witch's warriors.

Second impression: too long!

One of the Brit crits over on NRO made the remark that both Peter and Edmund looked like "public school boys," which, paradoxically, means they look like high-society expensive private school boys. I agree that Peter fits that description, but Edmund had more than enough snivelly weasel in his thin face to keep him from that category. That said, Peter was beautiful and delightful to look at. All of the children were wonderful, really, but Mr. Tumnus was my favorite, followed closely by the Beavers, a delightful married couple.

Aslan did not disappoint, and Liam Neesan's voice was just right, but he was far from my favorite. I do agree with other critics in that the film failed to make a big enough deal out of Aslan. In the final battle, the White Witch wears a fur collar made of Aslan's shorn mane, and the sheer audacity of that gesture is wholly lost on an audience who hasn't read the book and doesn't understand who/what Aslan actually is.

That said, I appreciated how non-gritty the battle preparations and actual fights were. The good Narnians have some kind of special magic armor that never gets dirty or tarnished (heh). I loved the continuous echoes of Art Deco that permeated this movie, although the overall effect didn't reach the sublime heights of Jackson's vision of the Elf-realms in LOTR.

I've been weighing DVD purchases carefully recently -- I didn't just knee-jerk buy March of the Penguins, for example, even though we all enjoyed it. I'm not convinced we'll ever watch it again, so there's no need to buy it. But Narnia will be a welcome addition to our library when it is released.

Saturday, January 07, 2006

in other news

I feel like crud.

I haven't had any exercise except physical therapy since my surgery, having managed to make it to yoga class I think 2 or 3 times before the kids got sick and we went away and all that.

Since graduation from physical therapy, the only exercise I've had was walking/carrying kids around Disneyland -- and that was just a few days over a week ago.

Those few pounds I gained over the holidays are still with me, and I'll probably gain more if I keep eating as much junk (chocolate, pasta, bread, coffee drinks) as I've been eating lately.

My face hurts, too. All of my salivary glands have been acting up for a couple of weeks now, and it's extremely annoying. It's not an excruciating pain or anything, just a slight ache all above and below the jaw, and alternating states of being awash in salty saliva or having no saliva at all.

My RA is once again starting to kick my butt, but that makes sense given the lousy diet and lack of exercise.

And bad sleep. I've been staying up way too late, trying to clear my head (ha!) -- it's a transition time, getting used to having Mom here. When I do get to bed, I don't sleep right away as I usually do.

I need to get a handle on this because it's not going to get better on its own. With DS2 going back to school this week, hopefully we'll be able to settle into a better routine, one that includes me getting some exercise time and space, and developing a more healthy mechanism for rebalancing myself.

My overall impression of today was that it sucked, because of traffic idiocy, kid squabbles -- I actually had to rearrange their seats in the van on the way home this evening to keep them from beating on each other -- and garden variety accidents: DD dropped her coffee in the children's section at Borders. You ask: she gets her own coffee? I reply: Not after today, she doesn't.

Some good things about today: I cleaned the bathrooms and changed out the linen on all the beds, and even washed the old linens. My friend M came and visited with her 3 chihuahuas, and I took a million pictures; they're adorable. The holiday gingerbread cake at Border's is really delicious. The new episode of Battlestar Galactica was all kinds of good, and I'm not even plugged into the series. Tomorrow is Saturday and I can sleep late!

That good-things list seems a bit thin, but it's enough. And now I'll take myself and my sinus headache off to bed, and hope things are brighter in the morning.

Sleepy time!