bunrab | Entries tagged with low-sodium recipe

I thought I had put my low-fat, low-sodium, vegan curry recipe on here, but my friend

guavmom tells me she can't find it, so I guess if I did put it here, it's untagged, and therefore lost to the world. So I'll do it now! It's a fairly complete meal, though if you want something in the way of "green" veggies, you might want to add spinach, or chop lots of fresh parsley or cilantro over it. If you're willing to go vegetarian rather than vegan, then serve the traditional mint-yogurt and cucumber salad with it. It's a two-part, two-pot dish, and it looks like a lot of ingredients but it is easy.

Chickpea Curry

Pot (saucepan) #1:

Brown rice

water

sliced almonds

raisins or currants

curry powder (see note 1)

cumin

Pot 2:

red lentils (dried)

brown lentils (dried)

dried apricots

tomato paste (no-salt-added, small can, anywhere from 4 to 6 ounces)

canned chickpeas (garbanzos) (no salt added, about a 16-ounce can)

can of "lite" coconut milk

In pot 1, put 1 cup brown rice, 2 cups water, 1 handful almonds, 1 small handfull raisins (or currants, or even dried cranberries or dried cherries). Add 1 Tbsp. curry powder and 1/4 tsp. cumin. Bring to a boil and simmer for as long as the brown rice package says to, usually 50 minutes. (Covered, usually, unless the package says otherwise!)

While that's simmering away, start pot 2. Put in 1/2 cup red lentils, along with as much water for that much lentils as the package they come in says to. Add 1 cup brown lentils, and as much water as their package says to for that much lentils. Add 1 Tbsp. curry powder and 1/2 cup sliced dried apricots. (Sliced dried mango will also work in this.) Bring to a boil and then cover and simmer for 30 minutes. At this point, quickly lift the lid off, and add the tomato paste, drained can of chickpeas, and half a can of coconut milk. Stir vigorously but briefly, cover, and simmer for another 20 minutes. (Right when you add this stuff would also be a good time to check on the brown rice and see if it needs water - add another 1/2 cup if it looks like it's drying up.) This total of 50 minutes will turn the red lentils, which cook more quickly than brown ones, to mush, which then forms a thick sauce with the tomato paste and coconut milk.

Serve the lentil mixture over the rice mixture. If you can't find pappadums to serve with this, find some thin, crispy crackers. Iced chai goes well with this, as does ginger beer (non-alcoholic, like root beer, and spicier than ginger ale.)

Note 1: any yellow curry powder will do - the stuff in a small jar from the supermarket, any blend from a spice store where the main ingredients are cumin and turmeric with some saffron, or any blend you make yourself that's mainly those ingredients. The main difference between yellow curry powders and red ones is how much in the way of ground chilis are in there. This particular bunch of ingredients tastes better with yellow.

Thursday, December 14, 2006

Easy recipe time!
Roasted Winter Vegetables
1 bag "Golden Nugget" or other fingerling (tiny) potatoes
1 bag pearl onions
1 sweet potato
1 butternut squash
1 bag parsnips (giant white carrots)
optional: 1 small box brussels sprouts, if you're not a supertaster who hates them
olive oil
fresh rosemary
fresh thyme

Scrub the potatoes, but you don't have to peel them. Peel the outer layer off the onions. Peel the sweet potato and cut it into 1" cubes. Peel the butternut squash and cut it into 1" cubes. Scrub and peel the parsnips, cutting off the tops, and cut them into 2" long segments at the thin end, 1" long segments at the thick end. Remove any wilted leaves from the brussels sprouts.

Place all the veggies in a large baking dish or casserole dish. Bloop a few tablespoons of olive oil over them, and toss till everything has a very slight touch of olive oil on it. Now strip the leaves from 4-5 branches of rosemary, and from 4-5 branches of thyme, and sprinkle them over the veggies. Toss the veggies again, so that the herbs are distributed throughout. Roast, uncovered, in a 350° to 375° F oven for about one hour, or until a fork stuck in a potato or cube of sweet potato goes in easily. Serve hot. This makes a lot - 8 people or so's worth - so if there are leftovers, they taste just fine rewarmed the next day.

The even easier version of this recipe:
Instead of all those kinds of veggies, just get one bag of the Golden Nugget potatoes and one bag of some other kind of tiny potatoes - "new potatoes" or "fingerlings" or anything else where each potato is only golf-ball size. Do the same bit with the olive oil and the herbs. But you don't have to do all that peeling and cutting. Same baking instructions.

posted by Kelly : 4:29 PM

Tuesday, December 12, 2006

This week's article:

Magnets may interfere with pacemakers and ICDs
Dec 08 (HealthCentersOnline) - Certain types of magnets that are becoming increasingly popular in clothing and jewelry may interfere with the function of pacemakers and other implanted cardiac devices, according to new research.
Implanted in the chest, pacemakers and implantable cardiac defibrillators (ICD) are two types of battery-powered devices that monitor and, if necessary, correct an abnormal heart rhythm by sending electrical charges to the heart.

Researchers in Europe recently evaluated several types of magnets to see if they were capable of interfering with pacemakers and ICDs that had been implanted in patients.

The study found that while traditional magnets commonly found in the home and office are not dangerous, other types of magnets can be. Specifically, the research found that powerful magnets made from neodymium-iron-boron (NdFeB) are capable of interfering with cardiac devices implanted in the chest.

NdFeB magnets are becoming increasingly popular in office products, toys, jewelry and some clothing. Because of this, the researchers urge the manufacturers of the magnets to place warning labels on their products.

The study included 70 patients, 41 with pacemakers and 29 with ICDs. Each of the patients was tested with two spherical magnets that were 8 and 10 millimeters in diameter, as well as a necklace made of 45 spherical magnets. In every instance, the magnets interfered with the implanted heart devices of the patients. After the magnets were removed, the devices all resumed their normal function.

"Physicians should caution patients about the risks associated with these magnets. We also recommend that the packaging include information on the potential risks that may be associated with these types of magnets," explained Thomas Wolber, a cardiologist at the University Hospital of Zurich in Switzerland and lead author of the study, in a recent press release.

The results of the study were published in the December 2006 issue of the journal Heart Rhythm.

posted by Kelly : 2:57 PM

Tuesday, December 05, 2006

This week's article:

Possible cause found for deadly rapid heartbeats
Nov 30 (HealthCentersOnline) - A recent study may help researchers to better understand the mechanism involved in a certain type of heart failure.
Heart failure is a chronic condition in which at least one chamber of the heart is not pumping well enough to meet the body's needs. This leads to congestion in the lungs or pulmonary blood vessels and may cause fluid backup or swelling in the lungs, legs and ankles.

Ventricular tachyarrhythmia is a type of tachycardia, or abnormally rapid heart rate, that originates in the lower chambers (ventricles) of the heart. Ventricular tachyarrhythmia can lead to ventricular fibrillation and/or heart failure.

Researchers from Germany may have found an explanation for why ventricular tachyarrhythmia occurs in some instances. Using mice and heart muscle cells from rabbits, the researchers were able to find a possible molecular reason for the abnormal heartbeats.

The study showed that a substance known as an "effector" for a protein called calmodulin may be improperly regulating the influx of sodium ions into the muscle of the heart. Previous research has shown that genetic problems with the regulation of the sodium ion influx puts a person at increased risk for ventricular tachyarrhythmia.

The researchers suspect that the disruption observed during the study may be a contributing factor to the onset of dangerous ventricular tachyarrhythmias that are associated with heart failure.

The results of the report were published online on November 22 in advance of its print publication in the December issue of the Journal of Clinical Investigation.

posted by Kelly : 1:40 PM

Tuesday, May 30, 2006

Ladies Home Journal had a short blurb, which I can't find amongst my clippings right now, about how and why blood thinners help reduce the chances of SCD from atrial fibrillation. I don't remember the details of how it does that, but I do remember the statistics they cited in the column: if you are at risk of atrial fibrillation, and you don't take any blood thinners, you have a 1 in 20 chance of having an incident that could kill you, each year. [Note, my own EP says it's one in 17, not one in 20; I suppose they were rounding off.] If you take low-dose aspirin as a blood thinner, that lowers your risk to 1 in 40 - only half the chance. And if you take coumadin, it lowers your risk to a 1 in 70 chance each year.

So, even if you don't need blood thinners because of clotting risks, apparently you should take them because of fibrillation risks. While taking a strong blood thinner such as coumadin can carry its own risks - I ride a motorcycle, so I'd never take a prescription strength blood thinner, since it could make even a mild accident fatal - taking "baby aspirin" has far fewer risks and apparently accomplishes a lot. And, according to my cardiologist, if you take a proton pump inhibitor, such as Prilosec (available over the counter), it reduced the chances that aspirin will give you stomach ulcers. On the other hand - and isn't there always an other hand? - proton pump inhibitors such as Prilosec and Protonix (one of the newest prescription ones) are in one of the classes of drugs that can lead to increased risk of arrhythmia (see post about 9 posts down from this one). So it sounds like we've come full circle, hasn't it!! Apparently, if possible, to reduce your fibrillation risk in an optimum manner, you should take the low-dose aspirin without the proton-pump inhibitor, if possible.

