Mark Twain

"Twenty years from now you will be more disappointed by the things that you didn't do than by the ones you did do ...
Explore. Dream. Discover." Mark Twain

Monday, August 14, 2023

Ann and Jane - Their YouTube Videos, Cookbooks, and their infectious zest for life and food!!


Once I knew my eating life was going to change and center mostly around a plant based diet, 

  • ... and once I found a way to control my disappointment that this would be forever, 
  • ... and once I recognized that my body had already been evolving in that direction anyway, 
  • ... and once I accepted the time involved to develop a library of meals that were good,
  • ... and once I adopted the idea that I would need to do more cooking (!!yikes!!), 

Yeah ... once I got passed a few little bumps in the road - I decided to change up my approach.  After all, what we enjoy in life is frequently influenced attitude ... and I had to 'go find me' a different attitude!! 

I started with YouTube videos because they were cheap (free) and I could skim through various feeds quickly (‘cause not everyone out there is good at this, you know.)   I don’t know how many videos I started then skipped before I came to an almost hour long video called:


In the picture on the right - the two ladies in the Yoga pose - Ann, the mother, is on the right.
At the time the book was published, she was 88!  

Esselstyn Foundation and family life experiences behind this very like-able pair.  Ann is the wife of Dr. Caldwell B Esselstyn, the author of a book Prevent and Reverse Heart Disease.  Ann then wrote the recipe companion book called Prevent and Reverse Heart Disease Cookbook.   In addition, their whole family, (adult children, adult children’s spouses, and grandchildren) are all plant based.  Ann and Jane have over 140 videos on YouTube demonstrating various food prep strategies, and they are the authors of the book Be A Plant-Based Woman Warrior which I ordered.  It is an amazing book.  Extremely well done and very inviting.  
  • Eat nothing with a face: Well ... if you are plant based, that is an expectation, but in social situations I'll be flexible just to be polite.  That shouldn’t happen often.  This is about diet choices, not cult obedience! One animal protein meal now and then won’t undo months of plant based eating.
  • No eggs, no dairy: Hmm ....  I eat eggs or egg whites every morning.  If I start my day with anything else, I am hungry at 10:30 am.  I'll listen to my body for now and keep to my routine.  And no fat plain greek yogurt is a healthy choice in almost every other diet. It will remain in my diet occasionally. 
  • No oil:  I can drastically reduce my oil intake, but minimal olive oil will stay.
Other plant based guidelines strongly recommended by Dr. Esselstyn and company that I can get behind are:  avoid salt (buy salt free products) and minimize sugar, eat greens 6 times a day - as much as possible, eat more oats - as much as possible, eat lots of beans and lentils, eat whole grains, limit coconut, nuts and avocados (eliminate those 3 entirely if you have heart disease,) eat a tablespoon of chia seeds and/or flax seed meal each day, drink lots of water, read the ingredients of any item you purchase.  

Got it!


 
I suspect their ideas are very similar to that of others who espouse plant based eating.  But what the mother and daughter team brought to me was their total joy and fun and enthusiasm for cooking and eating a plant based diet ... all of it presented in a way that says ... “Yup!! - you can do this -  follow us.”

I am following.


Saturday, August 12, 2023

Back again with a Leona and Lennie Update

The “update" of Leona and Lennie

(thank you Wendy for the Liver name Lennie - it is perfect!)

 is short and sweet.  

All seems pretty quiet with no changes.  Leona, the singleton kidney, is still plugging along at a kidney function in the 30s or Stage 3, and it may be a year or more before we see any movement upward (or maybe never if my Internist is correct.)   As far as Lennie, my bigger than normal liver, is concerned, no news is good news.  Lab work is normal.  Of course, making life easier for Lennie, might help him shrink - only time will tell.  

And how do you make life easier for a kidney and a liver??  Life style changes, it appears.  No magic pill or treatment.  An improved diet and exercise routine.  Easy-peasy, right?

Sort of.

Diet wise I was drifting towards a Mediterranean Diet about a year and a half ago.  I was not rigid in that choice, but it was just a way to drop some poor choices off my dinner plate without making too large a split from the foods my husband preferred.  This past spring, however, when my medical concerns shifted from - “gosh I am getting old” to “yikes, one kidney down, cancer avoided and a fatty liver” ... my diet decisions shifted into high gear.  Lean protein and less less of it, reduced salt, lower potassium and phosphorus, complex carbs and less of them too, and minimal fats - just to name the big players in the food story. It seemed like only one “diet structure” fit those concerns: plant based eating.  And to be honest, that kind of eating suits me very well. While I welcome these food changes, it comes with some effort.

