I ran into a friend/reader the other day, who reminded me that you can’t read my mind when I leave these pages blank. Sorry about that.

When last you looked in, I was rededicating myself to the lovely pool, and feeling good and rather full of myself over several silky blue laps in my new bathing suit. Also, I’d just been diagnosed with Lyme disease, and had started taking antibiotics to treat it.

And then I melted. I soon learned that when left unchecked for a few years, the bacteria that cause the infection we know as Lyme disease, can really dig into various tissues, and when they’ve done that, they don’t want to leave.

When we send in the big drugs to kill off that scum, a toxic response ensues, and a delicate girl like me can go from sick to wishing-I-wouldn’t-wake-up-again very quickly.

That sums up the past couple of months for me. I’ve been struggling to clear this nasty sludge from my system, injecting heavy antibiotics straight into my heart through a Picc line every day, and trying to put out flares of inflammation hop-scotching through my body while managing side effects from heavy antibiotic therapy that accompany the death and destruction of all your friendly bacteria.

All the while, slowly getting better. Big improvements in my brain. The horrible and constant headaches I called migraine were probably a form of encephalitis common among people infected by tick-borne bacteria for a long time. Those have diminished dramatically.

I’m thinking much more clearly. Lyme can rob you of language skills, both comprehending written and spoken language, and speaking — finding the right words. Other kinds of comprehension — decoding traffic lights and dashboard controls, for instance, can disappear with Lyme too. I didn’t talk about that much, because, because I was terrified, I guess. But now that I’m confidently reading, writing, and driving again, I’m coming out with it. And if you were the poor man driving the pickup behind me when I attempted to step on the clutch that I haven’t had in my car for 20 years or so, coming to a full fast breaking stop in the middle of the street a few months ago? I’m really sorry about that.

A Picc line, if you’re not familiar, is a flexible line in your upper arm, inserted into a vein, and run up into your vena cava. The other end is anchored to your arm with a bracing device and a couple of stitches, and then kept under sterile wraps for the weeks to months that you have it in place. It ends in a receptacle for the syringes or the IV infusion pumps used to deliver meds.

It does not allow swimming. Nor showering, really. Not at all. And I may be stuck with this thing until all of my symptoms subside. The symptoms still left are mainly painful joints, problems sleeping, a little trouble focusing, and balance problems. I’ve been falling down.

My struggle with fitness right now is finding something I can do that doesn’t hurt and trying very hard not to feel sorry for myself. That emotion almost always finds me face down at the bottom of a Ben & Jerry’s container. So my weight just creeps up and up.

But I’m coming around. Walking more. Trying out the elliptical machine (handrails are my friend!). I’m writing more (Did you see? We’ve launched middlesexmd.com!). And working with friends on a new writing project.

I’m interested in hearing from people with arthritis. What do you do with your sore joints? How do you give yourself enough exercise to stay fit and keep your metabolism humming? What can you tell me about how to work around or with balance problems? Give me hints. I’m all ears!

You know those dreams when you’re trying to get somewhere, do something, but your legs are too heavy, and you can’t make a move?

The waitress dream is table after table of new customers, and you’re trying to get to your tables to pour water and take orders, but you can’t, while orders nobody placed are piling up in the kitchen. The student dream is tomorrow’s exam, but you haven’t been to class all semester.

I have many versions of this dream, but the weirdest latest one: I have to swim uphill to get to my family. They’re up there, on an island atop this mountain of ocean. And I should be able to reach them, but I’m swimming so slowly and getting so tired. I never make it. I just wake up tired.

So returning to swimming at the pool has been a wee bit worrisome for me. I imagined that I’ve grown so out of shape I would just be recreating that nightmare, that the far side of the pool would be too far out of reach for me.

But I also knew that with inflamed joints I really have no other options. I had to get into that pool, face down the dream, start somewhere.

So I rejoined the little club, and programmed all the open lap times into my calendar, packed my gym bag, even finding all my pool gear, my various goggles and swim fins and lap counter.

I sat on the edge of the pool and went through my goggle bag. The elastic on every pair but one had rotted out. My battery-operated lap counter, of course, was dead. So were all of my swim caps.  It’s been awhile since I swam, okay?

I grabbed a kickboard and held on for dear life, just sure I’d never make a lap without it.