It gets more complicated all the time.

posted by Kelly : 3:47 PM

This week's article:

Common painkillers may raise risk of heart failure

May 23 (Reuters Health) - Patients who use non-steroidal anti-inflammatory drugs (NSAIDs), which include over-the-counter analgesics such as ibuprofen or naproxen, have a small increased risk of experiencing a first hospitalization for heart failure, researchers from Spain report. They also found that for patients with pre-existing heart failure, NSAIDs may worsen the condition, triggering the need for hospital admission. ...

With current NSAID use, the overall risk of a first hospitalization for heart failure was increased by 30 percent after accounting for major heart failure risk factors, report Huerta and colleagues from Centro Espanol de Investigacion Farmacoepidemiologica in Madrid.

The increased risk of heart failure hospitalization associated with individual NSAIDs ranged from 10 percent with diclofenac to more than threefold with indomethacin. The dose and duration of use of the drugs had no apparent effects.

Heart failure hospitalization was also associated with known risk factors including high blood pressure, diabetes, kidney failure, other heart disease and anemia. Obesity, smoking, alcohol use, and recent hospitalizations and specialists' visits -- two indicators of other illness -- were also associated with an increased risk of hospitalization.

However, a prior diagnosis of heart failure was the main risk factor triggering a first hospitalization for heart failure, increasing the risk by more than sevenfold.

The investigators point out that their results are compatible with the findings of other published studies indicating that NSAIDs exacerbate heart failure symptoms, leading to hospitalization among susceptible patients, such as those with a history of cardiovascular disease and, in particular, previous heart failure.

The new study adds the finding that NSAIDs trigger the risk of hospitalization for heart failure in patients without a history of heart failure, the researchers conclude.

SOURCE: Heart, May 2006.

posted by Kelly : 3:47 PM

Monday, May 29, 2006

Science News has a short blurb mentioning that they've found out exactly what it is that makes it a bad idea to eat grapefruit or drink grapefruit juice when taking certain medications. Lipitor, for example, and the other statins, which most of us with almost any heart problem seem to be taking. So anyway, it turns out to be certain compounds called furanocoumarins, which are in grapefruit juice but not in other citrus juices, that are the metabolism-interfering compounds. Since the furanocoumarins can be filtered out of grapefruit juice, this may mean that in the not too distant future, those of us on medication can start drinking grapefruit juice for breakfast again! Whee! Don't know as there's any way to do that with fresh grapefruit, though; I guess we'll have to keep on eating those high-in-potassium canteloupe halves instead of grapefruit halves. Oh well.

posted by Kelly : 9:29 PM

Friday, May 26, 2006

More ICD news

Boston Sci finds battery problem in some devices

May 16 (Reuters) - Boston Scientific Corp. on Monday said it had notified doctors that some of its implantable cardiac devices, which it acquired as part of its purchase of Guidant Corp. last month, could be at risk for early battery depletion.
Boston Scientific, whose shares fell 1 percent, said the problem occurred in a single lot of 996 implantable cardioverter defibrillators and cardiac resynchronization therapy defibrillator devices that had been implanted in patients globally. No deaths or injuries were reported.

Implantable cardiac devices, or ICDs, are used to jolt a dangerously racing heartbeat back to a normal rhythm. Several models of the life-saving devices have been the subject of recalls or safety alerts by Guidant and other manufacturers in recent years.

Boston Scientific said 30 of its Guidant devices had been returned by May 8, and it had received an additional 46 reports of devices that remained implanted but showed signs of premature battery depletion.

The devices, which contain a faulty component from the single manufacturing batch, are in the Vitality DS, Vitality AVT and Vitality 2 ICD lines and the Contak Renewal 3, Contak Renewal 4 and Contak Renewal 4AVF lines of CRT-Ds.

In information posted on its Web site, Boston Scientific advised doctors to schedule follow-up appointments as soon as possible with patients who had received the devices and contact the company for instructions to determine remaining battery life of the devices.

The battery problem came to light after an overall review of Guidant's product lines, Boston Scientific said.

Boston Scientific swooped in to buy Guidant for about $27 billion after Guidant initiated a series of device recalls and was stung by criticism over its failure to promptly notify physicians and the public about life-threatening defects.

"We understand and acknowledge we have to do a better job of communicating, and this is a step in that direction," Boston Scientific spokesman Paul Donovan said.

Boston Scientific also advised doctors of two device malfunctions linked with implantation of Guidant defibrillators in an unusual position.

Planting one of these devices below the chest muscle, rather than below the skin, can result in mechanical stress to an area of the titanium case that can cause the product to malfunction, the company said. The uncommon technique could affect devices in the Renewal 3, Renewal 4 and Vitality HE product lines.

The two patients whose devices malfunctioned underwent successful replacement procedures, Boston Scientific said.

Morgan Stanley analyst Glenn Reicin said the product notifications stem from an approach adopted by Guidant last year to update physicians regularly about performance issues.

"Investors should view these communications as normal course of business," Reicin said in a note to clients.

Boston Scientific is currently working to resolve a warning letter from the U.S. Food and Drug Administration over quality control issues. The Guidant division also faces its own FDA warning letter over its ICDs.

posted by Kelly : 8:04 PM

Tuesday, May 09, 2006

Here's a relatively low-sodium macaroni and cheese recipe. Please note that this recipe is NOT low-fat; I don't know of any way to make mac-n-cheese that is low-fat, low-sodium, and tasty all at once; at most, you can get two of those together. This one is low-sodium and tasty. There are footnotes telling you where some of the ingredients are available.

Macaroni Quattro Formaggio
Cook 12 ounces of elbow macaroni or other small-to-medium pasta (tiny shells, rotini, radiatore, etc.) according to directions on package.
Grate an 8 ounce bar of low-sodium cheddar cheese⁽¹⁾. Dice up 4 ounces of FRESH mozzarella cheese⁽²⁾. (If you have an ounce or so of leftover swiss⁽³⁾ (gruyere, emmenthaler) cheese, you can grate that and add it too.) Mix these cheeses with the macaroni, and place in a casserole dish. Over the top of the macaroni, sprinkle about 2 ounces of grated Parmesan and Romano cheese⁽⁴⁾, then on top of that, about 2 ounces (1/4 cup) of low-sodium seasoned dry bread crumbs⁽⁵⁾, spreading the Parmesan/Romano and the crumbs as evenly as possibly across the whole top of the casserole. Then slice up 2 tablespoons of unsalted butter, and dot the top of the casserole with little chunks of butter. Over the whole thing, pour a can of evaporated milk - depending on where you live, that's somewhere around 8 to 12 liquid ounces; the exact amount isn't critical as long as it's at least 1 cup and not more than about a cup and a half. Place the dish, uncovered, in a 350°F oven, for 25 minutes, then switch the oven to BROIL and 400°F for 3 minutes, to brown the crumbs on top. Let the dish cool for about 5 minutes before serving.Serves 4 to 6 people as a main course, depending on the people.

To fancy it up some, drain a can of no-salt-added diced stewed tomatoes, and add them in when you are first mixing the macaroni with the cheddar and mozzarella.

The leftovers are extremely tasty cold, too; it can be served as slices, along with a salad.

(1) Heluva Good makes low-sodium cheddar; if you can't get your local supermarket to order some, you can order directly from the company. You'd better like cheese though, since it's a minimum of 4 bars.
(2) Most larger supermarkets will carry a national brand of fresh mozzarella, such as Bel Giorno, which has about 70 mg of sodium per ounce. Fresh mozzarella comes in round balls floating in liquid, by the way. If you can find some from a local dairy, though, those fresh mozzarellas often have as little as 15 mg of sodium per ounce. High-end markets such as Whole Foods, Central Market, etc. will usually have local-dairy mozzarella in their cheese assortments.
(3) Swiss cheeses vary greatly in their sodium, so you have to check the labels, but there are quite a few brands that run only 50-75 mg of sodium per ounce, including the house brand from Giant, and the commonly available Alpine Lace brand.
(4) Parmesan and Romano, or any grated cheese intended for spaghetti, can vary widely in sodium, too. This will be the highest in sodium of the cheeses in this recipe. But you can find one that has 75-100 mg of sodium per serving compared to others that have 150-180 mg of sodium per serving, and that's what to look for.
(5) Healthy Heart Market, see the link at right, carries low-so bread crumbs. They also have the canned no-salt added tomatoes, if you decide to add those.

posted by Kelly : 2:11 PM

<hr>
This week's article:

How exercise helps heart failure patients
May 04 (HealthCentersOnline) - A small study may help explain why aerobic training helps to reverse the abnormal heart patterns that appear in patients after experiencing heart failure.
Heart failure is chronic condition in which at least one chamber of the heart is not pumping well enough to meet the body's needs. This leads to congestion in the lungs or pulmonary blood vessels and may cause fluid to back up in the lungs, legs and ankles.

