Good Riddance, 2011

Yeah, yeah, I know. I still have a good 3 weeks + of 2011 to go. I'm skipping over Christmas entirely, and I never did post any Thanksgiving photos or recipes. But honestly, because 2011 has been such a craptastic year for me personally, I'm all for ushering it out as quickly as possible. Bring on 2012!

I don't want to get into a woe-is-me kinda state, because really this post is about looking toward the future. But if you want the quick run down of 2011, it goes something like this: Febuary: Moved to small town Michigan during the biggest snowstorm of the year. Arrived our new house at 1 AM with about 2 feet of snow in the driveway, and temperature sensitive goods in the car. Commence overnight shoveling. March: Begin new part time nursing job where every doctor is a prima donna and one actually refers to himself as "god." Yes, that's true. Oh, and I manage to piss off the scheduler from close to day one. Talent. April: The great endo search begins. At best, I'm travelling an hour and a half from my home. At worst, I'm waiting 6 months for an appointment. In between, I'm getting bad, outdated information from patriarcial groups who don't believe in the patient as part of the team. Other specialists I see are caught red handed giving me wrong infomation simply in an attempt to get money out of me. And insurance. Ah, insurance. well, what would a year be without me spending 100+ hours on the phone with customer service representatives, each one giving me a completely different set of steps to take to deal with the same issue? June - Midmichigan gets a torrential week of rain, and we get our first flood in the basement, leading to days of dryouts, ripped up carpet, ripped up dry wall and pulled out insulation - all which our lovely landlord never repairs. August - Flood number 2. Go through dry out and no repairs again. October - In a vain attempt to meet people, I go to a young adults group at a new church, and I am completely ignored. I'm not sure why I find that so ironic. There is something very ingrained in me expecting "church people" to be nice. November- Because I pissed the scheduler off, I am given Thanksgiving on call to fill a hole from someone leaving. (Never mind that I am part time, have no famly anywhere in the vacinity, and I am the only person who also has a holiday next year, also around the big holidays - New Year's Eve.) Being that I can count on one hand that number of aquaintances we have here, even though we have lived here now 10 months, Thanksgiving is spent at a BW3's. I don't recommend it. :) December - Flood #3. The sump pump goes out while we are away for a weekend. Ironically, we are over at a friend's house trying to fix their sump pump at about the same time ours probably went out. We come home to 3 inches of water throughout the entire basement (The other floods were kept to one side of the basement). The dryers are still running down there now, and we haven't been able totally gauge the loss yet, but some wedding pitures and electronics did get damaged. So add that to the year's general disappointment of not finding a job in the food industry - which was my goal as we moved and I took a part time position. I, of course, did not forsee that there is neither food culture nor an economy in Michigan.

So honestly, I can say that the year wasn't stellar - but it wasn't the most worst possible horrible year EVER. No one died. In a year that was very difficult for many, many people, we were blessed with jobs and food and a roof over our heads. Most of the problems were from unmet hopes, expectations, and my own assumptions, really. So even though hope may have smacked me around quite a bit this year, I'm hanging on for a brighter 2012. Cheers!

Sometimes the internet is really, really cool. Like when you find an absolutely gorgeous blog post about modern day farmers and consumers, through another friend's blog that is not food related in any way. (Thanks, Tricia!)

I wanted to share it here. It echoes thoughts I have had about our industrtial food system for years, firsthand from the farmer's perspective.

My favorite part, one that really makes you think -

“Why have I thought a good education was about sending our children away? Why do we teach that dirt doesn’t matter and growing food is menial? Why do we think success is measured in the distance we travel away from the land and its crops that our very stomachs crave three times a day?”

Cooking Fears

I stared at the giant green globes piled high on the folding table of the farmer's market, surrounded by less intimidating bunches of beets, peppers, and pumpkins. They were so large they could have easily fed a family of eight. Their flimsy, early spring green leaves belied the fact that it was the farmer's market's final autumn weekend - my last chance. After this, a winter full of grocery store, shipped-from-mexico produce awaits me.

"Come on." They whispered. "You know you wanna try it."

I still swear those cabbages were laughing at me.

