On the menu this week is the long-awaited potato leek soup, plum sorbet (no raspberry this time), roasted artichoke, acorn squash risotto and jalapeno cilantro hummus.

As I continue to be frustrated and completely exhausted by medication changes to manage my hypertension, I realized that nutritional intervention is needed.  Reducing sodium is a no-brainer. Seriously, if you have hypertension and you continue to consume processed foods and eat at fast food joints, don’t whine. I thank you for rising health care costs and for keeping me employed. “Nuff said.

In speaking to many of my holistic and nutrition-minded friends, they constantly remind me to increase my potassium.  I’ve found several journal articles relating to potassium and hypertension so I went on a hunt to find something that would provide an in-depth nutritional breakdown besides calories, fat and fiber.   And here it is…NutritionData.com. Great site providing comprehensive nutritional analysis and best of all?  Free!  Plus you can print labels for foods that you make yourself.  Pretty slick, eh?

Turns out, I”m not eating enough vitamin D rich foods. So I select that vitamin to find naturally occurring sources, and it’s mostly fish. (Yes, soy is fortified, but I said naturally occurring.)  Kinda cool.

Anyway, so notes about this week…the soup tastes a lot like stew so I’m kicking myself for not having added some beef.  However, until I find a good place for grass fed beef though, I’m laying off of that.  It’s also funny I say that because the recipe is vegan   I added carrots and used chicken stock.  The carrots mixed with the Yukon Gold potatoes turned the soup to an interesting color after it met with my hand blender, but nonetheless, it’s still pretty yummy.

The roasted artichoke was what I was most excited about.  I was on the phone with my mom when I realized that this artichoke which had baked for 50 minutes yielded a heart just bigger than a golf ball.  So not worth the hassle!  It was yummy, for sure, but this might be just one of the few things I eat from a can from now on.

Acorn squash. Not my fave that’s for sure, but I had one left over from the basket and had to find something to do with it. Knowing it’s a great source of potassium and Vitamins A & C, I sucked it up and searched for a recipe where it could be disguised as much as possible. I picked up a recipe from yet another vegan website. Added mushrooms, didn’t even consider adding the fake sausage or nuts, and was a little miffed when I realized I didn’t have curry. Again, using chicken stock, this recipe turned out pretty decent.  The squash hide nicely behind the mushrooms (I added an entire package…ha!).

On to the hummus, I froze a couple of jalapenos from the last time I made it.  I prepared it pretty much the same way, this time I had planned to not add the greek yogurt thinking that the freezer would take some of the bite out of the peppers.  Was I wrong!  Well…probably wouldn’t have been nearly as striking had I seeded them. Whoops!

Here’s to hoping all of this comes together soon. These medication changes are so frustrating.  Weaning beta blockers after having been on them for about six years is pretty tough, considering I actually want to be physically active and should be pretty far in to training for the PF Chang’s Rock ‘N Roll Half Marathon in Jan ‘10. But when your heart rate jumps drastically after two flights of stairs and you get winded chopping vegetables while talking on the phone, you tend to be scared to jump on the treadmill, you know?

I know it will all be ok though…it always is, no matter how big of a pain in the ass it is going through all of it. (S)he conquers who endures, right??

Something crucial to a morning of cooking and food prep was not added to the earlier post: music!  Here’s what kept me rocking all morning….

1. Again, Flyleaf
2. Spellbound, Lacuna Coil
3. Forever, Papa Roach
4. Maybe, Ingrid Michaelson
5. Sleep Apnea, Chevelle
6. Break, Three Days Grace
7. If It Means a Lot to You, A Day to Remember
8. Dreams, Brandi Carlisle
9. Scarlet Letters, Mudvayne
10. Savin’ Me, Nickelback
11. The End of Heartache, Killswitch Engage
12. Please Don’t Leave Me, P!nk
13. Dead Memories, Slipknot
14. Halo, Beyonce
15. Do What You Do, Mudvayne

I liked it so much I had to share Enjoy!