But here is the happy surprise. Not only could I do it, but I completed many laps with barely a rest in between. And not just any laps, but one or two of them with a decent semblance of form. I chucked the kickboard pretty quickly, and smiled inwardly, and just swam and swam. The water stayed flat. No mountains anywhere. It behaved just the way I can rely on water to behave in the real and rational world.

That was a couple of weeks ago. I’m pretty chlorinated now. Friends returning from their southern treks are urging me into water aerobics classes too. And I’ll enjoy those for the girliness of it, but there is nothing quite like laps. I may be more of a manatee than a seal, but we’re all graceful in the water. Blue grace. Blue, quiet grace.

Sorry for not checking in sooner, gang. I’ve been a bit plowed under. I expect I will be now and then. Get this: I’ve tested positive for Lyme Disease. I’m quite surprised about it, but it certainly explains the past couple of years. Started on an antibiotic, and I think it may already be helping.

So, here’s to stepping right past your fears and anxieties and just starting again. It feels so good.

I remember when my family started eating yogurt. It was in the early 1970s. We had returned to the U.S. after living on a naval base in the Philippines for a few years. It seemed as if the whole world had changed in the few years since we’d left the States. For one thing, there was yogurt in the grocery stores.

My mother, who did some of her growing up in Switzerland, loved yogurt, craved it, and lived without it for many years. Muesli with plain, good yogurt was the breakfast of champions, as far as she was concerned. But she had never tried to introduce these foods to us, because, well, she couldn’t find yogurt, and because we were the Lucky Charms and Captain Crunch kind of kids.

But the 1970s ushered in an interest in whole foods, and that interest was echoed by my grandmother, a physician and friend of Adele Davis’, who had long been preaching the need for a big, wholesome breakfast. Providing milk and oats and whole grains and fruit for breakfast were at the top of her list of essential maternal duties. My grandma was a bit tough.

So… yogurt. Right. We would have never touched the stuff if it hadn’t been for… what was her name? Gretchen? Maybe? … A German exchange student hosted by my aunt and uncle. Every one of us fell madly in love with her, and she ate yogurt. Every day. So we ate yogurt, every day. Loved it.

My mother was thrilled. So happy. Until she started factoring the cost of keeping her four children supplied with the pricey yogurt. Soon yogurt was rationed as carefully as cookies and candy in our house. And it stayed that way for a few more years until Mom met another German friend, who taught her to make it. Giselle was her name.

At first we rejected the whole idea of homemade yogurt. But it wasn’t long before we figured out that the homemade stuff, a.) wasn’t rationed. And b.) tasted better than the other stuff. That is, stirred up with enough strawberry jam and granola, it tasted better.

Today we know more about yogurt. We know that it contains that great dairy fat that helps us control belly fat. Calcium to keep our bones strong, and all the lovely bacteria that keep our guts working gorgeously. A serving of yogurt as your last snack at night can help you sleep, too. Whiz it into with some whey protein for a morning smoothie. Add a handful of instant oats and some diced fresh fruit for a super fast muesli, or follow the recipe below if you want to eat the way the young women at my mom’s boarding school did.

Follow my mom’s yummy yogurt recipe to save a fortune on your yogurt bill, my friends, and enjoy the best yogurt you have ever eaten.

Yummy Yogurt
I make 2 quarts at a time, because that’s the size of pyrex bowl I have, and the amount of space I’m willing to devote in my fridge. There are just two of us in our household. My mom made a gallon-sized crock every week. But she had a spare fridge… You will soon know how much yogurt you want to make.

You should refresh your yogurt each week. It probably keeps longer, but that’s the advice I pass along from mom.

2 quarts whole milk
½ cup plain yogurt (the last half cup left from the last batch, or start with a good plain yogurt from the grocers. It must contain live cultures, and be plain, plain.)

You need a 2-quart non-metal bowl or crock for keeping/storing your yogurt, a bigger-than-2 quart saucepan or double boiler for heating your milk, a thermometer that will measure between 105 and 185 degrees F, and either a heating pad, a dish warmer, or a gas oven with pilot light. You also need 7.5 hours to complete a batch of yogurt.