An often revisted conversation between me and another foodie friend involves our greatest "cooking fears". Things that we've never done, things that sounds too big or too complicated or have too many steps. Sometimes these fears are completely.... well, I'd like to say random and baseless, but then I'd probably be referring to fears that aren't my own. :) My friend - who is, by the way, an excellent cook herself - is afraid to try her hand at mashed potatoes. Another pal hates touching raw meat of any kind. My own personal fears revolve a lot around baking - anything involving live yeast terrifies me. Also, any recipe that is long, drawn out, and has a lot of rare and expensive ingredients. I am a Midwestern girl at heart, and the idea of spending a lot of time and dollars on a failed, inedible project stops me cold before I even enter the kitchen.

Oddly, when it comes to actually eating, there is precious little that scares me. Raw fish or meat never even give me pause. Brains, intenstines, offal? I figure it's the perfect solution to using the entire animal, and I feel proud of myself for following the "snout to tail" dogma. Weird plants or bugs? I'll try anything once. I am a couragous eater. While travelling, I have been known to randomly pick something off a menu without even speaking the language. Talk about the ultimate surprise. :) I will also select the most random thing off menus, or pick a dish based entirely on a strange ingredient, for the simple reason of "Well? When else am I gonna get a chance to try that?"

So today, after my bout with the cabbages, I'm left wondering why that courageness abandones me in my own kitchen. Metaphor for life? Very possibly!

What does this all have to do with cabbages, exactly? Cabbages aren't scary in the slightest. Poor, innocent, maligned cabbages. I'll tell you in one word.

Sauerkraut.

The word itself sends shivers down my spine.

I love sauerkraut. Nothing say easy fall dinner better than a big plate of beautiful white slivers of fermented cabbage along side a roast porkloin, pork chops, or smoked sausage and apples...Mmmm...... I especially love homemade sauerkraut. As long as it's not my own. So in the world of "knowing exactly where your food comes from", this is a very ironic example of literally wanting to be in the dark.

I've talked about facing my fear for a good two years now. People tell me how easy it is to make. I've read articles, done online searches. Honestly, these things just serve to increase my activation barrier. (I have to sterilize a jar? How the heck do I do that? I mean, I work in an OR, but I think they'd notice if I slipped a mason jar into the autoclave.... And during the fermenting process the jar could possibly explode??!!! Seriously? Like a bomb? I have gruesome images in my head of my husband coming home to a zombie covered with shards of glass and cabbage....)

Seriously, doesn't anyone have an old German grandmother I can borrow for an afternoon? I really don't want to embarrass myself with an obituary that reads "died from an unfortunate self-inflicted sauerkraut poisoning".

I did buy that laughing head of cabbage. I will face this fear.

Who will be laughing at end? We shall see.

The Spiral Staircase

Do you ever feel this way?

Like you keep going in circles, over and over, passing by the same landmarks you've seen a few times before? Sometimes I think I must be living my own personal version of the movie Groundhog Day.

When will the view change? What can I do to effect that change? Do I act, or do I need to be still? How do I know the difference?

More importantly - Am I going up? Or am I headed down?

Hope is a necessary, beautiful, dangerous, lethal thing. Every time I seem to hit the proverbial bottom, I find I still have another few flights to go. And lately I feel like I'm falling down those flights face first.

Oven Roasted Squash

Somehow, fall always manages to completely sneak up on me. Wasn't it just a week ago that Mr. Foodie and I were enjoying 80 degree temperatures on the shore of Lake Michigan? What?!! It's mid-September already??!! Suddenly it's sweater weather and I have to put my sandals away.

Fall has it's share of good things, too. Like apple picking. And the explosion of cider apple donuts suddenly available near me. (Blood sugar willing, I'm definitely not going to say no to those!) Fall makes me want to bring out the comfy sweats and curl up on the couch and do absoultely nothing ALL. DAY. LONG. Along with the colder weather comes nice, warm comfort food. Yup, bring on the soups, braises, and all those one pot dishes I am so fond of.

