Pulling Teeth

One day four and some years ago, when I was going through emotional turbulence of the highest altitude, a tooth broke. It was December and I was shopping when I felt something crumble in my mouth.

I couldn’t figure out what it was; my consciousness and subconscious were both drowning in muck. Reality was a fog. Pain was the only thing crystal clear to me.

At that moment I was listlessly going through a rack of dresses. Pounds were melting off me and I needed a new wardrobe. I continued shuffling through hideous-looking garments till rock-hard fragments made their presence known to my frontal lobe.

I couldn’t believe it. Pieces of a tooth! I joked to a friend that I was so angry my teeth were self-destructing.

It was tooth #13, in dental parlance. It had broken as if it had been sliced in half lengthwise, the outside half still alive and well. My dentist gave me a temporary crown. Well, half of one. She said I had to do something permanent about it. Sure.

Last month that remaining half said goodbye and shortly thereafter so did the temporary half-crown. Thing is, the tooth had broken off, not fallen out. The root remained.

Lately, my rheumatologist has been on my case to start Fosamax. This tooth was a handy excuse not to start a med I truly hate. The dentist won’t touch me I said. And it was true.

Was true.

Because now my excuse is gone.

I was at risk for infection, I was told. After diddling around with the idea of an implant, one my dentist, a he now, he of bright, compassionate blue eyes, wanted me to seriously entertain. I did. Long enough to call the periodontist.

We start at $1,600 and go up to $2,500, she said. I already knew insurance wouldn’t cover a penny of it, but what really made my eyes bug out was the healing time. Four to six months, she said.

What?

All that plus a metal screw drilled into my jaw?

I went to see Blue Eyes yesterday and he extracted what was left of #13. It took him approximately two minutes. I barely got the chance to enjoy the reggae station they had playing for me.

Unfortunately, I had to go back to him five hours later. It kept oozing, blood-tinged. Where I thought it was draining too much, he said it was “too dry.” He expected more blood to fill, occupy and seal the cavity. So he pulled out his needles again and sutured the site.

Strangely, I feel no pain. Just tenderness.

But then, tenderness is what was offered to me.

Free of charge.

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Soup For Life

The meat, the meat must be beef shank, preferably with bone in; it makes a much better tasting soup. Set it to cook in a large pot three-quarters full of water. You add the spices at this stage. Salt, black pepper, garlic. The amounts are not measured; taste is what matters.

You must watch it closely at first. The fat will rise and needs to be scooped out, a spoonful at a time, making the broth leaner, clearer. Then you let it simmer as life simmers, gently but persistently, bringing memories bubbling to the surface.

“Papa, when do you add the vegetables?”

“I don’t know, Mijita.”

You know he does, but you say nothing and instead turn back to the stove. The meat is soft now and curls around its round flat bone. The bone is white as white can be, the marrow nestled in its center. You poke at it with the spoon, breaking it up into pieces, allowing its juice to mix with the broth. Meanwhile, you have chopped an onion into large chunks and added it to the broth in progress. Its layers float to the top, shimmery, translucent, adding their own juice.

It is you in the kitchen this Sunday morning. Your mother is sick, a migraine keeping her abed. You feel a deep sense of desperation. You want to fill in for her, but you can’t. You are not her and your father knows you are not her. He walks through the kitchen and steps outside, leaving you to divine the next steps. You know what the soup looks like when it’s done, but not how it gets that way.

With the fat scooped out, you can step away and leave it alone for an hour, or two, being careful not to let the broth cook away to nothing. This simmering will cause the meat to shred, making it so tender you barely have to chew it.

This soup was a staple in your home. Every other Sunday the house filled with the aroma of its cooking. Your mouth waters at the thought and you are helplessly transported back in time. You see the tall clay pot sitting on the stove, flames licking its full rounded bottom, its flared top opened wide, gaping at the ceiling, its middle pinched in like a waist.

It resembles a woman’s shape and you wonder what the potter was thinking while he shaped it. It doesn’t appear to hold much, yet your mother makes sure everyone eats their fill. You can never figure out how she does that.

