Tuesday, June 30, 2009

Nut Allergies and Nut Butter Substitutes

Today's visit with the allergy doctor yielded no surprises. He suggested we keep re-testing, feeling if DD17 outgrows her allergies, it will be slowly. He also thought a peanut vaccine would be available within five years. I doubt, however, that we will be first in line to try it. New vaccines make me nervous, and I especially don't want to experiment on DD17, with all her health problems. (I'm closely following the updates on the Swine Flu vaccine recommendations. I hope I don't have to make a decision to vaccinate or not if this flu mutates and becomes worse.)

So, we've become dependent on nut butter substitutes in this house. We like both I.M. Healthy soynut butter products, and Sunbutter Sunflower Seed Spread. They have distinctive tastes, and are reasonable substitutes for peanut butter. Sunbutter is a bit sweeter, while I.M. Healthy is less salty than peanut butter. I'm a little concerned about the soy in I.M. Healthy, having read conflicting things about soy products, but I guess everything in moderation is my motto.

Both products come in different versions (creamy, crunchy, cocoa), and are available in some supermarkets as well as online. I once tried baking muffins with I.M. Healthy, and they turned out OK. I have to experiment some more, perhaps with cookies.

Monday, June 29, 2009

Can Chemotherapy Cause Nut Allergies?

About three years ago, DD17 was eating raw peanuts from a tin we 'd received as a Christmas gift. She commented how it was funny that lately peanuts made her ears itch. A red flag went up for this Mom, who immediately went on Health Patrol and snatched the tin away from her. After waiting and watching for any other reaction, I breathed a sign of relief once all seemed well. We had an upcoming oncology visit, so we decided that all nuts would be off limits until we could get into the hospital and talk to the doctor. The oncologist had become our primary doctor, and I was finding it difficult to trust anyone else during this time, so I did not call the pediatrician.

During our appointment, the oncology nurse ran a RAST test, which measures allergy antibodies in the blood. Later that day the oncologist called us at home and told us that DD17 had indeed developed an allergy to peanuts, and advised further testing with an allergist. Since DD17 had never shown a reaction to any kind of food, the oncologist thought it was a possibility that chemotherapy had effected some change in her immune system, causing a nut allergy to develop.

Later, we had thorough testing with an allergist and DD17 was diagnosed with both peanut and tree nut allergies. Since most cases of nut allergies develop early in life, the allergist agreed with the oncologist that the chemotherapy was suspect. We received our prescription for an epi-pen and went home to check our cupboards and make yet more changes in our lives.

Most children never outgrow peanut/tree nut allergies, but since DD17 was a unique case, the allergist suggested yearly testing in case something changes. Tomorrow is our yearly visit, and while we've already completed our bloodwork at a local lab and know DD17 is still allergic, I'm looking forward to the visit in hopes the doctor can offer some promise for the future (I know there are studies and trials underway to end nut allergies). We'll see what he tells us.

I can't really find any literature linking the development of nut allergies with chemotherapy, but I guess anything is possible. That's the most frustrating thing about childhood cancer: side effects are not always well-documented, because the survival rate was so dismal for so long. As more and more kids survive cancer, I suspect the list of side effects will have some surprises.

I guess we're lucky, in a way. DD17 is old enough to check her own labels, and has even ventured into the school's kitchen to check product labels (the cafeteria staff likes her). I can imagine how difficult a food allergy would be for a younger child and the stress for the parents.

Friday, June 26, 2009

Adjusting, and Thoughts about Food

I certainly didn't win Mother of the Year yesterday. Dismal weather, a building migraine, and the usual adjustment period when school ends and all of us are home together 24/7 made me extremely cranky. Generally, kids need structure (as do most of us, I think), and the skidding halt of school and related activities can be overwhelming. Lots of hours to fill, especially if parents don't want kids (boys especially) playing constant video games.