I don’t live alone - and my spouse is a 'meat and potatoes' kind of guy.  While he supports whatever I want to do with my diet, he is not interested in any changes to his diet.  I support that - in theory.  The consequence, however, of two separate diets means more planning and more cooking for me.  And I am not wild about cooking.  But I am finding work-arounds.  I still make his favorites, but he knows he will be eating them as left overs since I am not sharing in those meals any more. 

For my diet, the work is harder.  I don’t have a lifetime of plant based recipes ready to whip out like I do for him.  I am still figuring out the basics:  finding and experimenting with recipes, discovering half of what I make for myself I don’t want to repeat, locating cooks and cookbooks that offer reasonable creations that don’t involve 20+ different ingredients, some that are hard to find and may never be used again.  And finding plant based recipes that don’t rely on salt to punch up the flavor is an advanced study course well beyond the basics.

And speaking of salt, my tongue (who has done absolutely nothing wrong in this whole adventure) is working hard to adjust to reduced or no salt meals.  Seriously, I came from a family that salted everything - even before tasting.  I salted things like bagels.  I was the salt queen.  No longer. That adjustment is actually coming along fairly well.  A few weeks ago, my husband wanted hotdogs for dinner.  My day had been very busy and my energy was low, so we both had hotdogs.  Wow.  That was eyeopening. Those dogs were very salty.

Beyond the taste, all food needs to be balanced with an eye to the big four: Potassium, Phosphorus, Salt and Protein - not to forget the other supporting players of Carbs and Fats.  Juggling those elements for every ingredient can make your head spin.  Thankfully I found an “app for that.”  It is called Cronometer and it took all the leg work out of totaling up those elements from the foods I log into it.  Thank God for technology.  But be careful what you ask for.  I discovered that although I am eating a more plant based diet, I still am getting too many carbs and too much fat. I am even getting too much salt on some days (the hotdog day aside.) So off I go on another quest to find other foods and  combinations that are better.  It never ends.  Gone are the days when I could walk into a farmer's market and joyfully know that absolutely EVERYTHING there was healthy for me.  Sadly, that is no longer entirely true.  Spinach, kale and dark leaf plants are potassium rich.  Got to be careful with those - because “rich” in this context is bad - not good.  And mellons and bananas, my very favorite and safe fruits, are also very very potassium rich.  A single serving - maybe once a day.  And be sure you know what a “single serving” is ... it is less than you might think. 

So so many elements to considered and understood and adopted.

Anyway,  I am learning and adjusting and most importantly, persisting ... because this isn’t just until I loose a few pounds - it is forever. I am not going to grow a second kidney.  My liver, once healed can be made sick and enlarged again if not careful. But the weight loss has been a pleasant side effect - like positive reward for making all this effort.  In fact, since last year I have lost 23 pounds.  Ten pounds were from Weight Watchers over 6 months.  Pretty uninspiring.  But between May and July I lost another 13 pounds.  That was all due to plant based eating.  And I am still losing, but just more slowly.  The weight loss was welcomed - and I am within 4 pounds now of a normal BMI which is important to my health. So that is all good.  I will be happier with this new way of eating when I have a selection of successful plant based food items to prepare without effort.

I sincerely hope that at my next lab test, we will see some appreciation from Leona and Lennie.

I will make a sincere effort to not let another month pass before blogging again!  Maybe with pictures next time.

Cheers all.



Tuesday, July 11, 2023

Just checking in

Here I am, 3+ weeks out from surgery, heading towards 4 weeks and doing great (well ... great-ish).  My incision is healed, I can drive again, walk as much as I want and do most things by myself.  That is the “glory" of laparoscopic surgery with robot assist!  While I am still limited in lifting stuff and I can't vacuum this very dirty house yet (which only bothers me - not my husband - because he is blind), I am feeling very fortunate to be living in an area of the country where this advanced technology and skilled surgeons using this technique are readily available to me.  Add that to my very supportive family, and you have a near perfect experience.

But it is “near” perfect only.

The remaining kidney has been a little slow in picking up the pace of its job.  The kidneys are very hard working little organs that don't get enough credit for the work they do - until they don't and then you got trouble. In fact, you would never know there was a problem until you are in serious trouble.  My remaining kidney (I will call her Leona going forward - 😁 in honor of my mom, her middle name, who suffered with kidney disease most of her life and died of kidney failure and dementia), Leona was expected to take a dip in her functioning, according to the surgeon right after surgery.  And she did dip by about 20 points off normal function.  Two weeks later she had dipped another 5 points.  hmmm.  But some other values were abnormal and my surgeon asked me to make a few adjustments to my eating and 4 days later I repeated the lab work.  Previous abnormals were corrected but Leona was now down about another 5 points ... treading very close to levels of kidney failure.