Right. It’s this easy:
Step 1: In your saucepan or double-boiler, heat your milk up to 185 degrees. I like to heat the milk slowly, stirring constantly, to prevent the milk from burning in my pan. If you are an easily distracted cook — you have small children around — use the double boiler. Your goal is to get that milk up to 185 degrees, which is just before the boiling point.
Step 2: Stirring regularly to avoid a skin forming on top, cool the milk to 105 degrees. You can speed this process up by putting your saucepan in a cold bath, if you like.
Step 3: Add your ½ cup of yogurt to the milk, and whisk it in well, to mix it thoroughly with your warmed milk.
Step 4: Pour this mixture into your very, very clean bowl or crock. Cover the crock with saran wrap. I poke holes in the saran, and then wrap the bowl in a couple of kitchen towels before putting it in my gas oven, where the pilot light keeps the bowl warm, at around 110-115 degrees. You may place the bowl in an electric oven with the oven light left on. Or on a heating pad set on low. Or on an electric dish warmer set on low. Most crock-pots are too warm for this purpose, but if you have one that can be set as low as 110 degrees, that would be perfect.
Step 5: Wait for 7 hours. You can let your yogurt go longer if you like it more sour. I like a sweeter yogurt, so 7 hours is just right for me. Much less than 6 hours, and it’s too soupy.
Step 6: Your yogurt should be set at this point. If it’s not, try another hour. Refridgerate for at least 4 hours before enjoying your yummy yogurt!

Muesli Defined

Bircher Muesli at Epicurious.com

Hi folks. Made a Facebook page for SDP last night. Follow the blog updates here, if that’s your preference.

Good grief, you ARE there. I don’t deserve you. But hello, there.

As I was saying, what, a couple of years ago…. this whole body maintenance thing… Not easy. That’s what I was saying, if I remember correctly.

While I wasn’t looking — attending to other things — I regained a bunch of weight. Not nearly all of it, not half. but a disturbing bunch. More alarming than the weight, for me, was how quickly and easily I lost fitness. It seems if one lies down and doesn’t get up for a couple of years, one loses muscle tone. Don’t bother looking it up. I tell you, it’s the stone cold truth.

I had grown proud of my fitness. Maybe a bit smug about it. And now, now that my ovaries are gone (poof!), and I have some inflamed joints to deal with (I sit up most nights, just me and my hip, in the dark, rocking), that fitness goal seems a bit farther away than it did even when I carried much more weight.

But I also know that without the fitness, the weight loss is simply not possible for me. I wouldn’t lose it, and I certainly couldn’t keep it off. So…

So tomorrow I rejoin the pool, at the club I am entitled to join because this year I turn 50. 50. That’s 50. And this club’s is for people 50+. (I’ll be the cute young thing there.)

Fighting pain? Fighting inflammation? Guess what’s good for those things? Um…. Eating well (eating your fish, cutting sugar and saturated fats and empty carbs)  and exercising. That’s annoying news, but true.

Argh. The pool. Now I’ve said I’m doing it. So it must be true…

Hi folks. Juju here. Are you out there?

I am still here. Thanks to those of you who wonder and post and check in now and then. It’s been a crazy year. I’ve been through some heavy transitions that I’ll tell you all about soon…

I remember reading somewhere that menopause hits women like a perfect storm. Your parents suddenly need you, your de-nesting kids suddenly need you, your career challenges hit their peak, and that’s when your body starts playing tricks.

Well, the truth of that seemed academic and far away for me just a few years ago. I was fit, healthy, having fun with my job. And then… Wow.

Here’s what I’ve learned: Respect for hormones.

Say, speaking of hormones (I’ve got no transition more clever than that): On the average of once or twice a month during the years that I regularly worked on this blog, I’d get the question: When are you going to write about sex? And you know, I always answered: No way, dood, my parents read this blog… I’m no prude, and I was thinking hard about how middle age affected my sexuality, but, really and truly, dood, my parents were reading my blog.

Well, I lost my dear mom. And my Dad, who suffers from severe dementia, no longer uses the computer or reads. No reason to hold back now, folks.

But I have an even better reason. One of my docs — an OBGyn I went to college with — and a colleague from a Fortune 500 company I’ve worked for, are starting up a website specifically to support the sexuality of women over 40. Respect the hormones, indeed.  They’ve asked me to come write for them. So… That answers that old question. When will I write about sex? Often. Daily. Over at MiddlesexMD.com. If the subject matter interests you or someone you love, check it out. We’ve launched just the blog today, but the whole site, full of lots of great info (oh my aching head), is under construction and ought to be up before spring sproings.