Once the meat has cooked through, it’s time for the potatoes. Scrub them well and slice them crosswise into thick slices, unpeeled. While they cook, chop up the rest of the vegetables, carrots, squash and cabbage.

Take a fresh corn on the cob and slice off the tip, then shuck the corn peeling back the husk to its core. With a firm grip, snap off the cornstalk. Under running water, work out the silk tucked into the rows of kernels. Score the center of the corn with a sharp knife and then break it in half and add it to your soup.

The corn was your favorite part. You looked forward to it. There seemed to be so few pieces in that pot, but your mother always made sure you got one. Those firm yellow kernels glistened sweetly as you inhaled your soup, leaving the corn for last. There was no need to salt it or add anything to it; it was perfect as it was. You ate it row by row, slowly working your way down the length of it. When all the kernels had disappeared, you siphoned out the succulent broth from within that cob, again working your way along it lengthwise, making sucking noises that made your siblings laugh.

When the potatoes are done, fish them out and place them in a covered dish. Add the rest of the vegetables and continue cooking. In approximately thirty minutes it will all be done.

There is not enough room in your deep stainless steel pot to hold all the ingredients at once. It makes no sense to you. It seems so much bigger than the clay pot of your memories. Nevertheless, you set the potatoes aside before adding the vegetables. You’re not sure when you figured out the sequence to this, if you were shown it or if it just came to you, but it matters not, now.

 

*Eat soup. It’s good for you.

**A version of this appeared on my blog, Prose and Possibilities.

Posted in Cooking, Food, Health, Memoir writing, Nutrition | Tagged , , , , | 4 Comments

My Mother’s Kitchen

I am always looking for my mother’s kitchen. The scents, the sounds. The tastes, the textures.  The colors, the flavors. The love she used to stretch each meal so that we were all left satiated once again. Each meal a true labor of love, whether it was a simple dish of eggs scrambled with tortilla bits, called Migas. Or a grand presentation of Mole Poblano, chicken in a spicy chocolate-based sauce.

I doubt I will ever find even a semblance of it, not even in my kitchen as my own table pales by comparison. She is cooking in heaven now and I am left with memories that propel me to keep looking so that every time I walk into a Mexican restaurant I wonder, is this it?

Chips and salsa

An occasional treat. If I eat too much corn, I notice swollen hands the next morning. RA imposing its limitations. The salsa has several health benefits, but what is salsa without chips?

wine

White Zinfandel. Something not found anywhere in my mother’s kitchen. Or my own actually. I keep Moscato around, and I found a strawberry Moscato that hits the right spot after dinner. Who needs dessert?

avocados

Guacamole. Avocados were a mainstay of my diet growing up and are a frequent part of my diet now. Avocados are loaded with vitamins and minerals, plus they are delicious plain or mixed to make guacamole.

Beef Tacos

Beef tacos. Another thing I don’t indulge in often, red meat, especially when it comes in a corn tortilla embrace. Another staple from my childhood was rice and beans, though  I gave up white rice a long time ago. The beans (B vitamins and Folic Acid) remain an important part of my diet, minus the sour cream and cheese topping. 

Pinata lanterns

We were enchanted with the star-shaped hanging lanterns. When we asked our server where we could buy some he said, “Guadalajara.” Hmm, that’s a ways away; maybe I’ll check online. 

Though this was a lovely place, the food delicious, and we received excellent service, it was not quite my mother’s kitchen. I know it no longer exists, but I can’t help wanting to find it.

***One of my favorite novels: Like Water for Chocolate, (Como Agua Para Chocolate) a luscious love story with a bonus of delectable recipes preceding each chapter, written by Laura Esquivel and translated into English by Carol Christensen and Thomas Christensen

 

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My Inspirations

My inspirations to eat right.

My inspirations to be healthier.

My inspirations to find joy.

Her favorite snack.

My beautiful veggie-lover.

Words fail me.

My sweet lovely.

My inspirations, my breath of life.

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An Apple a Day

I mentioned before that I’ve been studying foods for a few years now. When I decided I would write some food-related posts on this blog, in my own roundabout convoluted way of course, I surprised myself with just how much information I had gleaned.