Previous research has demonstrated that aerobic exercise can help a person with heart failure feel and function better. Now, new research suggests that this response works by suppressing certain neurohormones that cause many of the severe symptoms of heart failure.

Following certain cardiac events (e.g., heart attack), the body works to protect itself in the short term by increasing its production of certain types of B-type natriuretic peptides (BNP). These neurohormones constrict blood vessels and help heart cells to retain sodium, which allows the heart to continue to pump blood effectively.

However, over a period of time an imbalance of the BNP neurohormones can become detrimental, leading to irregular heart rhythms, tissue buildup and the accumulation of fluid in the heart.

Researchers from Italy have found that aerobic exercise helps to improve the effects of heart failure by lowering some types of BNP. The researchers studied 47 heart failure patients who had entered a nine-month aerobic training program. The 44 patients who completed the program reported an improvement in their quality of life significantly greater than a similar control group (that did not include heart failure patients). Testing also revealed the heart failure patients had lowered levels of three types of BNP.

"Reversing neurohormonal activation by physical training adds to the current clinical practice a novel non-pharmacological aid. Out of 85 patients who completed the protocol, only the 44 randomized to the training program improved functional capacity, systolic function, and quality of life, in contrast to the controls. These beneficial effects were associated with a decrease in plasma level of BNP, NT-proBNP, and norepinephrine, only in the training group," explained Claudio Passino, M.D. from the CNR Institute of Clinical Physiology in Italy, in a recent press release.

The results of the study appear in the May issue of the Journal of the American College of Cardiology.

posted by Kelly : 2:11 PM

Tuesday, December 20, 2005

News:

Micronutrients helpful for heart failure patientsec 07 (Reuters Health) - Micronutrient supplementation improves heart function and quality-of-life in elderly patients with chronic heart failure, according to a report from investigators in Germany and the UK.
"The vitamin story has been confused with studies examining the response to single vitamin supplements in relatively low-risk patients," Dr. Klaus K. A. Witte from Castle Hill Hospital, Cottingham, told Reuters Health.

On the other hand, "CHF patients are at higher risk and might have multiple deficiencies. Replacing just one micronutrient might expose deficiency elsewhere (the vitamin E and C interaction, for example), so a combination is important," Witte explained.

He and his and colleagues investigated the effects of long-term multiple micronutrient supplementation in 32 patients older than age 70 years with stable heart failure.

After an average of 295 days, the patients who had been assigned to get micronutrient supplements experienced significant improvements in cardiac pumping ability, the team reports in the European Heart Journal.

Also, patients taking micronutrients had an increase in their quality-of-life score, whereas the participants who had been given placebo supplements had a decrease in their quality-of-life score.

The differences in overall quality-of-life score were mainly due to improvements in scores for breathlessness on exertion, quality of sleep, and daytime concentration among the patients taking micronutrients.

"At present there are few supplements that include the constituents we used," Witte said. "I would generally recommend a combined multivitamin supplement along with zinc, copper, and selenium. I also feel strongly that a high dose Coenzyme-Q10 is important. Most currently available supplements do not have enough Co-Q10."

SOURCE: European Heart Journal, November 2005.

posted by Kelly : 3:50 PM

Sunday, December 18, 2005

Top Ten List: Ten Reasons Why CHF is Not the Worst Thing That Could Happen

10. No chemotherapy, radiation, dialysis, or daily injections.
9. You get to use handicapped parking spaces at the mall.
8. Perfect excuse for getting out of parties you'd rather not go to in the first place.
7. Lots of chances to lecture people endlessly when they say "you don't LOOK disabled"
6. ICD support groups serve free dinner at quarterly meetings.
5. Get to take part in medical studies and maybe even get paid for them.
4. Take naps in mid-afternoon even if you're under 65.
3. Improve your on-line research skills hunting for low-sodium products.
2. Takes your mind off worrying about getting Alzheimer's when you get old.
And the number one reason why CHF INTWTTCH:
1. Cardiologists' waiting rooms have such great magazines!

posted by Kelly : 3:31 PM

Thursday, December 01, 2005

It's the beginning of the holiday season! That means, for many people, FOOD.
And all those parties. Snacks and alcohol - what do we do about them?

First off, if you want to be sure there's something at a party that you can eat, bring something yourself; a bowl of my fruit salad with ginger dressing will work nicely. I can't seem to find the old post from a couple of years ago where I put this, so I'll re-print it below.

Eggnog is pretty much off limits. High in fat, higher in sodium than you'd think for a sweet beverage, and often has alcohol in it. A little alcohol will not hurt you, but eggnog can pack a surprising amount in it, with all the sugar disguising the alcohol content. So just say no to eggnog. You'll see "lite" varieties in the supermarket; these are lower in fat and cholesterol, but not any lower in sodium, and they tend to taste like vaguely rum-flavored thin milkshakes - worse, if they have artificial sweeteners in them. So they're not worth bothering with.

If you want to have a festive beverage that's very holidayish, consider mulled apple cider - there are thousands of recipes out there on the web. One way to make the making of mulled cider easier: instead of using cheesecloth balls to hold the spices (who even owns cheesecloth any more? How many of us would know where to find any if we wanted some? [The answer to that is: fabric stores.]}, use wire mesh tea balls. A large tea ball will hold the spices and brown sugar and allow the brown sugar to dissolve out into the cider just as cheesecloth would. And it's then washable and re-usable for your pot of tea.

Other beverages include sparkling cider - Martinelli's makes a non-alcoholic sparkling apple cider, as well as apple-cranberry and a couple other varieties. A chilled bottle or two of this with a festive bow is as welcome a hostess gift as wine, and drinkable by all. I served sparkling cider with Thanksgiving dinner, and everyone enjoyed it; we never even got around to opening the wine.

And then there's tea. Chai tea is a rich, spicy tea. It can be served sweetened or un; with milk or without. And there's decaf versions, if you are supposed to limit your caffeine intake. I also served chai at Thanksgiving - I made a huge pot of decaf chai, we sweetened it with Splenda, and drank it with dessert and afterward. One of my sisters-in-law is pregnant, so she really appreciated the non-alcoholic options. You can find decaf chais in various supermarket brands, such as Celestial Seasonings, or some good whole-leaf chais from on-line vendors, such as Plymouth Tea.

Finally, alcohol itself: a teeny tiny bit will not hurt most of us. I take 9 pills a day, including 5 that say on the label not to drink any alcohol. I have discovered, though, that I can handle 1/4 of a serving of alcohol without any ill effects. So I can allow myself a couple of gulps of beer or hard cider, or the bottom of a wine glass of white wine or champagne, or a bottle-cap-ful of Bailey's or other liquer poured over ice cream or into hot cocoa. I don't do it that often, but I can do it. Check with your doctor, and see if he or she goes into screaming fits at the idea, or instead says "yeah, you can have a sip of that as long as you don't drink a whole glass." Once you have that permission, though, don't overdo it!!

Festive Fruit Salad
suitable for bringing to parties or serving to company
1 banana
1 box of strawberries (more is OK- if you want to get a quart box instead of a pint box, that's fine)
1 large (quart) container of cubes of melon - most supermarkets have these, cubed honeydew and cantaloupe, sometimes watermelon too
1 can mandarin orange slices in juice
1 can pineapple chunks in juice
2 kiwi fruits (melon and kiwi are even higher in potassium than bananas!!)
several pieces of candied ginger

Use a bowl with a liquid-tight lid, such as Tupperware, to make this salad in.