And without a lot of fanfare, without a lot of wild resolutions, I’m going to return to this blog too. Try to neaten up the edges, dust under the carpets a bit. I’ve fallen away from the subject matter, and the fitness/diet world has only gotten crazier in the meantime. But hey, I still have a body. Why not write about it? Right?

If you’re still there, I hope you’re taking good care of yourself. I will if you will.

Hey y’all.

I swear I’m going to get to the Taubes book project. It’s coming.

I’ve hit a passel of little bumps in the road:

1. Learning an awful lot about blood (it needs our respect, this goo), about clotting, and about electrolytes, and the system that keeps blood volume in balance, and stuff like that. Not sure it’s going to be of general interest here, but you’ll likely hear about it all anyway, once I feel enough on top of it to report coherently. Meantime, let me just say, drink your dang water, will you? At least 2 liters a day. Make a point of attending to it. Get a bigger mug. Commit to lots of herbal tea, mkay? Because it just may be that those of us who work hard at dieting (too hard?) and exercise put ourselves in a particularly dicey place where consistent blood volume is concerned. Isn’t that one more lovely worry to worry about?

This learning is not entirely at my leisure. I am being studied. It’s interesting to be a lab rat. You know that feeling you sometimes have that you’re sitting on your own shoulder, watching the proceedings of your life? This living-under-study stuff is very much like that but moreso, because you can’t talk yourself out of the feeling. You really are a lab specimen. And I really have to collect perfect data. Collecting data about body fluids is plain awkward. You can extrapolate and understand.

2. And then the hubbub of the holidays, for which I am never actually ready, no matter how much I flatter myself that I’m on top of things.

3. And now that 2-week cold that we’ve been nursing at the office came home with me, and is all bronchial and sinusy and gut-grotty.

4. Oh, well, and I got a Kindle. And have been downloading and reading almost everything at Manybooks.net while nursing my cold. And thinking a lot about the Transcendentalists, and Hawthorne, and Austen. I love my Kindle. It’s my second ebook. And it’ll be awhile before there’s a perfect ebook in the world, but if anybody’s going to get there, I’d put my money behind Bezos. I’ll likely write about that over on my company’s blog site one of these days.

(Speaking of blogs. I’m also acutely aware that I am trying to keep up around 6 blogs. That seems like a lot, doesn’t it? I may have to think about that little problem one of these days. Who needs six? Who needs one?)

So, I’m late on my homework, but still intend to sum up Taubes, and still interested in participating in that discussion, but just a lot of stuff is jumping in the way. I beg your patience, if, in fact, you’ve been worried. Which is assuming a lot, I realize…(smile).

First on my list, even before Taubes, is getting out from under clots and colds and getting a new/old sort of daily movement program underway. One of my docs wants me to return to swimming (to avoid injuring myself, causing bleeds, starting inflammation). And I see the sense of it. I need to rejoin my old pool, and reestablish my early morning habit. It would be a far easier thing to do in July than in January, let me tell you. I well remember the cold transition from icy parking lot to never-warm-enough showers to never-warm-enough water in January.

But I have just this one body, and this is what it needs. So there it is. Taubes is coming.

Here’s what I’m thinking on this January 1, 2008 for my Skinny Daily friends. Be gentle with yourself this year. Excessive dieting, excessive exercise — these can cause more problems in the long run. I continue to learn about this the hard way, and don’t want you to have to repeat my mistakes.

And you’re in this for the long run, right? Do change your habits to lose weight, because it’s a healthy and wise thing to do, but take pride in changing as slowly as you can so that you know you can sustain your new habits over time. Drama is for the stage, for the screen, but certainly not for a delicate system like your body.

So… I’m not a fan of resolutions, but do like the idea of taking a day like this to assess my life and habits. I need to think about how much and how often I’ve tried to fix my body as fast as I could. How most of my diet efforts have begun with a frenzy of change and rather severe restrictions, goals, and expectations. I have even encouraged that sort of thing here now and then, and regret it.