Every two weeks on Saturday I crawl out of bed at 07:00, pull my hair back, throw on sweats, a tshirt and flip flops and head over to pick up groceries at a park just down the street. I’m sure I look dreadful, but in my mind’s eye the pink Coach sunglasses cover a multitude of sins. Not unlike when playing hide and go seek with five year old…if they have their eyes covered, then you can’t see them, right??. Anyway, by getting up at such an hour on the weekend, I score two small laundry baskets full of organic produce for $25 through a local co-op called Bountiful Baskets. Totally sweet deal and honestly too much for one single gal, but twice a month I end up with tons of yummy produce and best of all, I’m forced to come up with creative ways to use it all.

This week I received:

Veggies –

• Leeks (this week’s mystery veggie!)
• Red bell pepper (all unfortunately rotten, which is rare, what the heck?!)
• Romaine lettuce
• Cauliflower
• Celery
• Yellow squash
• Acorn squash

Fruit –

• Concord grapes
• Champagne grapes
• Apples (5# bag)
• Pears (10 large)
• Cantaloupe
• Plums (about 2#)

Upon picking up the produce, I realized that I am in Yuma two days next week so I have to figure out the best way to preserve what I can until my return Weds night. PLUS I still had two pounds of sweet potatoes left over from last time.

On the menu this week? Sweet potato pie and concord grape sorbet using mostly organic ingredients (however, I chose an easier route and bought a Marie Callender’s pre-made pie crust).  I made two pies — baked one and froze the other.

Making the grape sorbet was a bit more complicated than the plum/raspberry flavor, but that just made it even more fun to make.  I loved the rich purple color after the grapes simmered in the water.  It smells just like grape jelly while it’s cooking also, which was pretty awesome. When I return, I’m making peanut butter ice cream to serve with it…sort of a frozen peanut butter & jelly sandwich.

My next endeavor — locate grass fed beef in quanitities that is single-girl friendly. Seriously, who besides a family of six buys 1/4 of a cow?!

So there’s this thing that people use in the kitchen called a stove.  Since I’ve been talking a lot of health stuff these days, I became reacquainted with that appliance in my kitchen. We meet regularly now. Daily, even. It’s turning out to be pretty fun!  Every two weeks I pick up produce from the local co-op, Bountiful Baskets, and figure out what interesting things I’m going to learn how to make. This week it was sorbet.

Originally I had received about 5 # of pears and planned on making pear sorbet, but when I discovered they had been picked too soon and didn’t ripen, just went over to the dark side, I turned to plums.  I had just picked up two pints of raspberries and I found a recipe I modified.  It was super-easy…here goes:

• 6 plums

• 2 pints raspberries

• 2/3 cup raw sugar

• 1 cup water

• juice from 1 lime

Remove seeds from plums and cut into a few pieces. Add to sauce pan with water, bring to a boil then simmer for about 10 minutes. Add raspberries, sugar, and lime juice and let cool.  Puree in food processor then add to ice cream maker, though I s’pose you could just put in the freezer. And that’s seriously it!

Of note, I didn’t strain the mixture like the recipe called for because I’m weird and I kinda like the texture of the seeds. It’s all up to you though!

Today I’m making flourless brownies and jalapeno cilantro hummus. For the hummus, I’m adding some greek yogurt to mimic Pita Jungle.

Last week was a follow up with the surgeon from the ER visit post Lasix incident.

After waiting an hour (abnormal-ish for him), he enters, sits, and blurts out “Let’s just call a spade a spade; I screwed up and I’m sorry”.

I sit there stunned because 1) I had some idea he had screwed up, but the apology was significantly out of proportion to an adverse drug reaction and 2) this is, after all, a CV surgeon we’re talking about…and the Chief of CV Surgery, to boot.

He goes on to explain that my most recent echo had been systematically reviewed by one of his partners, a cardiologist, and my pressures were not significantly changed and the critical part? My aortic stenosis had not, in fact, increased. He stated he overreacted and is turning over most of my care to my new internist.