Of course, right now is prime time at the farmer's markets. The sheer bounty is crazily beautiful, eye catching, and claustraphobic all at once. The late summer peppers, eggplants and tomatoes are making their last stands while the winter squash start rolling in. And nothing tastes of fall like squash. I love squash because even grocery stores seem to obey the seasonality of squash. Unlike other produce, you can't really find a butternut squash in the produce aisle in, say, May. I assume this is due to demand because I thought winter squash could last pretty long. Baked acorn squash doesn't sound as charming in April as it does in October. :)

This week in our CSA we received a tiny little delicata squash. I know that most squash recipes lean toward a sweet application - maple syrup, brown sugar, cranberries - but I wanted to go a little more savory. Squash is sweet enough on it's own, especially when roasted, so the contrast with the garlic in this recipe is surprisingly delicious. Since our CSA squash was too little on its own, I supplemented it with a buttercup squash, but any winter squash would work - butternut, kabocha, hubbard, acorn.

I will readily admit, the worst part of this recipe is preparing the squash. My regular knives weren't good enough - I had to bring out the big guns.

The prize at the end is worth your effort though - Mr. Foodie and I pretty much abandoned plates and picked up hot pieces of roasted squash right off the baking sheet. Yes, it's that good.

Oven-Roasted Squash with Garlic and Parsley

From Eating Well

5 pounds winter squash, peeled, seeded and cut into 1 inch chunks
2 tablespoons extra virgin olive oil
1 1/2 teaspoons salt
1/4 teaspoon pepper
3 cloves of garlic, minced
2 tablespoons chopped Italian parsley

Preheat oven to 375. Toss the squash with 4 teaspoons of oil, salt and pepper. Spread evenly on a large baking sheet. Roast, stirring occasionally, until tender throughout and lightly browned, 30-35 minutes.
Heat the remaining 2 teaspoons of oil in a small skillet over medium heat. Add the garlic and cook, stirring, until fragrant but not browned (about 30 seconds to 1 minute). Toss the roasted squash with the garlic and the parsley. Adjust the seasoning and serve.

Serving size - 3/4 cup. 104 calories, 3 g fat, 21 g carb.

30 Things, Garbanzo beans, and Greens

I learned from several others in the DOC (that's the diabetes online community) that this week is Invisible Illness Week. And since type 1 diabetes is the very definition of an invisible illness (ever heard, "But you don't look sick!"?), I want to jump in with the 30 Things About My Invisible Illness:

1. The illness I live with is: Type 1 Diabetes.

2. I was diagnosed with it in the year: June 1998, right after my high school graduation.

3. But I had symptoms since: April 1998.

4. The biggest adjustment I've had to make is: Planning. For literally everything. What am I going to eat for dinner? How is it going to affect me in 2 hours? In 4 hours? Overnight? Is my BG high enough to exercise? Do I have enough strips/insulin/CGM sets/pump infusion sets for wherever I'm going? I am a relatively spontaneous person, and even after 13 years, the planning is hard to remember.

5. Most people assume: That I gave this to myself by eating too much sugar.

6. The hardest part about mornings are: That first BG reading that sets a tone for your day.

7. My favorite medical TV show is: Scrubs. Because it's so ridiculous it doesn't need to be realistic. All the others try so hard to be realisitic, and still get it wrong. I'm a nurse, so that irriates me!

8. A gadget I couldn't live without: ohhh.... This one's hard. It's a total toss up. My pump, first of all. I was only on MDI for a month and I HATED it. Second, my meter - because where are you without that baseline? And thirdly - my Dexcom. I totally depend on it, especially at work, to ward off lows before they hit. Again, in the OR, that is SO important to me. Seriously, I don't think I can pick just one!

9. The hardest part about nights are: Being woken up every 15 minutes by a low, or a malfunctioning CGM sensor, or a high, correcting, trying to go back to sleep... Then waking up with a rebound low/high anyway.

10. Each Day I Take 1 pill and 1 vitamin. But oddly, that has nothing to do with diabetes. I infuse insulin 24/7 for that.

11. Regarding alternative treatments: Ain't nothin out there that's gonna grow me a new pancreas. I hate the "This diet/juice/pill is a cure-all for diabetes" ads. It's not.

12. If I had to choose between an invisible illness or a visible, I would choose: I like the invisible, for the most part. I can talk about diabetes on my own terms that way, when I'm ready to or when someone shows an interest.

13. Regarding working and career: Being a nurse made me realize that not ALL doctors or nurses understand type 1 diabetes. So it is vital to be your own advocate.

14. People would be surprised to know: No matter how much you plan, no matter how hard you try, no matter how good your carb counts, sometimes D throws you for a loop anyway. There is no perfect. I just have to keep trying.