So these few holiday pounds I’ve found? I’ll worry only if I haven’t dropped them by June.

This will be the year of going slow. As slowly as I can. To gain as much as I can in health and longevity and daily well-being.

That’s what I’ve decided. How about you? Any ideas for today?

Okay, okay, okay, okay, okay. Okay.

Here’s the dealio.

I’ve learned from Jimmy Moore’s Living La Vida Lo-Carb (I need to catch up there. Jimmy’s been burning up the interweb with Taubes news.) that my other personal boyfriend Andrew Weil (yes, I have touched the beard) is asking all of his students and researchers to read Good Calories, Bad Calories, as he has, cover to cover. I won’t share the link to the contentious Larry King show that featured Weil giving his stamp to the book, because the segment is just stuffed with images of headless obese people, and I won’t perpetuate that kind of yellow journalism.

However. Here’s my concern, and my pledge. I’m concerned that the book, informed by 7 years’ research, and pared down from Taubes’ original 400,000 word first draft, is too much reading for most of us. And yet, to paraphrase another great thinker, people are dying every day for want of what is found there.

I’m thinking cliff’s notes. I’m thinking instead of one book report, I’ll take on Taubes’ book, and offer up my version of cliff’s notes of its contents. This is just to help spread the contents around. But it is not to keep you from:

1. Buying a copy of the book and giving it to your doctor.

2. Buying a copy of the book and keeping it on your coffee table, to engender discussion among your circle of friends.

3. Buying a copy of the book for anyone who’s got the job of preparing your food or your children’s food, at schools, churches, hospitals — particularly institutions.

4. Buying a copy of the book for your local library.

5. Buying a copy of the book for another local library where there isn’t much wealth or many book donors.

6. Sharing the book with your weight loss support group.

Okey dokey?

I can’t promise the cliff notes will come as fast as you want them to. I also can’t promise that they won’t be laden with my own snarky editorial commentary (I KNEW that Ornish was a prig! Stunkard’s onomatopoeia ain’t lyin.)

I REALLY hope — those of you who will absolutely read the book along with me — that you will jump in and question, correct, add to, subtract from my notes. I’m going to go chapter by chapter. And… if you’d like to help with this project, holler, will you?

This is big, y’all.

JuJu

Here’s a good way to enter the holiday feasting season, with a copy of Gary Taubes’ Good Calories, Bad Calories by your side. You remember Gary Taubes. He’s our friend from the 2002 NY Times article wherein Taubes begins to lay out an argument that refutes the low-fat diet so fashionable these past few decades.

Well, in Good Calories, Bad Calories, he’s finishes his thought. Boy does he. We stand to learn a lot, judging by the interview with my personal boyfriend, Ira, at Science Friday (give a listen, especially if high cholesterol and heart disease haunt you or your family.)

Those of us who have finally lost and maintained a significant weight loss by giving up sugar and flour will feel supported and sustained by this guy’s research and hard work. All of us are bound to gain a militant edge — again — over the means and methods by which public health recommendations are developed and issued. That is, it’ll get your back up. Oh it will.

So. A book report, or at least a list of favorite lines, when I’m done with the big read. I have a hunch it’ll keep me focused on the bird and not so much the spuds this year.

There should be a prize for this kind of writing, the kind that stands to save lives. Don’t you think?

I don’t think there is anything quite like a big bunch of investigative journalism on the food and diet industry that does quite so good a job of building my own personal resolve. I’m so glad for his timing.

Well, there’s one good thing about your tax dollars… they pay for this big research hospital in Washington (NIH, the nation’s hospital), where lots of lovely medical geniuses work to make medicine better, and sometimes that means doing great work on somebody you know!

Really, the experience of a not-for-profit hospital is a wholly different experience. I can’t quite process it all yet, but trust me, it is. I am well aware I am opening a gigantic can of words by bringing it up and then dropping it… but really. We need to do better.

While the patient is still not entirely the customer in this medicine, either, the patient is certainly a partner or collaborator, and that makes a big difference.

