Saturday, September 20, 2008

When My Stomach's THIS Happy, I Have To Share

I need several breaks during these long days of writing. I stand up every hour or so and do the dishes or water the plants or make up a grocery list or just go sit outside in the sun. I decided this weekend I'd cook between chapters to stock the freezer with some homemade foods. Cleaning, paring, chopping and slicing give me ample time to think about my life outside the book. (I have to remind myself sometimes that I still have one. A life, that is.)

I love fall for a lot of reasons, namely apples, pears, plums, pumpkins, tomatoes, zucchini and onions. On my way home from Pittsburgh yesterday, I stopped at my favorite farmer's market along Route 66 in a small, small town aptly named Orchardville. I like it because the family raises fabulous produce, they're nice folks and they take checks. (Does anyone carry cash anymore?) I picked up a half peck of Empire apples, five pounds of Roma tomatoes, three large zucchinis, some onions and a large bulb of garlic.

I had an additional five pounds of tomatoes here at home (gifts from gardening friends) and decided to make double batches of spaghetti sauce and roasted vegetable chili. I also wanted to make applesauce, something I hadn't done years, maybe? It's been a long time and I really don't know why other than I used to make it for my kids and they're grown and out of the house now. Come to think of it, I stopped making several things because the kids are gone, things I like to eat. So with this batch of applesauce, that crazy thinking is over with.

I forgot how much I love homemade applesauce. I poured a half cup (direct from the saucepan) in a small bowl and topped it with a quarter cup of Breyer's Double Churn fat-free vanilla yogurt and stood in the kitchen and ate it. Oh my, dare I say it was better than sex? I hope no one heard me :)

I'm ready to write again. Hope you're all enjoying the fine foods of fall as well. Be good to yourselves. Eat an apple or a pear or a plum or some pumpkin. It's good for you!

And because I know a few of you will ask, here are the recipes for the spaghetti sauce, the applesauce and the chili:

Lynn's Roasted Tomato and Garlic Pasta (and Pizza) Sauce
Serves 6-10, depending on what you're using it for

2 pounds Roma or plum tomatoes, halved lengthwise
1 medium onion, peeled and quartered
6 peeled garlic cloves
1 T fresh rosemary leaves (or 1 tsp dried)
1 T fresh thyme leaves (or 1 tsp dried)
1 T balsamic vinegar
1 6-ounce can tomato paste
½ tsp salt
1 tsp dried basil

Preheat oven to 375 degrees. Place the tomatoes, onion, garlic, rosemary and thyme on a baking sheet sprayed with non-stick spray. Spray veggies lightly with non-stick spray. Roast for 20 minutes. Flip the vegetables and roast for another 20-25 minutes or until they start to brown.

Scrape everything into a food processor fitted with the chopping blade or a blender and process until pureed. Pour contents into a large saucepan. Add vinegar, tomato paste, salt and basil. Simmer for at least 30 minutes. I sometimes go an hour for richer flavor.

This sauce keeps well for a three to four days. In fact, I think it tastes even better the next day. It’s great on pasta, squash and homemade pizza.

Lynn’s Roasted Veggie Chili
6-8 servings

4-5 cups total of veggies of your choice: carrots, zucchini, mushrooms, sweet red pepper and/or butternut squash
1 C chopped onion
4 cloves garlic, minced
1½ to 2 T chili powder (use more or less depending on how spicy you like it)
1 t sugar (may need to add a bit more later in the cooking process)
1 t salt
1/2 - 1 t cumin
1 t dried oregano leaves
1 t cocoa
½ t red pepper sauce
28 ounces canned diced tomatoes, undrained (or 5 -6 medium sized fresh tomatoes, skin removed, seeded and diced)
2-4 C vegetable or chicken broth (You probably won't need this if you use fresh tomatoes. It also depends on if you like your chili more like a stew or more like a soup)
2 cans (15 ½ ounces) red or white kidney beans or black beans or a combination of the two

Cut up the veggies into bite-sized pieces, put them on a baking sheet coated with cooking spray, sprinkle with garlic powder, cumin, and black pepper, and roast in a 400-degree oven for 30 minutes or until brown, flipping once after 15 minutes.

In a Dutch oven, spray the bottom with cooking spray and cook onions and garlic until tender, about 1-2 minutes. Add remaining ingredients except for the beans and bring to boil. Reduce heat to simmer and cook for at least an hour (I usually cook it for three hours). Add beans and heat through or cook an additional hour if you'd like.

Lynn's Favorite Applesauce ala an old Betty Crocker cookbook

4 medium tart apples, peeled, cored and quartered (about 4 cups)
1/2 c water
1/3 - 1/2 cup packed brown sugar
1/4 t cinnamon
1/8 t nutmeg

Cook apples in water on medium heat until soft, 10-15 minutes, breaking them up with a spoon. Add rest of the ingredients and boil and stir for one minute. You can mash it with a potato masher for a smoother consistency, or leave in chunks.

Sunday, September 14, 2008

A Sobering Email

Good morning, friends! It was so good to hear from all of you the last time I posted. The book proposal is coming along (with the help of a good coach who helps keep me on task), but I wanted to share some info I got from my friend Rhonda, a radiologist in Florida. Rhonda and I went to grade school and junior high together and I just saw her when I was in Minnesota in August.

Anyway, she sent me an email in response to a blog I wrote over on Refuse to Regain and I wanted to post her observations here as well as RTR. I was completely unaware of how being overweight or obese can interfere with what we might think of as the most simple medical procedure: an x-ray.