This morning I clipped several Sundays' worth of accumulated coupons in anticipation of more food shopping and a Target run. I've always been a coupon clipper, but since I started analyzing and changing our food habits, I've noticed there are very few useful coupons out there. Really, most of them are for processed foods. I still go through them, however, because there are some for soaps or detergent or toothpaste.

I spend a lot of time thinking about food and the choices we make. (Sometimes I think I should've named this blog "Adventures in Food Shopping"). I think we have too many choices in the United States, and that so adds to the confusion of what to eat. Last summer we spent two weeks in Italy, mostly in small towns, and saw the difference in how Europeans approach food.
There aren't many big supermarkets in smaller towns. There may be several different types of smaller markets, one for fish and another for bread, for example. The stores generally close around midday until about 4:00 p.m., so the day's meals have to be planned carefully. You can't really run out for last minute items. These smaller markets generally run out of fresh bread, for example, early in the day. No preservatives means these foods don't sit on the shelves for days on end, so you buy more often. You can't stock up on bread, like I do (I have a big freezer in my basement).

I witnessed a more personal relationship with food. You might go down the street to the man who raises chickens and ask for some fresh eggs for the day. If the market selling handmade pasta runs out, you may change your menu, rather than resort to dried (boxed) pasta like most of us do (I have about a dozen boxes in my pantry at any time). Or you make it yourself (I don't).

Meals are such an integral part of the day, and the meal itself is a topic of conversation. We ate at one home where much discussion focused on the quality of the balsamic vinegar sitting on the table. We were urged to dip into the bowl and savor the distinctive flavor. Here, I don't even think of the generic bottle sitting in my pantry until I use it to make a salad dressing, and I'm sure it is nothing special.

The disparity between American food culture and European food culture is so fascinating to me, especially as it relates to healthy, mindful eating. Michael Pollan's books explore this in great depth, but it truly doesn't become evident until you can visit another country where on a day to day basis the meal is front and center, not just an afterthought as it frequently is here.

Wednesday, June 24, 2009

School's Out

Today is the first official day of summer in our house. Yesterday was DS12's promotion ceremony...he is now a middle-schooler and our elementary school days are over. Transitions are rough around here, especially for him, but life moves on whether or not we're ready for it.

Here in the Northeast, we've been stuck in a dismal, rainy, cool pattern for weeks. I know the rest of the country is sweltering, and while I don't envy anyone the extreme heat, I'd like to see the sun. The summer is short enough around here as it is, so we do feel a bit cheated if we're still stuck inside in late June.

Summer Little League baseball marches on, however, rain or shine. If games were cancelled every time it rained this year, the season would be non-existent. Most games are played in the early evening, which wreaks havoc with the dinner hour. Too early to eat before, too late to cook afterwards. It's always a pain, every summer. The only good thing is that the rest of the schedule is clear...no homework, school events, etc., so if I can just go with the flow dinner-wise, all is well.

So today I ventured out to food shop with summer in mind. Healthy, last-minute meals, or pre-cooked-and-then-reheated dinners, as well as easy lunches, were my goals. Food shopping has become both easier and more difficult as I've ditched almost all processed foods. For the most part, I can avoid many of the center aisles of the store, with the exception of pastas, canned and dried beans and some other items (like tuna or cereal). That leaves dairy, meats, and produce.

I always buy too much produce (vegetables especially), and then have to scramble to cook things before they sit too long in the fridge. Greens, especially, get slimy quickly. Today I bought both swiss chard and broccoli rabe, and cooked them immediately (a simple saute) so we'll have some green vegetables ready for the next two nights. I'm still mulling over the accompanying starches and proteins, but it feels good to get the vegetables done so I don't have to rely on frozen, which just feels wrong this time of year.

Monday, June 22, 2009

Reach the Day

Reach the Day is an event taking place in Washington, D.C. today and tomorrow. Sponsored by CureSearch, it brings together childhood cancer patients, survivors, families, and the medical community to raise awareness for childhood cancer research. Attendees are given advocacy training, and then get to meet members of Congress to tell their story. CureSearch has made great strides in the last few years, but still has far to go to get more guaranteed federal money for pediatric cancer research, which is chronically underfunded.