Hey ... what gives, Leona!!!

But my surgeon and my internist both were ok with the values, so who am I to argue.   My own research indicates that kidneys are slow to adjust to change and that Leona could take months, maybe a year or more, to reach a level that is normal for me.  In the meantime, I have to eat healthy (well ... I will have to eat healthy the rest of my life, of course,) drink a lot of water every day and get various labs and diagnostic tests to track Leona’s progress.  And while I wait, I feel pretty good.  I have to remind myself that all is not yet back to normal and won’t be for some time.  But to look at me - I am good!

And I think I mentioned that they also discovered that I have an enlarged liver.  Today I saw my GI doctor and we had quite a chat.  They will be tracking this liver now.  And, of course, there is a diet for that liver (that is somewhat different from the kidney diet that I must also follow) and that discussion resulted in a referral to a speciality nutritionist who can help me sort through both conditions.  I’ll table that discussion for another post - after I see her in a few weeks.  My GI doc said that enlarged fatty livers are a quiet pandemic in our country due to SAD - the Standard American Diet.  It is known that 30% of our population has this condition and there are probably another 10-20% who have it and don’t know they have it.  She said she even has it!  Without diet and exercise intervention the condition can develop into scarring on the liver and lead to cirrhosis ... and eventually liver failure.  An special MRI test called an Elastography has been ordered.  It will look for any scarring or cirrhosis.  She feels pretty sure my liver is ok for a number of reasons - one of which is the normal contours have not changed - it is just too big.  A good sign.  That test won’t happen until September when I am entirely healed.

I haven’t come up with a good name for my liver yet.  I am open to suggestions. 😃

So that is my current status.  I’ll be back sooner rather than later - I have many many pictures on my phone of stuff I wanted to post to the blog. It has just been a very busy time.

Talk again soon.






Thursday, June 22, 2023

The Pathology Results Are In

Negative for cancer.

Oh wait, you might have missed that first sentence. 

NEGATIVE FOR CANCER!!!!!!

Me ... I am negative.

No cancer here!

UNBELIEVABLE!!

It appears that I fall into that small 10% 

of the population with a kidney mass that has a benign tumor!!!

I feel like I should go out and buy a lottery ticket or something.


Or 

maybe I should just say a little prayer of thanks.

Which I already did, but will do it again.

Some "thank yous" cannot be said too much!




Tuesday, June 20, 2023

Day 5 - Post Surgery

I am now on the “other side” of the kidney tumor surgery.  I am down to only one kidney, and the tumor - kidney duo is gone.  The whole process has gone exactly as described.  I am healing fast.  The pain is much reduced.  And as of yesterday, my energy levels have started to return.  I don’t need naps if I got a good night’s rest.  I have very few limitations - except that I should not lift heavy objects (they never gave a number of pounds but I am erring on the safe side and handling only light stuff) and I shouldn’t mow the grass.”  Ha! I am safe there - in a condo community we hire folks to mow the lawn. I can climb steps and I can even vacuum if I am using a stick vacuum.  Obviously this minimally invasive laparoscopic robot assisted surgery delivers on it promises of a fast recovery with less pain.

Two weeks from my surgery I will follow up with the surgeon and get my pathology results.  There was no new info given post surgery because based on pre surgery test imaging there were no surprises found when they did the surgery.  But microscopically my kidney cancer story may take a different path - and Oncology may be recommended.  In fact, she has mention that possibility at every interaction we have had.  I feel pretty sure she has been subtly prepping me for that possibility.

Based on my own research, if kidney cancer has spread - even microscopically, it is no longer treated initially with Chemotherapy and radiation therapies.  The current preferred treatment is Immunotherapy.  Immunotherapy is the use of medicines to boost a person’s own immune system to recognize and destroy cancer cells more effectively.  It is sort of the opposite of suppression immunotherapy used in transplant patients to prevent rejections of the implanted organs.

But that all is a future topic.  Right now I am only crossing bridges I haven’t come to - I need to focus for the near future celebrate the fact I am tumor free.  And I am very very pleased about that.

Just know that I am doing well right now - physically and emotionally.  I’ll get back again after the surgical follow up.


 

 

Monday, June 12, 2023

Fast Approaching ...

Sorry this update is delayed in coming. The surgery is this Thursday (OMG so soon) and (unless I have beaten down my true feelings on this), I am doing fine.