15. The hardest thing to accept about my new reality has been: That one autoimmune disease can open the door to others. As strong as I think my body is, it has its flaws.

16. Something I never thought I could do with my illness that I did was: Run a half marathon. Boo-yah, diabetes!

17. The commercials about my illness: annoy me. There aren't any type 1 commercials. And I hate how Wilford Brimley says "diabetes." I have seen one or two JDRF commercials, and of course they only include cute little kids. But folks don't always realize that you can get type 1 even if you aren't a child. And you don't grow out of it.

18. Something I really miss doing since I was diagnosed: Eating cereal. :) I love cereal. But no matter what, it whacks out my BG.

19. It was really hard to give up: regular soda. At first. Now I can't really tell a difference. Or, if I accidently get a regular soda, it tastes so absurdly sweet that I think it's disgusting! :)

20. A new hobby I have taken up since my diagnosis is: Running. See #16! And cooking. :)

21. If I could have one day of feeling normal again I would: Just jump in a car and go somewhere. Without anything. I'd eat whatever I wanted, without a single thought to what was in it. No planning, and lots of brownies....

22. My illness has taught me: Carb counting and what a generally healthy diet looks like. I am much healthier than I would ever have been without diabetes. And it has taught me to be thankful for each day and all my blessings.

23. One thing that people say that gets under my skin: It's not so much what is said as how it is said. What bugs me is people who don't live with this disease judging one number in a myriad of numbers that make up my day, and making an assumption on that. "You're 236? You should take better care of yoursself." (At a doctor's office, while afraid and stressed, also with a number that could be attributed to a rebound high.) Another big pet peeve? Calling ANY diabetic "brittle." Brittle is not a medical term. THERE IS NO SUCH THING. Fluctuations are what this disease is all about. It irritates me to no end that even medical professionals I know throw this term around.

24. But I love it when: People are genuinely interested in learning! I love it when people ask me what my pump is, or how my CGM works.

25. My favorite motto, scripture, or quote that gets me through tough times is: "Every Change Matters."

26. When someone is diagnosed I'd like to tell them: You CAN do anything. ANYTHING.

27. Something that has surprised me about living with an illness is: How finding other people with the same illness changes how you view everything. I have learned so much from my T-1 friends and the DOC, and I am so much healthier for it.

28. The nicest thing someone did for me when I wasn't feeling well was: My hubby is THE. GREATEST. SUPPORT. I need juice? He grabs it. Glucose tabs? Check. Remember how I'm not a great planner? He has a diabetes check list he runs down before we go on trips to make sure I have everything. He's even woken me up at night to check my blood sugar, checked it for me when I'm low, put new pump infusion sets and CGM's in my arm, and taken me to the hospital during a scary blood sugar of 29. That guy is a champ.

29. I'm involved with Invisible Illness Week because: It's only invisible until we open up and talk about it. When we tell the world about Type 1, we dispell the myths surrounding diabetes.

30. The fact that you read this list makes me feel: Awesome. You guys are great. Honestly. I have such an amazing support group.

31. The most embarrassing diabetes related thing that's happened to you: So I added this one myself. Because you have to laugh at yourself. I've had a LOT of diabetes snafus, but the most embarrassing one was at a very, very fancy New York restaurant when my pump fell out from under my dress and bounced off the maitre d's shoe.

Whew!! Long meme. :) But I love things like that, maybe because it takes me back to a time before my life shifted. Because I had a good 18 years on this earth

before diabetes, and it is interesting to see where my life has gone because of it. For example, I am much healthier now than I ever would have been pre-diabetes. I also eat a lot more vegetables I would never have given a second glance to back then. Like greens, for example. Which are now one of my favorite things. Any kind of greens - turnip greens, beet greens, collards, kale. Seriously, kale chips could turn me from potato chips for life. Dark green, beautiful, full of iron... This garbanzo beans and greens stew has amazing depth of flavor, fills you up quite inexpensively, and has nice autumn colors to welcome in the colder weather. I found the stew to be quite nose-runningly spicy, so if you are sensitive to those things you might want to dial back the crushed red pepper a bit. But be sure to serve the stew with some pieces of baguette, because you don't want a single drop to go to waste!