We've never made it to Reach the Day. It always seems to fall during the last week of school for us in the Northeast. I think it would be an empowering event for DD17. Maybe someday she'll get to go. She's already a very good fundraiser on her own, organizing events at school to raise money for research. Sadly, it seems every year another child in the community is stricken with cancer.

Friday, June 19, 2009

Lunch Dilemmas

The older two kids are officially on summer break as of today. DS12 has his last day of school next week. The big dilemma now is what to give them for lunch every day. Yeah, I'm a bit of a control freak--I don't share the kitchen very well. DD17 helps herself, but the boys are just too...I don't know, boyish to be trusted in the kitchen alone for too long.

I try to avoid deli products, not liking those scary nitrates. Whole Foods and some supermarkets sell nitrate-free deli, but it tends to be very expensive. Tuna is okay, but not on a daily basis. DD17 is allergic to all nuts (thought to be a by-product of chemotherapy...a post for another day), so I won't have peanut butter in the house. It's too risky, with the chance for cross-contamination in the jelly jar too high.

I'll probably rely on leftovers from the night before, as much as I can. It's much easier when they're getting one meal out of the house during the school year, as the boys especially like to buy their lunch rather than bring it. They like the variety, I think. Yeah, I don't know what's in it, but I figure the 80-20 rule is in effect...eat healthy 80% of the time. Don't worry about the other 20%.

Besides, it can't be as bad the lunch I saw a kid eating at DS12's table last week when I was the lunch/recess volunteer: a Diet Coke and a package of cookies. (shudder)

Thursday, June 18, 2009

Obsessed with Health News

I read health news of any kind. It's an obsession that has grown in the last 5 years. Sometimes health news contradicts itself, which can lead us to throw up our hands and give up trying to eat better, exercise more, etc. Generally, though, I can find some useful nugget of information that I can put to use in my daily life, figuring it can't hurt.

For example:
  • Carrots may offer more cancer-protective properties if they are cooked whole as opposed to cut up. I read this just the other day, in a study reported by Reuters. So while I usually chop up carrots, maybe now I'll use them whole, at least occasionally. My sister recently served a platter of whole roasted carrots and parsnips during a meal. Looked pretty, tasted great. Maybe healthier, too.
  • Research suggests letting chopped onions and garlic sit for about 10 minutes before cooking. "Chop then stop," as it's sometimes described, releases more of the vegetables' potent cancer-fighting and anti-inflammatory benefits. Not hard to implement at all, so why not?
  • Low levels of Vitamin D (the sunshine vitamin) is emerging as a possible culprit in some cancers and autoimmune diseases like MS. Those of us living north of Atlanta are probably deficient in the winter months. Dr. Weil has suggested for a few years now that the National Institutes of Health (NIH) suggested amount of 400 IU per day is too low. In addition to taking a multivitamin with 400 IU, I've tried to up my vitamin D with fortified yogurt, milk, and orange juice. Interestingly enough, at my last physical in November my doctor decided to do some bloodwork and also checked my vitamin D levels for the first time ever. They were on the low side of normal, so at her suggestion, I'm now taking a D3 supplement in addition to my multivitamin. If my husband is around for breakfast (not often), he'll take one too, along with a multivitamin, at my urging. Spotty nutrition, I know, but I do what I can. I'll probably check with the kids' doctors this year and see what their recommendations are. (The boys get a children's vitamin--although DS15 is adult-sized--but I've been afraid to give DS17 a vitamin. I can't seem to get a consensus from any doctor on whether or not it's a good idea for her. The information available online is sketchy in regards to benefits or risks for cancer survivors.)

Sometimes too much information can be overwhelming, but I think some judicious weeding through the onslaught of health news can help us make better choices. And some choices can't hurt, so why not?