“So….I’m OK?”

Answer to that would be a conditional ‘yes’, with the condition being lots of medication titration.  It’s my blood pressure that’s out of control and due to my defect, my symptoms will appear out of proportion.  The surgeon showed me mathematically and described in detail what this meant. (Incidentally, I actually understood this having been yelled at repeatedly by a pediatric cardiologist about this very same phenomenol during a donor case in March. The peds doc just couldn’t understand why I wasn’t fixing it even though I explained to him that I wasn’t the clinical lead. He chose to yell at me anyway. Details….)

I repeated…”So….I’m OK?”

He assures me I will be as long as I am committed to being a compliant patient.

Hells yes I am!

Do you know how grateful I am to be given this news just in time for hiking season in Phoenix??  It’s amazing how things like this happen and remind you of what you love doing.  After my heart was fixed, I discovered hiking…something I’d never really thought I could do before. After being temporarily sidelined with the ankle thing, I do admit to being a little frightened to get back on the trail again.  Until today.  Coming home with a sunburn after watching planes take off around Tempe Town Lake…nothing like it!

Oh, and I’m doing the PF Chang’s Half Marathon in January Anyone can walk 13.1 miles, right??

It’s interesting, in a conversation the other day I told someone I wished that I had this ability to mindlessly accept the information that healthcare professionals provided at face value and naively swallowed the recommended pills and to not question anything.

Isn’t it interesting that I’ve stopped wishing to have been born with a normal heart? When did I give up that pipe dream?

I met with a new internal medicine physician today…a very handsome man probably in his 50’s.  Oddly enough, looked just like a guy I recently dated, except with silvery gray hair.  He came highly recommended from my surgeon and his nurse…and virtually any nurse that I’ve run across over the past couple of weeks at  St. Joe’s.  (Here’s a tip to all you non-healthcare folks who may stumble haplessly upon this blog: if you ask a nurse about a physician and she wordlessly nods, odds are the dude’s a jackass. If s/he can’t shut up about the doc?  Ask them for the phone number.)

I explained to the new doc the course of my cardiac treatment which includes 1 diagnosis of syphilitic valve disease, 2 diagnoses of mitral valve prolapse, 1 diagnosis of ventricular septal defect , until someone finally decided to refer me to Mayo Clinic, Rochester, who arrived at the true diagnosis of subaortic stenosis in 2001. This diagnosis occurred five cardiologists and two years after the initial discovery of a heart murmur during an otherwise routine trip to the doctor.

I have trust issues. Some might even argue, I have good reason.

Tomorrow is a visit to the surgeon after a visit to the ER. I fell victim to over-aggressive diuresis. Lasix was my friend for a couple of days, and like any good friend, overstayed its welcome and sucked my brain dry. Nearly literally. With the help of some kick ass nurses and a nice doc, my tank was full and I was back in action the next day.

I’m nervous about what the future holds. I’m scared that if I don’t have a handle on the minutiae, it’ll be my downfall. But I’m also worried that even as aware and educated I think I may be, perhaps I’m not making the right decisions.

Time will tell.

…in congestive heart failure.

Might as well just come out and say it plainly.  After two years and three months, I began having these symptoms.  Extreme fatigue, nausea, cough, shortness of breath, lightheaded….  Surely it couldn’t be my heart.  On May 7th, I had been to Dr. Aklog’s office and had like the best news ever; I had been discharged to yearly visits. No way was there a cardiac culprit to this mess.

My regular doc was on vacation, of course. So the PA looks at me and says “You know, you seem sort of stressed out. Stress and depression can cause neurotransmitter imbalances which can cause physical symptoms”.

[She meant depression and her intentions were good. I mean, you don't work in organ recovery without some level of stress which is why there's this thing called 'therapy'. But I like the shady backdoor description that healthcare professionals are using these days. It sure wraps it up in a nice little package.]