Garbanzo Beans and Greens
From Cooking Light

2 bacon slices
1 cup chopped carrot
1/2 cup chopped onion
2 minced garlic cloves
1 teaspoon paprika
1/4 teaspoon kosher salt
1/2 teaspoon ground cumin
1/2 teaspoon crushed red pepper
2 1/2 cups chicken broth
1 cup water
2 15-ounce cans of garbanzo beans (chick peas), rinsed and drained
4 cups chopped fresh kale
1/2 cup plain reduced fat or fat free greek yogurt
4 lemon wedges

1. Cook bacon in a dutch oven over medium heat until crisp. Remove bacon from the pan and crumble. Add carrots and onion to the drippings in the pan and cook for 4 minutes, stirring occasionally. Add the garlic, cook for one minute, stirring constantly. Add paprika, salt, cumin, and red pepper and cook for 30 seconds, stirring constantly. Stir in chicken broth, water, and beans. Bring to a boil. Reduce heat and simmer for 20 minutes, stirring occasionally.

2. Add 4 cups of kale to bean mixture. Cover and simmer for 10 minutes or until the kale is tender, stirring occasionally. Ladle 1 1/4 cups bean mixture into 4 bowls and top each serving with 2 tablespoons yogurt. Sprinkle with bacon and serve with lemon wedges.

Yields: 4 servings. Calories - 216 Fat - 4.2 grams Carbs - 33.7 grams Fiber - 6 grams

The Tide is Turning

I went to my third different endocrinologist appointment within 6 months today.

Needless to say, I was a little worked up, nervous, and edgy.

Endo appointments are very touchy things by nature. It's a snippet of a very complicated disease wrapped within a complicated life written down on paper. Your life transcribed in numbers - blood sugars, carb ratios, grams, correction factors. It's difficult not to feel judged, especially by someone who doesn't know because they don't live with it.

I went with a doctor who just happened to be trained by my old endocrinologist back at the Joslin in Boston. Just mentioning that I used to go to the Joslin Clinic around here made other endos I visited very defensive. Before anything else even came out of my mouth, I heard, "Well, yeah, the Joslin's good. But we do things different here. That doesn't make us wrong!!!" I had never assumed that different was wrong - but there was a standard of care that I do expect in any endocrinologist, anywhere.

Seeking out this standard of care meant that I had to drive an hour and a half to Ann Arbor. When I arrived, I was immediately whisked back to the nurses, where they did a fingerstick, downloaded both my meters, and then - asked for my pump. Whoops. Not the day to use an arm site.

"What do you want my pump for?" I asked suspiciously. This was something I had never even done at the Joslin. "I don't use a Medtronic sensor. I use a Dexcom. And I already downloaded all the information."

"Oh, you did? We normally download the dexcoms here too." Weird..... Once I (awkwardly) unhooked and handed over the Paradigm, the nurse retrieved all my settings off my pump, saving me from doing it (very tediously) manually.

After that, I didn't even wait two minutes before the doctor was in my room. She did an actual physical exam. She looked at my dexcom read outs and my blood sugar logs and knew how to use them. She made good, acceptable suggestions while asking me my thoughts on what was going on. She spent two and a half hours with me, her patient. When was the last time a doctor spent more than 10 minutes in my presence? I can't even remember!

What the heck was going on here?? Had I actually found a knowledgeable, caring, empathetic doctor? And then, while looking at my meal logs, she leaned over and said -
"I see you have sushi listed here and then two hours later you went low. Sushi's really hard to count. I try all the time at restaurants, and IT IS NOT EASY."

I think I have just died and gone to diabetic heaven.

My doctor, a non-diabetic, apparently tries to understand what her patients live every day by learning the ins and outs (and difficulties) of carb counting! She also remarked on which of the lancets she had tried out and which brand she thought were the most comfortable.

I never once felt *judged*. I felt the way I think you are supposed to feel after an endo appointment - empowered and educated to take care of yourself and your disease. I felt that she acknowledged my efforts in my control while still managing to fine tune things. And she listened. When I told her about some difficulties with another specialist I see, she immediately asked, "Do you want a second opinion? Because that just doesn't sound right." Exactly what I'd been thinking, but it's much more comforting coming out of a medical professional's mouth.

The drive home sure didn't feel as long as getting there. I was flying high on the slivers of hope that she had given me. I am so thankful that there are still doctors like this out there, even if it is a hike.

And I think she beat out even the Joslin. :)