Actually I feel great physically as well.  In fact, I am thinking of asking the surgeon to give me a picture of this tumor that has caused all this hub-bub because other than all the doctors' visits and testing (and the results, of course), I feel no different.  I could make a case that it is all a sham!  🙃  Well, not really. I believe everything I have been told, but a small part of me still wants a picture.  

Of course, in the result of the last test - the MRI -  there is more going on in my abdomen beyond that tumor.  

When you start poking around in the body of a 76 year old person - you are bound to turn up something. It showed 2 things:  1) small multiple cysts in my kidneys and my liver - and 2) some liver enlargement.  The enlargement was described by the radiologist as "fatty liver.”   Well, crap!  So I did my web searches on cysts and fatty liver, and it raised even more questions.  Does this ever end!!  I have so many questions about this new development (well “new to me” development as I have probably been carrying around a tumor and cystic organs for some time.)

Nothing they found, however, changes the surgery.  We are a “go” for that.  I did discover that fatty liver can be found in 30% of Americans on SAD - the Standard American Diet - and most don’t even know they have liver problems until liver damage starts to show up in blood work. Guess I am “lucky” I discovered this problem while looking at the tumor, which was discovered while looking at my GI system!!! *sigh*  Ranting over now.  I found the diet recommended for turning fatty liver around - and healing the liver.  I started that diet a week or two ago.  It is basically just a very healthy diet of veggies and fruit, limited complex carbs and no added sugar or salt, and lean proteins like fish, chicken, turkey and soy, no dairy, no red meat, and no alcohol. Boring, but fine with me if it keeps me around another 15 years.  And my internist will be very pleased if I can stick to that diet.  I found a bright spot in that diet!  Coffee is good for the liver.  I feel like I was just given a lollypop!!  (A lollypop without sugar, of course.)  But questions still remain on how I got here and if this is related in any way to my strong family history of Polycystic Kidney Disease.  I see a Nephrologist in September.  The first appointment is for an hour!  Good, because by then I will have so many questions he might not get time to answer if it is less than an hour.

That’s the story so far.  I am eager to get this tumor out and start healing.  I will admit to a bit of nerves mostly because I am the oldest I have ever been for a surgery (and I have had a few surgeries.). They were all successful with no complications so I need to focus on that.

And have I mentioned my amazing kids (who are not really kids being in their 40s.). Since I will not have my husband’s assistance at the hospital or at home due to his disability, my son is taking me to the hospital and will be the designated family member to remain until the surgery is over.  Over the weekend we discussed departure times and other details ... and he said, "Oh, and mom, the night after surgery I will be right across the street.”  Me ... looking blankly. - what??? I had an instant vision of him outside the hospital standing on the sidewalk until visiting hours opened up again. (I know, crazy mother thoughts.)  He went on.  "I have booked a room right across the street in a hotel."  Well ... I really didn’t know what to say at first.  I was so touched.  And it stunned me even more to realize I took comfort in the knowledge that he wouldn't be far.  Maybe I am more anxious than I am willing to admit.  And then there is my daughter who will come to be with her dad the night after my surgery - and who plans to stay with us both until I am able to putter around for myself.   And my sister who plans to show up with meals for us the day I get discharged.

Truly, I am bursting with pride at the adults my “kids” have become.  They are the very very best things I have done with my life. My sister, who has been through much much more than this, dealing with the polycystic kidneys she inherited from our mom, cooking for us (which my husband is secretly looking forward to because my sister is a great cook.). I really do struggle with accepting all of that help while at the same time I am so very grateful for it.

Next time I blog - I will be cancer free!  See you guys on the other side.


Tuesday, May 23, 2023

A break in the action

The last few weeks have been a roller coaster ride.  This week is an appointment free week.  As much as I really want to move forward, I am glad for a break in the action.  I need to get my brain and emotions in sync.

But while I am on a mini-high right now, my CT results came back: normal for my age.  Bones show age related degeneration and some arthritis only!  Beautiful words.  A month ago I would have fretted over those results. Not now.  It is all about perspective!  Now I want nothing more than to be “normal for my age.”   (But I do have to keep up those leg and back exercises.)

Other thoughts have been taking up space in my brain.

?? A Preferred Cancer List ??

To start ... if you have to get cancer, I guess kidney cancer is pretty high on the “preferred list” if there is such a ridiculous thing as a “preferred list” for cancer.  It can be cured with the swipe of a surgical knife.  You have a back up kidney, and one kidney is actually plenty to live a normal life. Renal Cancer doesn’t spread fast.  My tumor is large so it is hard to know how long it has been sitting in there with plans to spread its wings.  Still - the feedback so far is that it has not spread. 