1. Open the 2 cans and drain the juices into a separate bowl. Put the fruit in the bowl you're making the salad in.
2. Dice up the candied ginger into teeny pieces. Put it in the juices to steep. You can add a little bit of sugar to this if you want, but not too much!
3. Chop the banana into bite-sized chunks. Halve the strawberries. Cut the melon cubes, which are usually pretty large, into bite-size chunks. Put them in the salad bowl, and toss a couple of teaspoons of the fruit juice with them to keep everything fresh - the vitamin C (ascorbic acid) in the juice will do that.
4. Peel one kiwi, slice it in half, and then slice into thin slices to toss with the rest of the fruit. (You'll use the other kiwi at the end.)
5. Pour the rest of the fruit juice/ginger mix over the tossed fruit, and stir thoroughly. Cover, stick in the refrigerator, and let sit for at least 2 hours, and preferably more. At least once, more often if you think about it, tip the bowl around to stir up the ginger-juice so the fruit at the top gets to marinate in it.
6. Just before serving or setting off to the party, peel the other kiwi fruit and cut into thin circles. Toss the salad one last time, then place these kiwi circles decoratively on top - arrange them in a pattern, or cut snowflake shapes out of them first, or something decorative. Cover the bowl again until the minute you're ready to serve it or to put it on the buffet table at the party you're attending.

posted by Kelly : 11:39 AM

Monday, November 24, 2003

The full recipe makes 10 pounds of fruitcake; most years I only make a half recipe, 5 pounds, which is 3 largish loaf pans. Here goes:
1 cup seeded raisins*
2 cups seedless raisins* (*I usually use all seedless, mixing golden and brown raisins)
1 cup chopped dates
1 cup halved candied cherries
2 cups candied citron
1/2 cup candied lemon peel
1/2 cup candied orange peel
1.5 cups walnut or pecan pieces
-------
a note about all this fruit: it adds up to 10 cups. I usually don't stick to the exact list here - and I add dried cherries and/or cranberries to the raisins. So I usually wind up with about 12 cups altogether of fruit and nuts, frequently: 3 cups mixed candied fruit, 1 cup citron, 1 cup candied cherry pieces, 3 cups assorted dried raisins and cherries, 1 cup chopped dried apricots, 1 cup chopped dates, and 2 cups chopped nuts - pecans, usually, since I've been in Texas. Feel free to adjust this to your family's tastes - no citron, candied or dried pineapple instead of cherries, more orange peel, fewer raisins... as long as you have between 10 and 12 cups of dried or candied fruit and nuts, it will work. We now return you to your recipe...
-------
1/2 Tbsp grated orange rind
1/4 cup fruit juice- any kind you have around, grape, orange, pomegranate...
2.5 cups sifted flour
optional: half tsp salt (I've left this out for decades, and no one has ever complained)
1.5 tsp baking powder (I use the calcium-based baking powder substitute)
2 sticks (1/2 pound total) unsalted butter (note - you can substitute a cup of shortening for this, but the butter really tastes better)
1 cup white sugar
1/2 cup brown sugar
2 tsp cinnamon
1 tsp cloves
1 tsp allspice
1 tsp mace
1/4 tsp ginger
5 eggs, well beaten (Scramblettes/powdered eggs work just fine)
2 tsp vanilla extract

Make sure that there are no pits in any of the fruit, and no shells in the nuts; rinse all the fruit and pat dry. Combine fruit, nuts and grated orange rind. You need a HUGE bowl for this- a punch bowl works well. Pour fruit juice over fruits. In a separate bowl, sift flour, salt, and baking powder together. In yet another bowl, cream the butter (it helps if you microwave each stick for 10 seconds first) both sugars and all the spices, then beat in the eggs. Add the butter mixture to the fruit, then all the flour mixture, and mix THOROUGHLY. Make sure there's no clumps of dry flour there, and that ever piece of fruit has at least a very thin film of batter on it.

Line 3 loaf pans with non-stick parchment paper, or brown butcher paper, heavily oiled. Divide batter between the three pans- it will fill all of them all the way to the top and maybe a little rounded up in the middle. Smoothe the tops with a scraper. Decorate tops of cake with halves of candied cherries, chunks of candied pineapple, and/or almond slivers, as desired. (You can do none of those, or any one, or all. I like making almond-sliver snowflakes/stars.) Bake in a slow oven (275 to 285 degrees F, or 135-140 degrees C) for about 2 hours - depending on the size of your loaf pans. Check first at 1.5 hours, and keep checking at 15 minute intervals after that, till toothpick comes out clean. Remove from oven and let cool in pan, on rack, for at least a half hour. Remove from pan by lifting edges of parchment paper, then peel off the paper.

Now the fun part: once the cakes are completely cool, wrap each in a double layer of unbleached muslin. Pour cheap brandy over the top- about 1/4 cup per cake, soaking it into the muslin well. Wrap the muslin-covered cakes in tightly crimped aluminum foil. Then put the loaf, with its wrappings, in an airtight container- a heavy Ziploc freezer bag will do, or a nice decorative tin with a tight lid. Then, at least once every 2 weeks, haul out the entire arrangement, take off the aluminum foil, pour another 1/4 cup brandy over the muslin, and rewrap and return to tin. Ideally, you should start the fruitcakes the week after Easter, so that they will be 90% brandy by Christmas, but they'll be adequate if you make them 6 weeks before Christmas, and remember to brandy them about every 10 days. Unwrap the foil and muslin, wrap in decorative cling wrap or cellophane, and present to the recipients, with a warning about serving it to underage people or designated drivers :-)

posted by Kelly : 3:37 PM

Saturday, November 15, 2003

Yeehah! The state approved my disability pension! Given that I'm unlikely to live to 65 or whatever the retirement age will be by then, I wanted to get SOME of my own money back, and they agreed! This is great, because the paycheck I get from teaching a couple of courses at Sty. Ed's is about what you'd expect for working 6 hours a week, and I don't think I'm capable of trying to do full-time work again - both because of fatigue and because of the stress. The pension means that we can buy presents for the holidays this year, maybe even fly to see my parents (my Dad's got prostate cancer, and surgery, scheduled for next week, should be a breeze; I do want to make sure I see him before either of us gets too sick, though! He lives in Maine.) It means that next summer I can pay the electric bill including air conditioning without having to resort to eating rice and beans for most of August, which is what we seemed to be doing this summer. Not that I have anything against rice and beans, mind you, but even I get sick of garbanzo beans one day, black beans the next, garbanzo beans again... To celebrate, I zipped over to the supermarket and purchased candied fruit, to make fruitcakes- low sodium, low-fat fruitcakes, of course. I didn't make any last year. Really, to make this fruitcake recipe correctly one should make it about the weekend after Easter, and then marinate it in brandy every two weeks until Christmas, so that it's quite flammable. However, local supermarkets don't have candied fruit available in the spring- they only start stocking it around Thanksgiving. So it will be a very mild fruitcake. Or should I say, fruitcakes- the recipe makes about 10 pounds. It's from a 1953 cookbook that my mother was collecting - a volume a week from the supermarket - when she got married and then when she had me. So it's sort of a family heirloom. Besides the usual candied orange peel and citron, and some pineapple and cherries for the top, I have fresh Texas pecans (instead of the walnuts the recipe calls for) - why not use local stuff? And raisins, and chopped up dried apricots, and some dried cranberries to go with the raisins. The recipe makes a cake that is mostly fruit, held together with a cement of cake - sort of a concrete aggregate, if you will - as opposed to mostly cake. I read in some book or another about heart failure that the candied cherries are high in sodium, but I can't see anything on the ingredients label that looks even vaguely sodium-ish, so I must have imagined reading that.

Anyway, off to do some cooking. I will provide the fruitcake recipe as soon as I get a minute to transcribe it.

posted by Kelly : 2:49 PM

Monday, July 28, 2003

I was 99% finished with a long post about beta-blockers, when Windows decided to crash. I am too lazy to re-do the entire post right now; I'll get back to it tomorrow. Sorry 'bout that.

Oh yeah, vegetable broth - easiest way to make your own is to buy a can of no-salt-added Veg-All, pour it in liquid and all, and liquify it in the blender or food processor, then pour it through a strainer into a container, to filter out the largest of the remaining vegetable bits. Add water or carrot juice, to make 2 cups, then pour it into ice cube trays, so that you can store it for months and use 4 cubes at a time, as needed, to add to soup, stew, rice, etc.

posted by Kelly : 9:00 PM

Saturday, July 26, 2003

We're having people over for supper, and it's my turn to cook. Here's what I'm making:

Chicken and Rice
2 lbs boneless, skinless chicken breast pieces (you can use turkey instead, if you want - turkey is slightly lower in sodium than chicken see nutrition database)
1 cup uncooked brown rice
minced garlic or onion, to taste (a tablespoon or so)
1 cup low-sodium chicken broth (Use broth powder; you can also use vegetable broth, or mushroom juice or carrot juice - a vegetable flavor goes quite well with this.)
1 can ready-to-heat low-sodium cream of mushroom soup
1 small can no-salt-added mushrooms
pepper to taste, salt substitute to taste

Check the brown rice package to see how much liquid they say to use for cooking 1 cup of rice. Mix your cream of mushroom soup and your chicken broth together in a large measuring cup, then add water until you have 1/4 cup more liquid altogether than the rice package says.
Flour and then brown the chicken pieces in olive oil. Put the rice, pepper, garlic, and a dash of salt substitute into a casserole dish that has a cover. Pour the can of mushrooms, liquid and all, over that. Put the chicken pieces on top, pour the soup/broth mix over it, and dot the tops of the chicken pieces with little slivers of unsalted butter.
Cover the casserole dish, and bake at 350 degrees F for 1 hour.

You can add some more seasoning if you like; you know me, I throw a tablespoonful of Italian seasoning into almost anything. You could also try a couple teaspoons curry powder (without salt) and a handful of slivered almonds, for "instant Indian food."