Tuesday, June 16, 2009

Roasted Asparagus

I think of asparagus as the quintessential spring vegetable. When I see it in the supermarket, I know Spring has arrived, regardless of what the weather says. Barbara Kingsolver's Animal, Vegetable, Miracle, an account of a year spent eating home-grown or local food, dedicates a whole chapter to asparagus (Waiting for Asparagus: Late March). It truly is the foodie's symbol for a new season.

Here's my favorite way to prepare it:

Wash and trim a bunch of asparagus. I usually just snap the ends of the stalks. Coat a baking sheet with 1-2 tablespoons of olive oil. Lay the spears in a single layer on the baking sheet, rolling them in the oil so that they are completely coated. Sprinkle with some coarse salt. Bake at 425 for about 20-30 minutes. Turn them once, halfway through cooking. I like them a little browned, which I think develops the flavor, but you can remove them earlier if you prefer.

Asparagus is a good source of potassium, Vitamins C, A, and K, and folate. I don't even mind the um, smell 4 out of 10 of us notice afterwards, although it does disturb my daughter a bit. ("Are you sure this is normal?")

Monday, June 15, 2009

A Second Home (Not)

Saw this entertaining article in Newsweek about vacation homes and the economy:

http://www.newsweek.com/id/199931

It's timely because as we count down to the last day of school, I'm anticipating the quiet that will descend on my (already quiet) little town. It seems everyone leaves for their second home (or their parent's beach home, which they will inherit someday) as soon as school's out. Really.

We consider ourselves lucky to be able to pay one mortgage and other bills, along with the myriad costs of raising three children, in this economy. I realize everyone's circumstances are different, but from a practical standpoint, I can't even begin to contemplate the energy it would take to deal with another house on the weekends, when I can barely keep on top of the chores for this one.

Thursday, June 11, 2009

Pasta with Broccoli

One way to get vegetable-averse DS12 to eat broccoli is to incorporate it into a pasta dish. This is a staple in my house, and not your typical restaurant pasta/broccoli dish (at least, I've never seen this version offered in a restaurant.) It is, however, very common in Italy.

Bring a pot of water to a boil. Meanwhile, saute a few cloves of smashed garlic in some olive oil (maybe 1/4 cup of oil for 1 pound of pasta). Add some finely chopped anchovies for that elusive umami taste and some omega-3 fatty acids. They'll disintegrate in the hot oil and you'll never even see them. Add some good quality paprika, maybe two tablespoons, to the oil, and stir. Remove from heat to keep garlic from browning too much. To the boiling water add the pasta (I like Barilla Plus/ Multigrain) and about 1 pound of broccoli florets. (I've never actually weighed the broccoli, tending to eyeball the amount. I think more is better.) Cook for about 10 minutes. Pasta should be cooked al dente, which sometimes tastes undercooked. Italians prefer it this way and it lowers the glycemic index of the pasta. Drain the pasta and broccoli mix, reserving about 1-2 cups of the pasta water. Toss the pasta and broccoli with the oil mixture, adding the reserved pasta water as desired to moisten. Add some grated Parmesan or Romano cheese, and salt to taste.

You could add some cooked and diced chicken breast to this dish, but I like it best vegetarian. I love anchovies, and think they work well in this dish, but you can leave them out (I have to sneak them in when the kids are around.) You can also scoop out the garlic from the oil before adding it to the pasta.

Tuesday, June 9, 2009

The World's Most Perfect Food

The sweet potato has been called "the world's most perfect food." A nutritional powerhouse, it's high in fiber and full of antioxidants. I feel good serving it to my family and try to include it in many meals.

Today was damp and cool (again) here in the Northeast, so it seemed like a good night to make a warm meal and include some colorful sweet potatoes. One of my favorite ways of preparing them is simply to peel and dice into cubes. For my family of five, I'll use four big sweet potatoes. I toss the cubed potatoes with about two tablespoons of olive or canola oil and some kosher salt. Sometimes I'll add a dash of hot red pepper. Spread them onto a baking sheet and bake for about 30-45 minutes in a 400 degree oven. With a spatula, flip them once halfway through baking. They won't be as crispy as white potatoes cooked this way; rather, they'll be soft and creamy and really delicious.