When I returned a week later, insisting that something was wrong, the physician reiterated the PA’s nice little speech re: depression. One would surmise anti-depressants are frequently prescribed there. I’m all in support of this…when the patient actually has depression.

So the MD performs the physical assessment with labs. Viral. No.  Gastrointestinal. No. Renal. No. Anemia. No. Labs all within normal limits.

WTH.

Hey doc, could this be cardiac? My blood pressure’s running  a bit borderline and I’m a bit tachycardic. I realize that I’m at 85 now, but my usual resting heart rate is 55 and I’m on two blood pressure meds and I’m running 138/85.  Surgery wants my systolic no greater than 110.

Nah, you’re fine, she says.

Famous last words.

When my blood pressure stayed its course and I started getting short of breath making my bed and suddenly gained about 7 pounds in a week, I called the surgeon’s office.

The visit went something like this:

Nurse: How you been?

Me: (describing symptoms)

Nurse: Any swelling in your feet?

Me: let me check (reaching down and grabbing left ankle), um, I don’t think so….

Nurse: I still see your thumbprint in your ankle

Me: crap

Nurse: Can you be back at 12:30 for an echo?

So I had the echo and my velocities are back up and with my symptoms, I’m in class II CHF. They’ve added Lasix, Potassium, and Norvasc in addition to Lisinopril and Propranolol to keep my systolic blood pressure between 100 & 110. The thought is that if it stays low, then maybe the gradient will remain steady at what it is for awhile.  If not, then I’m back in for an aortic valve replacement this time.

I’m back to blogging to share my experience with others who may be going through it also at a young age.  I hope to capture the experiences of juggling the medical management of CHF along with maintaining a social life and activism and a career.  It is possible to do it all….I think

Good night for now!

I found this article amusing. I often check my Facebook page or blog with a company-issued Treo 700wx. Yikes!!

So…what does YOUR phone say?

I have the utmost of respect for my director.  Not only because she has faith that I can do my job with some degree of competence, but also because she’s always thinking of new ways to improve and evolve.

This week was Email Free Friday, the idea being to improve internal and external customer service by actually getting up and talking to people.  Because of my inability to sit still for any extended period of time, I thought I did a pretty good job of this already, but having a day where I am mandated to talk to people?  Awesome!

I needed to talk to Kirby about redesigning a sticker for a hospital.  Turns out it was helping staff to remember to call us, mostly because they are now peeling off the phones and sticking to people’s hair.  Though I found this moderately funny, this combined with the ink that is rubbing off, is leading to a re-design of these stickers.  So I traverse Cube Land and recount these experiences wtih him and provide assurance that a graphic designer won’t be needed if the printer will just stick to the template I will develop.

He says, “You’re smart, I know you can do it.”

Aww thanks.

Then says, “You’re smart, just have no common sense.”

Laughter comes from my director’s office as she says “Did you really just say that to her?”

And we’re supposed to be focusing on customer service….  See what happens when we’re forced to speak to one another?   I vote for Insult Free Friday next week. 

I’ll be out of town.

In honor of the infamous question “What are you thinking?”, the less obvious sibling to “What do you want to talk about?”, I’d like to share what I am thinking about at this very moment.  I know both of the people who read my blog are dying to know…so here goes:

1. The car needs an oil change and an equally necessary visit to the car wash.
2. I’ve been getting a lot of unsolicited advice/sympathy about my scar, i.e., “Wow, it’s too bad your scar didn’t heal better” or “You should massage that to make it less noticeable”.
3. In response to #2, stop staring at my chest, you insensitive, socially-inept moron.
4. OMGosh, OMGosh, OMGosh - I’m turning 30 in a month.
5. Does he think of me as much as I think of him?
6. Enrolling in grad school is a necessary evil.
7. What is Melissa’s fascination with rodeos?
8. Why we hate outsourcing call centers to India, but think nothing of outsourcing someone’s uterus.
9. Oprah is annoying.
10. I’m insane for treating the ICU and ED staff of a local hospital to ice cream in the middle of July.