Gotta go - kitchen awaits.

posted by Kelly : 2:30 PM

Thursday, July 24, 2003

You really have to watch out, even when reading labels, for wildly varying sodium counts. For example, I bought a box of a noodle dish; the sodium content per serving was labeled as, I kid you not, 0.6 mg, 0% of daily value - and yet salt was listed in the ingredients, and not as the last item, either! I suspect that there was a translation error somewhere (the product was made and packaged in Spain), and that this is really 0.6 grams, or 600 milligrams; the 0% DV is because having entered the 0.6mg, of course whatever program spits these things out is going to calculate that as 0% of 2000 mg per day. So do a reality check when you're reading - if you see salt or sodium in the ingredients, yet the label shows -0- mg, question it!

Likewise, counts can vary wildly even among similar products. Bremner's low-sodium table crackers: a 15 gram serving has 10 mg sodium. Breton's reduced-sodium whole-wheat table crackers, a 13-mg serving has 70 mg. Others are in between. And club soda or seltzer - certain big-name brands say "low-sodium" on their label - which is nominally true, since there's less than 130 mg - but have 30, 40 or even 60 mg of sodium per cup, while other brands that make very little fuss on their labels, such as Canfield's, have -0- sodium. Canfield's also makes a famous diet chocolate soda. I can't seem to locate a web page for Canfield's, though. Ask your grocer.

Diet soda - remember that saccharine is sodium saccharine; look for other sweeteners instead. Hansen's brand diet sodas have no sodium (I'm drinking diet Black Cherry flavor right now). Locally, I can buy Hansen's at quite a few places, including Whole Foods. Whole Foods carries a lot of organic brands of food, too, including Eden and Westbrae, both of which make many no-salt-added canned goods. I also shop at Central Market, a local chain of only a few stores, owned by HEB, a regional supermarket chain operating mainly in Texas. Central Market is the place to buy sodium-free, fat-free sorbet in a zillion flavors; last time I was browsing through their frozen stuff, they had pints of flower-flavored sorbet, as well as apricot, three kinds of chocolate sorbet, mango, pear & cinnamon, and such things as passion fruit. I'll admit, despite my love of fruit in general, I don't like passion fruit and guava. I guess they're acquired tastes. Anyway, I've found that the HEB chain is fairly responsive to customer input, and one can get them to order brands one likes with only a little bit of nagging.

Oh, and some really egregious sodium manipulation: spaghetti sauce is notoriously high in sodium, right? So I usually wind up ordering it from Healthy Heart Market (see link at right). But Spousal Unit was browsing the supermarket shelves a few months ago, and spotted a spaghetti sauce that claimed to have only 80 mg of sodium per serving. We brought it home- then noticed that the serving size given was **two tablespoons**!!! Most spaghetti sauces give their serving size as 1/4 cup, which is 12 tablespoons for those wondering. Who the heck would use only 2 tablespoons of spaghetti sauce??? Heck, even 1/4 cup is a bit scant for me - I like a little spaghetti with my sauce, you see.

So read every bit of those labels, people- don't just glance at the sodium line and assume that what's listed there accurately reflects normal use of the product!

posted by Kelly : 3:32 PM

Wednesday, July 23, 2003

Today it almost rained here; it did rain southwest of us, but here it was just overcast. The cloud cover was enough, however, to lower the 5:00 p.m. temperature to under 80 degrees. Five is the hottest time of day here, having to do with our latitude, our position with respect to the edges of our time zone, and daylight savings time. Anyway, it was positively pleasant to ride to school; with the 35-mph wind-chill factor on the bike, it was almost cool enough for a long-sleeved shirt. Not quite, though. And it won't stay like that long enough to actually make me feel better - it's going to be 98 degrees tomorrow, according to weather.com. Oh well. The class I teach Wednesday nights is "Quantitative Applications Software" - essentially, Excel basic-intermediate-advanced smushed into one semester, for the business majors - who will, after all, be using Excel or something much like it for the rest of their working lives. Unfortunately, the students in this class are doing pretty well; I say unfortunately, because I had a great extra credit project in mind if someone needed to do one. I was going to have them compile a list of nutritional data from various supermarket items into an Excel database, then use various pivot-table and filtering techniques to show me reports about sodium content. I figured if three people needed extra credit, one would get to find 30 canned-food items, one 30 frozen items, and one 30 dairy items, and then I'd have the beginnings of a nice list of stuff to buy or to avoid. Well, maybe next semester. I think it is a good project for them, even if I do have an ulterior motive! Better yet, have them go search on the Web and find nutritional data from, say, five different restaurants, for six entrees at each, and compile that into a database. If sometime during the fall you suddenly see a nice list here, you'll know that one of my fall semester students needed some extra credit!

posted by Kelly : 9:48 PM

Wednesday, July 16, 2003

My local newspaper, the Austin American-Statesman, has an article today (7/16/03) about low-sodium diets. Most of the article is on-line. If that link doesn't work because you find this blog after the date the article gets archived, email me, and I'll get you hard copy. There are a few things in the print version that aren't in the online version, mainly this:

Resources for sodium saving
· "The American Heart Association Low-Salt Cookbook" (Clarkson Potter, $22.95). Among the useful features are a list of ingredient substitutes, tips for dining out and a guide to herbs and spices.
· "The No-Salt Cookbook" by David C. Anderson and Thomas D. Anderson (Adams Media, $12.95). More than 200 recipes from guys who've been there. Also visit the Andersons' Web site: www.saltfree.com.
· The National Institutes of Health has developed something called the DASH diet (for Dietary Approaches to Stop Hypertension), a low-sodium, low-fat diet that has been proved to lower blood pressure and cholesterol: www.nhlbi.nih.gov/health/public/heart/hbp/dash.
· The U.S. Department of Agriculture's nutrient database lists the sodium content of hundreds of foods: www.nal.usda.gov/fnic/foodcomp/Data/SR15.

Please note that the use of quotes for book titles instead of italics is the newspaper's, not mine. The Statesman's editing has always been glitchful. You should see their hyphenation!

I just ate a can of "almond-flavored apricots." Not a very strong almond flavor, and somehow even mushier than canned apricots usually are. I think I would be better off buying apricots and sprinkling slivered almonds on them. I keep unsalted nuts around - slivered almonds on Shredded Wheat cereal is breakfast around here, and filberts (hazelnuts) are for snacks - about a dozen filberts in a handful is a nice protein snack mid-afternoon. Don't forget to read the sodium content on cereal boxes - even very sweet cereals can turn out to have a lot of sodium, while some that aren't sweet are sodium-free. Check different brands of puffed rice and puffed wheat. Granola especially needs watching - an amazing amount of fat and sodium can work its way into granola.

posted by Kelly : 11:35 AM

Tuesday, July 15, 2003

This semester, I am teaching classes Tuesday and Wednesday evenings. This makes my sleep schedule even weirder than it's always been. I find that I need more sleep - not surprising, with an ejection fraction of 20%, that I'm always tired. What I've tried to do last semester was to wake up at a normal hour - before 9 a.m. , which wasn't difficult because I had a 9:30 class to inspire me. Then, I'd come home and take a nap most afternoons, and wake up before Spousal Unit got home from work. This semester, though, I have office hours from 5:30 to 6:45 and class from 6:50 to 9:40. So I'm gone before Spousal Unit gets home, and then I'm wired from teaching and have difficulty falling asleep at 11-ish, our "normal" bedtime. I've been staying awake till, like, 2 a.m., and then sleeping till 11:30 or so. This is not only annoying to all my friends and relatives who are on a regular schedule, it's annoying to me, because I miss a big part of the day in which I could run errands to places that aren't open at 2 a.m., such as the post office. Also, I would like to see more of my spouse. I can't figure out how to fix it, though - just setting my alarm clock doesn't seem to work; I hit the snooze button, or even manage to turn it off entirely, without opening my eyes. What makes it harder is that I've always been a night owl by nature- this schedule is closer to my natural inclinations, so I am fighting between nature and my mind, which would like me to be a functioning human being pretty much overlapping with the rest of my city. And since the prior forty-mumble years of having to be at school or at work by 9:00 a.m., if not earlier, have not conditioned me to wake up before 9 naturally, I don't think conditioning works. Wish I knew what would.

Since that's all whining, it must be time to lighten things up with another recipe.
Summer Pickles
2 cucumbers, peeled and sliced into about 1/3" slices
1 white onion, sliced into thin half-rings
1 carrot or parsnip (parsnips are a sort of white carrot), sliced into "sticks" (you know, carrot sticks - long thin pieces, rather than round slices?)
Tablespoon of whole black peppercorns
Teaspoon of whole mustard seed
Teaspoon of caraway seed
Vinegar* - quantity to be determined after you do the rest.