Here's what Rhonda wrote:

“I am reading this blog on a short break at work, where I am reading CT (CAT) scans, MRI's and Ultrasound exams, and it struck me to let you all know one of the health benefits that your weight affords you.

“We all know and think about the decreased risk of diabetes, heart disease, stroke, etc., from weight loss, but one of the things that I see in my daily practice is how much harder it is to image someone who is significantly overweight. The bigger you are, the more x-rays it takes to penetrate your body and the fuzzier the pictures are (even a plain old chest x-ray can be suboptimal). The bigger you are, the more your own body fat throws artifact on a CT scan, making it difficult to see. Ultrasound is not good at penetrating fat, so there are a lot of things we can't see with it in large people.

“If you are big enough, you may not even physically fit into an MRI scanner and for many, important applications, the open configuration magnets (which are often a lower magnetic field strength) are not adequate. All of our CT tables and tables where we do angiograms have weight limits above which we can't move the table with the patient on it or risk the table collapsing. Never mind the risk to hurting the patient, the repair bills for those tables can run in the hundreds of thousands of dollars range, so we end up having to literally not perform studies on patients who are over the weight limit. Even mammograms, in very large patients, I have seen us have to take four overlapping images for just one view of one breast in order to be able to cover the tissue adequately (a standard mammo consists of a total of 4 films, 2 views each breast).

“Some would say that by not having tables large enough to accommodate the bigger patients (there are a few manufactures out there who offer them), we are being discriminatory to the obese. The problem is that these machines cost upwards of $1 million for MRI and CT scanners and the larger format scanners often times give markedly suboptimal exams for people with more normal body habitus.

“My point is that not only are you decreasing your risk of significant health problems by losing weight, if you do become ill (brain aneurysm, appendicitis, etc. -- things that don't care how much you weigh), the chances of us being able to use our high-tech gadgets to diagnose and treat you are markedly improved by your weight loss.”

I wrote back and asked her, “If you were to find a lump and doctors performed surgery, is the actual surgery more difficult through layers of fat and is recovery more difficult?”

She wrote back:

“Since I am not a surgeon, I don't have 100 percent knowledge of surgical complications, but I can tell you about my experience with angiograms.

“When we get someone who is significantly overweight (but not over the table limits), they are prone to an increase in several complications. First of all, they may be so big that we can't feel the femoral pulse in order to do the puncture. That means we may need to use ultrasound to identify the artery and guide puncture. The gel from the US MAY slightly increase the risk of getting an infection at the puncture site.

“Secondly, we may need to use a longer need to hit our target.

“Thirdly, once we get in the vessel, we then put a guide wire ( a wire that looks like a guitar string with a floppy end at the front and a stiff part in the middle and end) so that we can take the needle out and put our catheter (tube with holes in it) over the guide wire into the vessel. Much harder to get a catheter to follow a guide wire through several centimeters of layers of fat, rather than just a couple for normal sized people.

“When we are finished with the procedure, we remove the catheter and hold pressure on the artery to stop the bleeding: harder to hold in big people and this increases the risk of getting a hematoma (a big blood clot in the tissues). Even if you don't get a hematoma during the hold, one can develop in the hours following the procedure and is harder to diagnoses if it is buried amongst the fat. Also, our bigger patients tend to also have back pain, which makes it harder for them to lie flat in bed (which we require them to do post procedure in order to heal the site). So if they are squirming around because they are uncomfortable from their back, this increases the risk of them getting a hematoma.

“Regular surgery can be technically more difficult in big patients. I still remember a lecture from one of the teachers in med. school. The lecture was ostensibly about ovarian cancer (which affects the 4 "F's": female, forty, fertile, fat). Most of what I remember was slide after slide of the retractor devices this particular doc had designed to hold back the pannus of the patient to adequately access the surgical site. It can be harder to keep the surgical site clean, post-op, increasing the rates of infection.”

Thanks, Rhonda, for the great info.

Tuesday, September 2, 2008

Hello from the Crazy Abyss

Arghhh! I can’t stand it! I’ve missed this blog so much and it’s only been, what? A week?

I’m roasting veggies, I’m making soups, I’m cleaning out the freezer, and yes, I’m writing the book, but it feels like forever since I’ve written something other than emails and the book. So allow me to bore you a bit with my recent observances.

I was all prepared today to step on the scale and see a number over 130. As you know, I’ve had a crazy schedule since late July and so my workout schedule has been sketchy at best. However, I’ve eaten well, stayed true to my stomach, and when I got on the scale this morning, I was 129.9. Point nine! Not 130. Point nine and still in the 120s. Yes, I know it’s a mind game. I know that on my doctor’s scale I’d have been 133 or something, but still, it got me through the day. With that number in my head, I was better able to complete a 60-minute cardio workout plus some strength training and abs and stretching. Sometimes you have to fake yourself out, you know?

What wasn’t crazy this weekend was the time spent with my granddaughter and my kids and my sister. Right now I’m home and alone on my back deck, absorbing the last of the summer heat, but I’m very sad to have said goodbye to them all yesterday. What’s different now is that I don’t eat my way through the sadness. Not that I binged before, but a little extra cheese here, some Tricuits there. Heck, light ice cream couldn’t hurt, right? Maybe not if I’d limited myself to a half cup.

Food challenges still abound. I’m glad I can navigate them easier now. But it doesn’t mean they don’t still exist. Why are they such a first line of defense (or offense, depending on the feeling of the mood)?

My brain is on overload, my friends, so I hope this blog entry makes some kind of sense. I just want you to know that I’ve missed this and will post again soon. I miss hearing from all of you.