Genes

"The pessimist complains about the wind; the optimist expects it to change; the realist adjusts the sails." -- William Arthur Ward

My father came home from the hospital with more health problems than when he entered. He is 81, so I guess it is to be expected.

However, every time a parent develops a new health problem means our own health story changes, as well as our children's. So, I must make a mental list of new issues to share with my doctor at my next physical appointment.

They say genes are 30% of the story and the rest is lifestyle. That's what I try to explain to my kids. You can't chose your relatives, but you can choose how to live your life. You can't control your genes, but you can control your choices. I hope I am presenting them with the tools to make intelligent health decisions.

Friday, June 5, 2009

Sandwich Generation

Today I truly feel as if I am part of the Sandwich Generation, that group of midlifers responsible for both children and parents. It adds an incredible amount of stress to my life to worry about both sets of people.

My father is in the hospital, again. My mother may need surgery, if not immediately, then soon. Meanwhile, my siblings and I have decided not to tell my father about my mother's health issue (I don't think it's an emergency, yet) in case it exacerbates his own problems, which are cardiac related. We're hoping his doctor, who is also my mother's doctor, won't mention it during rounds.

It's interesting to realize how advances in medicine have made the Sandwich Generation possible. My parents did not have these issues with their parents as they (mostly) did not live as long, since many health problems could not be treated successfully. My sister contends we midlifers need to start planning now how to live out our old ages, as we will likely (and hopefully) be around when our own children are midlife adults themselves, with their own responsibilities and problems.

Luckily, my parents live close by. I can only imagine the stress if they lived far away.

Thursday, June 4, 2009

Kleen Kanteen

The whole BPA (Bisphenol A) issue worries me. We are a Plastic Water Bottle Family. We need portable water. We are always on the go, as are most American families with school age kids. All three kids play sports, and DS12 carries a water bottle to school.

When I started paying attention to the BPA issue, I got rid of any plastic water bottles marked with a 3, 6, or 7. Apparently, anything with a 1 is considered safe for one-time use (Poland Spring bottles, for example). To further complicate matters, recent news reports suggest that leaving plastic water bottles in an overheated car renders the contents unsafe. That, of course, leads me to wonder if Poland Springs (or any) delivery trucks ever overheat. Are the trucks air conditioned? Somehow I doubt it. (Obviously, I can out-worry anyone, with the things I think about.)

So in a quest to minimize our plastic water bottle use, I purchased a Kleen Kanteen at a local sporting goods store a few months ago. I decided that DS12 could carry it to school, eliminating the need for a new bottled water every day (which he questions anyway, especially when Earth Day rolls around).

The Kanteen I purchased is aesthetically pleasing: a cool, shiny metal. It doesn't impart any taste to our well water, which tastes so fresh and clean in a glass, but not in plastic. And if you add ice cubes in the morning, it really keeps the water cold all day, at least indoors.

There are some downsides to the Kanteen, however. First of all, it's heavy! Filled with water, it adds a significant weight to the already overweight backpack. But my biggest complaint is that the bottom dents, significantly. I don't know if the contents of the backpack dent it, or if DS12 drops it during the day, but our Kleen Kanteen now looks like the Leaning Tower of Pisa. I'm wondering if the insulated totes sold as an accessory to the Kanteen would help. However, it would add another piece that would need to be washed.

Finally, I wonder if equipping everyone with a Kleen Kanteen might be a bad idea in the warmer weather. When I wash the Kanteen with hot water, the metal heats up so rapidly that it quickly becomes uncomfortable to handle. I think you would have to keep the Kanteen in a cooler outdoors, or the water inside would heat up. Perhaps the insulated tote would help here, also. I may have to try it. As usual, there are no easy answers.