Even with all those positives (?), it IS a Cancer!  It can hide for a long time and it can spread. I got lucky - it was found, but I want it out (... like yesterday.).  If it has spread I am ready for Oncology (... like yesterday). Give me those drugs.  Give me that radiation.  Sign me up for all the weapons of medical “war” that science has to offer (... like the day before yesterday!!) Can you tell that patience is not one of my virtues?

The Real Me

The real me - (the "cut it out, poison it, burn-it-to-the-ground" me) - that me hasn't changed one bit since I was in my 20s. I am an Aries** through and through. Stubborn, hard-headed,  opinionated, etc.  My kind of personality is hard to be around sometimes!  But in a “fight”, it is good to be an Aries.  

For example - I experienced a cancer scare 6 months after the birth of my son when I was 26.  I discovered a lump in my breast.  My doctor said I was too young for cancer.  (I bet they don’t say that any more.). Back in 1974 you entered the hospital the night before for a biopsy and you signed away your breast the night before surgery, because if the biopsy came back positive ... as you lay on the surgical table, they did the mastectomy before you woke up.  That night before the biopsy, a nurse came to my hospital room to prep me for surgery.  She asked me how I felt about maybe waking up with only one breast.  She was young - like me - but I remember telling her, “They can take the whole right side of my body, if it saves my life.  I have a son to raise.”  “Good answer,” she responded.  It wasn’t cancer then.  It is cancer now. I feel exactly the same today. My Aries traits will serve me well.  

The Me I Know 

I have worked in medicine most of my professional life - administratively mostly, but enough to know the short comings and strengths of medicine and the people who make these life and death decisions.  I am not in awe of doctors. I greatly respect their knowledge and training, but know they are people just like me, and they can make mistakes in judgement just like me.  Mistakes get made when you are over worked and fatigued.  

I believe medical care and decisions should be a team event: the patient or their advocate and the doctor.  I was my mother’s advocate for 8 years and many of my interactions with medical professionals were confrontational because some physicians didn’t function well as team players.  I challenged some decisions (or lack of them,) demanded further explanations until I understood, asked about options not offered, and made damn sure that my mom got the very best of what modern medicine had to offer while minimizing difficult procedures that would not benefit her in her fragile health state.  It was a balancing act.  I often felt like a warrior with the sword and shield on her behalf. They had to go through me to get to her and I did speak my mind without a filter.  (Aries ... another trait.) I was not out to make friends (and often didn’t), but I did get what she needed.  

 The Me I Don’t Know

This whole month I have wondered just where that “warrior” person has gone.  I am not good at being the patient and the advocate simultaniously for myself.  My husband isn’t good at this either.  Of course, two BIG differences between my mom and I are that she had dementia and could not speak for herself, and she had fragile health and would not benefit from unnecessary testing that would lead to a surgery that we would not do.  I have no mental limitations, and I am younger and healthier than she was - so I should be able to speak on my own behalf.  Mom needed an advocate. I should not.  BUT it is hard work to think and evaluate when your head is spinning.  Hard, hard work.  If this whole experience goes past Urology into Oncology, maybe by then the shock will have lowered a bit - and the “Aries” me will start to show up more frequently on my own behalf. 

Knowledge Is Power

Finally, I have a cousin who has been an RN for a very long time. Currently she is a Nurse Navigator and has experience working for patients as they wade through the medical establishment in pursuit of care.   In sharing this news with her, she sent me the NCCN Guidelines for Patients - Kidney Cancer Guidelines.  This very informational book created for patients provides all the details related to kidney cancer and the questions for doctors.  When I first got it - I was in the “I have a cyst” phase of my journey.  I did open it and began reading various sections - but as I skimmed through it - it made me a bit uncomfortable.  I was uncomfortable enough to close it thinking ... this is serious stuff. I set it aside because I had a cyst - not a tumor.  No need to upset myself.

The “I have a tumor” phase has begun.  Time to start reading and getting familiar with exactly what I have.  My personal comfort level now has no bearing on this situation.  I need to be armed with information.  

This could be a “war” and my Aries self needs to know the enemy!  


** I am not a believer in Astrologic signs.  But I can’t ignore the similarities between my personality and the Aries traits. I remember a conversation I had with my daughter on this subject.  She observed just how much her Astrologic sign matched her personality.  I read up on my sign.  I didn’t like all the “bull-headed” observations of the Aries Ram sign.  I observed that I wasn’t all those things!  She just smiled and said, 

“Oh mom, you are such an Aries!” 😂😂