So, I had arguably the best radiologist and intervention radiologist and hemotologist in the country staring at my pasty, clotty left leg or the past few days.(Along with a horde of technologists, nurses of very ilk, and hospitality folks. Washington hospitality ladies are all the spitting image of my mom. I kept them with me longer than usual, I suppose.) I learned a lot about clots, their diagnoses and treatment, and came away with the understanding that…
0. There are a lot of undiagnosed clots out there, which sometimes kill and sometimes never cause any problems, but can cause a lot of problems later on, down the road, as we age…

1. The ultrasound tests that most of us can afford can help us deduce the existence of a clot, but it doesn’t give much information about the clotting in your veins at all. A venogram (contrast die injected into a vein in the top of your foot, + expertise, +xray) will help you understand where the clots are and what’s going on with them. Your insurance company may not pay for that.

2. Lots of medical folks and most of the rest of us don’t understand clots very well. Turns out they actually don’t melt away with the anti-coagulents. Those drugs prevent more clotting. Your body takes care of the rest, BUT actually most of the time the clots just tend to stay put and scar over, and cause narrowing of veins, or eliminate the use of that vein, and your body creates collateral veins — new routes around the clot. But these new routes don’t have the same ability to return blood/fluid that your original equipment has, and especially don’t have the valves needed for good flow, and that’s why long-term leg pain and ulceration happen with the current recommended therapy in 50-66% of cases.

3.That clots in the thigh almost always start in the calf and travel up. And that was true in my case. I had a bigger problem with clotting in my calf, but never felt it there, and might not have felt it in my thigh either, because…

4. I am officially a “variant” (Explaining my draw to X-men and Spiderman movies…), owning strangely duplicated venous systems in my thigh and calf. Probably both legs, but they spared me the venogram in the other leg. This is where things get a little too detailed to be of interest to most of you, and also makes my eyes cross, but just take away this one piece of truth. I’m more evolved than most of you… or less. Or neither.

5. Our family probably has a genetic clotting factor or two. They were able to do some of the tests, but not the important one, because I came already on Coumadin. They will give me more info in 6 months. But our family history (Grandmother’s death from pulmonary embolism, Dad’s vericose veins, etc.) x being of
northern European extraction suggests this already. High liklihood that we have and pass along a gene that predisposes us to clots. This is important for all the women in our family to remember, that birth-control pills will be especially hard on us. Also, I may not be the only variant among us… We should form an army….

7. I need more protein in my diet. I am addicted to caffiene, and need to get off of it.

8. Standing doesn’t do you a bit of good. Walking is the thing. It’s the action of your calf muscles that make your blood go, and keeps your leg veins and valves happy and healthy. Pull your toes back and point them forward often while you’re sitting or on a plane, but especially on a plane.

9. The head radiologist here thinks 10% of people who get off of long airline flights have clots that go untreated and cause problems later.

10. Be. Careful. Wearing. Spanx. Or any undergarment that restricts circulation in your thighs, but not in your knees and calves. If you feel you must wear them, get a size bigger of these garments than you think you need, and don’t wear them all day. And walk a couple of miles after you take them off before you go to sleep. I’ll be editing my I-love-spanx post to say so…

11. It’s not at all unusual for women, even young women, to get clots in their left leg as a result of the proximity of our veins to our arteries, and the way they bump together as we walk. Apparently our arteries can just beat our veins to pieces, causing a narrowing of the vein, which leads to clotting. Unfortunately, without Thrombolysis, the narrowing won’t be discovered. It should be, and should be treated through thrombolysis, and maybe even stenting, especially in young women. This is called May Thurner’s… something. And my doc made a point of telling me about it, because he wants to spread that word.

12. Thrombolysis is getting safer and safer all the time. Anybody who wants to know more about that should call Dr. Richard Chang or Dr. Don Horne at NIH. This protocol study I participated in is for vastly reduced exposure to rTpa, and no mechanical removal of the clot, making the treatment quite safe.
Their paper on the subject may be out as soon as March, 2008.

13. For thrombolysis to work well, it has to be used early, before the clot forms scarring. This therapy doesn’t work on scarred over veins.

(Just for my sibs: get ready for a giggle… but I get to join Dad in sartorial splendor with my new PRESCRIPTION KNEESOCKS! TOLD you I was Daddy’s girl! For 6 months only, but still… Yipes!)

“We mock the thing we are to be.” –Mel Brooks

Missed you guys, but I’ve been on a narrow table in an intervention radiology unit for three days… seems like without a break. Back home soon.