In a sealable container such as Tupperware, around a quart size or a little larger, preferably with a flat bottom rather a curved bowl:
Lay down alternating layers of cucumber slices and onion and carrot pieces. After the first two layers, sprinkle half the spices (peppercorns, mustard, caraway) across the layer. Then layer the rest, and sprinkle the rest of the seeds on the top. Now pour in vinegar until it just covers the top spices. Seal the container, and stick it in the fridge. Whenever you think of it, turn it upside down and back again, to stir the flavors. The pickles are ready after at least 24 hours, and taste even better after 48 hours, and will keep for another week in the refrigerator, so you don't have to eat them all at once. You can serve this as a salad simply by slicing fresh tomatoes onto a dish and adding the pickles. You can easily double or triple this recipe, if you have larger sealable containers to work with.

*What kind of vinegar depends on taste. Myself, I like red wine vinegar for this; it's stronger than white vinegar. But you can try apple cider vinegar, or even one of the herb-infused vinegars, if you want. White vinegar is cheapest, which may recommend it to some people.

posted by Kelly : 11:09 PM

Monday, July 14, 2003

One of the things that makes sticking to a low-sodium diet easy, for me, is making my own bread. I bought the West Bend Just for Dinner breadmaker from Amazon.com. (Try Thursdays - some Thursdays it's on sale for $39.99.) This breadmaker makes a small loaf of bread, about 8 slices, in 45 minutes. I started out using the recipes that come with it, leeaving out the salt and using unsalted butter instead of regular. The recipes work fine without salt- it's sugar that helps the yeast out, not salt. I usually throw in a bit of powdered ginger - it doesn't make the bread taste gingery, but it does give it a little of the sharpness that salt would. Over time, I've developed a basic pattern for loaves I like. If you have a larger breadmaker, just double everything in my recipe below, except the yeast- one package of yeast is still enough.

1/2 cup warm water (nuke tap water for 15 seconds)
1 tablespoon unsalted butter
1 cup bread flour (I use the store's house brand- it works fine)
1/3 cup whole wheat flour
1 tablespoon sugar
1/8 tablespoon powdered ginger
1 tablespoon Italian seasoning (oregano, thyme, basil)
1 package rapid-rise yeast or yeast that says it's for bread machines

Add to baking pan in the order your breadmaker's instructions suggest.

This makes a nice mild herb-flavored bread good with sandwiches. If you want something different, try these:

for a curry-flavored bread that goes very well with vegetable dishes, substitute 1 tablespoon (or less, to taste) of curry powder for the Italian seasoning and a scant 1/4 cup of crushed almonds (start with sliced or slivered almonds and crush them with your hand or a rolling pin.)

For breakfast, substitute 1 heaping teaspoon cinnamon for the Italian seasoning, and 1/4 cup raisins or mixed dried raisins and cherries.

If you're serving Italian food, add a tablespoon of minced garlic and 2 tablespoons grated Parmesan cheese, along with the Italian seasoning. The Parmesan has some sodium, true, but figure 1/8 (a slice) of 2 Tbsp. is not much.

When I make sandwiches, I use Swiss cheese (including Emmenthaler and Gruyere) because it's lowest in sodium of all the regular cheeses. Alpine Lace's Swiss has only 60 mg of sodium per slice. So I can make a sandwich of 2 slices of cheese, some avocado if it's in season, tomatoes, lettuce, and horseradish sauce of some sort (instead of mayo). My supermarket sells squeeze bottles of horseradish sauce for sandwiches, but you could also use any horseradish mix, or a teaspoon of horseradish mustard (100 mg of sodium, but that's quite a bit less than regular mustard!). The mustard is especially good if the sandwich contains leftover meatloaf (see earlier recipe), which is usually what I have for lunch the day after meatloaf for supper. Another thing that's good on meatloaf instead of using ketchup is fruit-flavored sauces, similar to chutneys. Fischer & Weiser, a local firm in Fredericksburg, Texas, makes a Seville orange-cranberry-horseradish sauce that goes well with meat loaf or any kind of poultry. It's 0 sodium, too. A horseradish sauce can also make a good dip for french fries, instead of ketchup, if you are not on a low-fat diet. (For me, I don't have coronary artery disease or any cholesterol problems, so I don't have to watch fat nearly as closely as I do sodium.)

Alpine Lace also makes a reduced-sodium Muenster cheese if you get really tired of Swiss cheese. The reduced-sodium Muenster actually has slightly more sodium than the Swiss, but it's still low enough to go ahead and put two slices on a sandwich. Around here, most supermarkets carry it; it's not a specialty item. If yours doesn't carry the Muenster but does have other Alpine Lace deli products, they should be able to order the Muenster for you. You've got to be aggressive with supermarkets; if you give them the product number and stand there and watch the manager actually write it down, chances are they will actually order it for you.

posted by Kelly : 1:54 PM

Saturday, July 12, 2003

One of the books I ordered and read shortly after I got diagnosed was Success with Heart Failure by Marc Silver. It had some good information in it, although not much that I hadn't already found on the Web, but I didn't keep it because I found that the author's ego got in the way of reading it. Every chapter seemed to consist of about 50% Marc Silver congratulating himself on helping people nobody else could help, or trying procedures nobody else had thought of, or just having better surgeons than anyone else... there was this constant refrain of "I am the best heart failure doctor in the world" running through the book. It may or may not be true, I don't know, but it's tiring to read about regardless. Other books about heart disease tend to have only a single chapter about heart failure, so they have even less information. The net is the best source of info. If you can find Silver's book in the library, or used, it's probably worth it for that price; since about 50% of it is information, it's worth paying half-price for.

Not much else to say today. We had leftovers for supper, no interesting recipes spring right to mind right now, and I'm too lazy to go give you summaries of the other books I've looked at. Besides, I hear a bowl of chocolate sorbet calling my name.

posted by Kelly : 10:10 PM

Tuesday, July 08, 2003

So how did I get diagnosed, anyway? I have allergies- had bad seasonal allergies all my life. Occasional episodes of reactive airway disease (RAD). So when I started having to stop to breathe a lot, and coughing a lot, we naturally assumed that the RAD was developing into asthma. Particularly in a city known for having something new pollinating every single month, this is not uncommon- keep irritating the bronchii, and eventually they rebel. And in medicine, there's a saying that goes "When you hear hoofbeats, expect a horse, not a zebra." Which is to say, that one looks first for the obvious and most common things - in someone with a history of allergies and respiratory problems, in a city where asthma victims fill the ERs pretty regularly, that would be asthma. It certainly wouldn't be heart failure, particularly not in someone under 50, who has no family history of any heart problems, doesn't have diabetes, doesn't smoke, etc. etc. So, my doctor kep trying newer (and more expensive) asthma inhalers, and larger doses. Trying all this took about 6 months- get a new set of inhalers, try them for a couple weeks, call the doctor and tell him it's not helping. Once we got up to the heaviest dose of Advair, the state of the art for asthma, and it didn't do a damn thing for me, my doctor had to admit he was stumped. So he sent me to a lung specialist (pulmonologist). Who took chest x-rays, took one look at them, took one listen at my chest, and told me to sit down. He delivered the diagnosis. He referred me to a cardiologist, but he was sure enough of the diagnosis to write me out prescriptions for a diuretic (furosemide, the generic of Lasix) and a bigger dose of Diovan than I already took for hypertension. (Diovan is one of the sartan bunch of drugs, the ACE II inhibitors. Diovan is valsartan. The prils are the original ACE inhibitors- lisinopril, Captopril, etc.) The pulmonologist also explained one of the rules of thumb for checking such things: pointing out on the x-ray, he showed how the heart sits slightly to one side of center. Normally, if one were to take that heart and imagine sliding it over so that one edge is just touching the sternum (front and center of the ribcage) then the other side of the heart would still be contained within the chest. An enlarged heart, however, sticks out past the ribcage, by an inch or two, if moved to such a position.

One of the things about such a diagnosis is that it seems as though, for the next few weeks, you lug the giant folder the chest x-ray is in, everywhere. Bring it to the site where you're getting your echocardiogram. Your EKG. Your first visit with the specialist. Your first visit to the specialist's nurse practicioner. Your first visit to the weekly clinic sessions. The hospital where you're getting your angiogram. After a month or so, apparently, the entire medical community of your city has copies of that chest x-ray, and you can stop carting the big folder around. And then when you sit in the waiting room, you can recognize who's new, because there they are, carrying their big folder around!

posted by Kelly : 9:13 PM

Wednesday, July 09, 2003

P.S. Today's recipe:
Roasted Steak Fries.
Buy one large baking potato per person. Scrub them. Peeling is optional, according to your taste.
Slice each potato into 8 wedges lengthwise.
Pour a couple tablespoons of vegetable oil (the kind with the good fats in it please!) onto a baking sheet. Rub all sides of each potato wedge in the oil, and lay them out on the cookie sheet. Now sprinkle a spoonful - somewhere between a teaspon and a tablespoon - of your favorite no-salt seasoning mix over each set of wedges. Some ideas: any Mrs. Dash's seasoning; Chef Paul's Cajun Seasoning, no-salt version; "Italian Seasoning" which is usually a blend of thyme, oregano, basil, and other spices; even liquid garlic steak sauce without salt. Bake the wedges on the cookie sheet in a 350° oven until they are fork-tender, anywhere from 30 to 50 minutes depending on how big the original potatoes were and how large the wedges are.

Other places to order the Mr. Spice salt-free, fat-free, garlic steak sauce- and other terrific salt-free stir-fry sauces and meat marinades - include:
Peppers.com
Hot Shoppe
Healthy Heart Market

posted by Kelly : 4:32 PM

Well, I spent an exciting afternoon at the Texas Textbook Hearings. The TEA is considering adopting new biology textbooks this year, and there are many people who want all textbooks to "present evidence against evolution" and to include "alternative theories" such as so-called Intelligent Design. What, you may ask, does that have to do with heart failure? Well, although I don't have word-for-word of my testimony, here's roughly what I said:
"Hi, I'm _____ ______ and I teach at St. Edward's University. You've already heard from many of my academic colleagues, so I'm not going to repeat their testimony. Instead, I'm going to speak about why I have a very, very personal interest in making sure that Texas science teaching doesn't get weakened by watering down evolution or including intelligent design in biology textbooks. I have congestive heart failure. I just got a pacemaker a few weeks ago. The latest research on heart failure is being done on zebrafish, because they can regenerate damaged heart muscle, and this research is propelled by a full understanding of evolutionary biology. As far as I have been able to find out, intelligent design theorists and the Discovery Institute have contributed nothing to medical research, not even any testable hypotheses which could be the basis for future medical research. If Texas high school students are taught only the "weaknesses" of evolution, and/or are taught intelligent design, they are going to be at a severe disadvantage in getting admitted to medical schools. In fact, they'll be at a disadvantage in getting admitted to veterinary programs or even two-year college programs for medical lab technicians. I need good doctors. So if any of you are considering demanding that intelligent design be added to Texas textbooks, I want to ask you to ask yourself a very personal question: 'Am I contributing to medical research, or am I contributing to ______'s early death?' Thank you."

posted by Kelly : 4:12 PM

Friday, July 11, 2003

Got the pacemaker adjusted; I don't feel any different. I could bore you stiff with the settings AIR-R vs. DDD-R vs. just DDD but that would be more than anyone would want to know. I also got my permanent plastic pacemaker ID card to carry in my wallet at all times, replacing the temporary pasteboard one. Yeehah. I had already ordered, and received, several different forms of medical alert jewelry to wear. What I find most convenient is this small lightweight charm which can be hung on a chain around the neck, attached to a watch band, or for that matter hung from a hoop earring. It is very, very lightweight. Cheap, too.

What should be on your medical alert ID? That you have an implanted defibrillator and/or pacemaker; what cardiac meds you take (and for some of them, the dosage - while there's a wide safe range of how much Diovan or Lasix one can take, and Coreg only has 2 strengths, based on total weight, digoxin has a vary narrow range and switching dosages and even just switching brands can be harmful. So emergency personnel need to know that sort of thing.); any other meds you take that aren't optional. That is, while seasonal allergy medications are optional- you'll still live without them - you wouldn't want to suddenly have your thyroid medication or your diabetes medication or your anti-depressants discontinued without notice, so list them. List, of course, any allergies to medical products, and any really bad food allergies, as well (penicillin, peanut butter... I suspect you don't have to worry about allergies to shellfish though; I really doubt they're gonna feed you shellfish in a hospital :-)

Many people get medical alert bracelets, but I find them too large and heavy, particularly in the Texas heat, and bracelets in particular tend to be not a good thing to wear when one rides a motorcycle. Probably a heavy metal bracelet also wouldn't be a good idea for anybody who works with machinery all day, or for that matter at a computer keyboard all day. So I prefer the necklace. I did get a waterproof bracelet, though, to wear when I go swimming - the "charm" is not waterproof, really, and most silver necklaces don't take well to water; even gold isn't that fond of swimming pool chlorine. And having a necklace flapping around in the water probably isn't that safe, either. So that's one occasion where you'd want an alert bracelet, and not a metal one either, unless maybe it's stainless steel or titanium. Here's one with a quick-drying nylon band and a stainless steel tag; it's also velcroed, which makes it easier to fasten than some. And here's another place that sells lightweight fabric and/or plastic "pleather" velcro bracelets and titanium tags for medical ID's.

Our friend Liz is a vegetarian, and she's horrified when we occasionally eat meat. Usually, it is easier to make low-sodium foods if you are sticking mostly to vegetables, but there's that protein issue- tofu, the main vegetarian source of protein and meat-like substitutes, is chock full o' sodium. But there are some nice well-balanced meals that can be made without tofu.

Here's one of them. It's possibly the world's stupidest recipe- scarcely deserving of the word recipe- but hey, it works. It is great for those days when it's your turn to cook, and you're exhausted, but your spouse is also exhausted and therefore in no shape to complain about what gets served. It's got complete protein, vitamins and minerals, fiber, all that good stuff; its only flaw is that it seems too easy to be good for you.

The easiest vegetarian entree
1 can no-salt-added (NSA) diced tomatoes (if you like food spicier than bland, try diced tomatoes with green chilies)
1 can NSA black beans
1 can NSA kernel corn
1 tablespoon of whatever-your-favorite-no-salt-seasoning-mix-is (e.g., Italian seasoning, or chili powder, or Mrs. Dash)

Open and drain all three cans; toss contents and spice into a microwave-safe casserole dish and nuke until warm, about 4 minutes depending on the shape and height of the dish. Stir and turn the dish 1/4 of a turn halfway through.

Serves 2 with a bit left over if this is all you're serving; to serve 4, you could cook brown rice with olive oil and no salt, using the amount of water it says to on the package, and cooking for the length of time it says in the package, to make 4 servings of rice. That's more work, though. You could just open 2 cans of everything canned, instead.

posted by Kelly : 10:28 PM

I'm not feeling very creative today (or rather, yesterday; I haven't gone to bed yet, but it's really tomorrow already). My spousal unit has been sick the last few days, and it's been a bit wearing on me, too. Friday I don't have to work, but I do have to go to school to help a student out this afternoon, and then I have to go by Austin Heart to have them change the programming on my pacemaker a bit.

I got the pacemaker put in 4 weeks ago today. There's still this big lump there - even when the last of the swelling goes away, there will be a bulge; it's not going to sink beneath the skin. Right now, it's part scar and part scab; I am not allowed to go swimming until it's all scar, no scab.

These days, getting an ICD/pacemaker put in is outpatient surgery. I wound up staying overnight, though, because they finished later in the day than expected. That was because this particular kind of pacemaker has three leads, instead of two, and they couldn't get the third one in. My veins were too "tortuous" to quote my doctor. So I don't have the advantage of bi-ventricular pacing they had hoped to get with this particular unit. It still does plenty for me, but not as much as we had hoped. If I get worse later on, they can go in through a different kind of incision, a keyhole incision in my chest rather than the one below the collarbone, and get the third lead in that way. That kind of surgery, although still not as drastic as open-heart, still requires several days in the hospital, so the doc says let's put it off until you really, really need it.

So, in lieu of anything more interesting, here's a meatloaf recipe. Not only is it low in sodium, but it's higher than most in potassium, because of the "secret ingredient." I guarantee that when you serve this meatloaf, no one will guess that there is a banana in it; it just tastes like a nice, moist meat loaf.

Banana Meatloaf
1&1/2 to 2 lbs of extra lean ground beef (95/5 or 96/4)
1 cup bread crumbs, low-sodium variety
1 egg, beaten to even consistency
1 banana, average ripeness, mashed
1 small onion, chopped into small pieces
1 tablespoon of Italian seasoning (or any mixture of spices you like in your meatloaf- some people like a teaspoon of chili powder, some like a teaspoon of curry powder...)
You can add a teaspoon of minced garlic if you'd like.

Mix everything together in a bowl, thoroughly. Place in non-stick loaf pan and bake in 350 degree oven for 60 to 70 minutes; check with fork to see if inside is cooked, and if you still see pink, cook another 10 minutes. Remove from oven and let cool for 10 minutes before trying to slice. Serves 4 to 6, with a slice left over for a sandwich the next day.

posted by Kelly : 2:03 AM

Friday, July 04, 2003

Why should I have a diary about heart failure? Well, I'm younger, better educated, and more articulate than many people with this disease, so I guess I feel a little noblesse oblige, to communicate to others stuff your doctor may not have mentioned, or not in plain English, anyway, and also, of course, misery loves company.

I'm 49. I have no family history of heart failure, and none of the common indicators. I don't smoke; my high blood pressure has been under adequate control for years with medication; while I've been overweight, I've never been obese; I don't have diabetes. I don't have coronary artery disease. What I have is idiopathic cardiomyopathy, and an ejection fraction of 20%, which hasn't improved at all even after 6 months of the state-of-the-art medication regimen. I just got a pacemaker (or more accurately, a defibrillator that happens to be a pacemaker) three weeks ago today.

I hope to tell you about medical research I've read, about my experience with the pacemaker, about learning to live with a low-sodium diet, and so on. You'll also get side notes about my pets, my motorcycle, my reading habits, and my other health issues- doesn't that sound like fun?

For now, it's the Fourth of July. Let's put in a low-sodium picnic recipe.

Low-Sodium Three-Bean Salad.
one can NSA (No Salt Added) black beans, drained and rinsed.
one can NSA garbanzo beans (a/k/a chickpeas), drained and rinsed.
one can NSA string beans (a/k/a green beans), drained and rinsed.
One small white onion.
A handful of cilantro- or parsley if you can't stand cilantro. Out of a 25 cent bunch of cilantro, I use about 1/4 of the bunch for this, but you may want less.
One each green, red, and yellow bell peppers.
Sugar
Vinegar

Throw all the beans into a bowl. Chop the onion into small pieces and add it; chop the cilantro or parsley leaves into small pieces and add them. Slice peppers and remove all seeds and stems and pith, then chop them into squares, and throw them in the bowl, too. Now sprinkle two to three heaping tablespoons of sugar onto the mixture, and toss thoroughly, till you can't see the sugar any more. Pour about 1/2 cup of vinegar - good salad vinegar or red wine vinegar works best - over this; place a secure lid over the bowl, and refrigerate for at least two hours to let the flavors blend. It's even better if you can can let it chill overnight; if you think of it, a couple of times turn the bowl over to redistribute the vinegar and then put it back to marinate. Serve cold; serves six to 8 people, and my experience is that even people who aren't on a low-sodium diet will like this.

If cans of NSA food aren't available where you are, here's one on-line source:
Healthy Heart Market

posted by Kelly : 6:44 PM

Saturday, July 05, 2003

Got back from a late supper. Eating out becomes something of a challenge when one is supposed to avoid sodium. So many things in restaurants have sauce on them, and sauce is pretty salt-laden. So there are some rules of thumb for eating at restaurants: avoid stuff with lots of sauce, avoid fried foods, avoid processed meats, blah blah blah. What is harder to figure out is what, besides green salad with no dressing, you can eat. So here's some things I've discovered:

Entrees with fruit in them are likely to have less salt than other entrees. Look for things with pineapple, in particular. In Mexican restaurants, this may mean a taco of shrimp and pineapple; in Chinese restaurants, it may mean sweet-and-sour something. These aren't completely salt-free, but they do have less salt than other dishes from the same menus. Luby's Cafeterias have a carrot-and-pineapple salad...

Baked potato. Ask if the kitchen has unsalted butter, and use a small slice of that, and ONE TEASPOON of sour cream. (So ask for the sour cream on the side.) Don't get bacon bits or cheese, but if they offer chives or green onions, or sliced mushrooms, put lots of them on the potato.

Swiss cheese. Swiss cheese is much lower in sodium than most cheeses; lower, in fact, than many "reduced sodium" cheeses. So you can get something with cheese on it, if the cheese is Swiss. Swiss cheese varieties include Emmenthaler and Gruyere. A sandwich of Swiss cheese and veggies is a good choice. One of my favorite places to eat serves a sandwich called the Flamingo: Swiss cheese, avocado (the good kind of fat!), bean sprouts, and tomatoes. I eat it without any mayo, of course.

Red Lobster has teriyaki-glazed fish, a couple different kinds. Of them, the tilapia, or rockfish, is the cheapest. The teriyaki glaze is surprisingly low-sodium, and according to published reports, that entree has only about 475 milligrams of sodium. Get a plain salad and a plain baked potato with it, and you're good to go. (Avoid those cheese biscuits, though!!)

If you're a meat eater, a small filet mignon has less sodium than any other beef entree on a steak menu. Provided, of course, that it is NOT served with bacon wrapped around it.

There, hope that helps. It's not a complete list, of course. But I'm glad to be able to give some specific suggestions of things one can eat, instead of all those lists of things not to eat.

One of the things that annoys me about restaurants lately is that here in Texas, the price of iced tea has been going steadily up. I don't know why that should be; the wholesale price of tea has not had any sudden drastic increases. But now a lot of restaurants are charging over $1.50 a glass for tea, and I don't think there's a glass of tea in the world worth $1.65, let alone $1.95. Just as well, I suppose, since I'm only supposed to have one cup of black tea a day, to keep down the caffeine, but still... Incidentally, the tea served in most Chinese and other Asian restaurants is often Jasmine tea, usually a green tea, so you can drink more of that, because it's got much less caffeine than black tea. Still, of course, following your doctor's recommendations as to total liquid intake for the day.

posted by Kelly : 10:29 PM

Monday, July 07, 2003

You know, it's been thundering and lightning-ing on and off all day, and I don't know whether I should be more worried about lightning than I used to be. One can't, after all, put a surge protector on a pacemaker. On the other hand, since I ride a motorcycle, I already try to make a point of not getting caught out in the rain, so my chances of getting hit by lightning are lowered.

Why a motorcycle? Well, it's fun- if it weren't, all the other reasons wouldn't matter. But, for me at least, all the other reasons matter enough that if they weren't there, I wouldn't have bought a bike just for fun, either. My Honda Nighthawk gets 65 mpg city, 73 mpg highway. It cost only $3400 brand new. I can park anywhere- and since I teach on a university campus, that is an important point. That's why I first started riding- when I was in college, I lived in Boston, where parking is always scarce, and also where the gas crunch of '72 raised the price of gas three-fold. I've been riding for over 30 years now. Motorcycling is a risk, true. Being alive is a risk. Having heart failure doesn't change my perception of the risks of motorcycling at all. What I do to mitigate those risks resembles stuff that's good for us all anyway: never drinking and riding (alcohol is involved in many motorcycle accidents); never using recreational drugs and riding (ditto); always wearing the very best helmet I can afford, rather than the least I can get away with; wearing sturdy shoes or boots rather than flip-flops... You know what we call those people on bikes with flip-flops and shorts and no helmets? Organ donors. I almost always obey the speed limits. I take the Motorcycle Safety Foundation course every few years as a refresher. (They have a beginning rider course and an experienced rider course. Taking either will get you a 10% discount on your insurance in most states.)

I have a handicapped license plate (or disabled plate, if you prefer); I don't take advantage of it often, except when I have to go over to the University of Texas campus (which is not where I teach). Parking at UT is so awful; one needs every advantage one can get. I use UT's library a lot, which is why I'm there. Disabled parking puts me only half a block from the library door; motorcycle parking is an entire long block away, and car parking is something close to nonexistent without a special UT permit, anywhere withing campus. My doctor had no problems signing the paperwork for me to get the plate, not with an ejection fraction of 20%. I also got a hang-tag, or placard, as they call it, to use if I am in a car. This helps when I go grocery shopping. Walking up and down all the aisles of a large supermarket is pretty tiring all by itself, never mind the thought of carrying the groceries out to the far corners of the parking lot. Sometimes I even go ahead and borrow one of the electric carts to do my shopping; I know there are people lots worse off than I am, but if a cart's available, well, I use it. Store personnel are sometimes suspicious, because they've just seen me walk in from the parking lot. Do you get that a lot? The "you're not visibly crippled so you must be cheating on the handicapped thing" attitude? Sometimes I calmly offer to trade them whatever they think is wrong with them, with whatever handicap they are so sure I don't have. That usually shuts them up. On a good day, of course, I can walk the supermarket and push a regular cart, and I do so. But days when I've gotten too little sleep, or it's so hot that it's annoying my blood pressure, I definitely feel like I'm Class III. On the good days, I'd be counted as Class II based on results, although that 20% ejection fraction would still argue against it.

The funny thing about getting the handicapped plate for the bike is that apparently, it's quite common- the county clerk's office has piles of handicapped motorcycle plates to hand out, just like they do car plates and regular bike plates. I thought about that for a while, and then figured, with the lifestyles that many of the bikers lead- you know, the ones that make TV news, or that you can hear rumbling by your house in gangs - there are probably quite a few riders with emphysema and similar disabilities, that don't affect our legs directly, so we can handle all the levers and pedals, but do affect our ability to walk very far. And this is indeed a disability. The TXDOT (Texas Dept. of Transportation) form to apply for disabled plates lists as its very first qualified mobility impairment "cannot walk 200 feet without stopping to rest" even before the parts about using assistive devices such as walkers and wheelchairs. (That form, by the way, is from Harris County (Houston) web site, but is good all over the state - check your own county clerk's website for details of where to send the application.)

OK, if you aren't interested in motorcycles, that may have been more than you wanted to know- but then again, if you didn't know that heart failure qualifies you for handicapped plates even though you can still walk, I may have done my good deed for the day :-) Happy riding or driving, as the case may be.

posted by Kelly : 2:35 PM

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