I was also surprised to find composition books filled with neat penciled, cursive writing. Such patience. Such yearning. Such neatness. Such legibility. Such heartache. Running my fingertips lightly over the words as I read, I felt the me of so long ago. The me who had written them, as if the careful writing down of this vital information would somehow help my pain go away.

Fear not. I do not plan to impart solely the clinical. More so the personal, and share what I believe has helped me. The main objective for this study of foods was/is to combat inflammation. That to me is far more important than thwarting fat. Because having a few extra pounds of fat on board is not as lethal as having a few extra ounces of liquid on board.

I learned that the hard way a few weeks before being formally, officially, definitively diagnosed with Rheumatoid Arthritis. Prior to that event, I ended up in the ER with fluid squeezing my heart and lungs to the point that I presented as an MI patient.

I’d known there was something wrong with me for a while. Something that rest and sleep (hard to come by with a job and kids) and regular doses of OTC pain killers couldn’t seem to touch. My primary care physician mentioned the possibility of RA and handed me over to a rheumatologist.

Unfortunately, this rheumatologist turned out to be the wishy-washy kind. “It could be this. It could be that.” I don’t remember him laying a finger on me, not to examine me nor even to offer a bit of sympathy. And not surprisingly, he never came up with a diagnosis.

But he did treat. Vioxx, right before that blew up. Advil, yeah, like I hadn’t thought of that already. Paraffin wax baths for my hurting hands, hah! I’d read about those in my Fundamentals of Nursing textbook in 1978. This was 2004!

I thought we’d come a long way, baby, but apparently he hadn’t. In August of that year, I went to my PCP and spoke my mind. “That man is going to kill me.”

Little did I know.

He referred me to another rheumatologist and I was given an appointment for mid-October, new patient and all. I tried to think positive. Help was coming. I could see the light at the end of the tunnel.

On Oct 3rd, what I saw were the bright overhead lights of the ER exam room where at least ten people floated around me, sticking needles into my veins, needles into my radial artery, pills under my tongue, O2 onto my face, leads onto my whole body for a 12 lead EKG.

And the funny thing was that I didn’t care! I didn’t care what all they were doing to me because when you can’t breathe you don’t give a crap about anything else.

After 24 hours of very expensive testing, it was determined that my heart and lungs were fine. As the ER physician put it as he sat next to my hospital bed, “It’s your inflammatory condition.”

It was not his place to diagnose a specific ailment and then come up with a long-term treatment plan for me, to do the job of the specialist who should have. It was his job to pinpoint the obstacle to my heart and lungs functioning as they should right then. I returned his wry smile with my own. We both knew why I was there, why my status had deteriorated to the point where he and I ever had to meet at all.

I immediately envisioned chest tubes being inserted into me to drain the fluid. I’d lost track of how many times I’d assisted a doctor with their placement in critically ill patients. Had I been thinking clearly I would’ve realized that had I needed that particular intervention, I would already have a Pleurevac hanging off the side of my bed.

Though I lay amidst wires, lines and tubings, which made for one very restless night, it was only IV lines, heart monitor leads and an oxygen sensor clipped to my index finger that held me captive to the bed. That, and my yet-to-be-diagnosed disease.

I was sent home on oral steroids to treat my pleural and pericardial effusions. That’s when I first met up with my buddy, Prednisone. We’ve had a rocky on and off relationship these past ten years. Mostly off, but I like to keep my buddy handy, or as I tend to think of him, my frenemy.

Our first dalliance lasted till the following February. By the time I got to see my new rheumatologist, I’d gone through the one week’s worth of treatment prescribed by the ER Doc. The first thing he did was to put me right back on the steroids. “We don’t want it happening again,” he said. No, we sure didn’t.

The next five years were a blur of pain, but at least I knew why.

Come 2009, something happened. I’d left my job several years before and my youngest child had flown away to college.  I began to feel better physically. The fog was lifting and I began to look around. And I thought wait a freaking minute. There’s gotta be more to this than pain and drugs. And so began my journey, into exercise, into foods, into love. Into me.

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Weekend Getaway

Room  with a view.

Room with a view.

Walking the Riverwalk.

Walking the Tampa Riverwalk.

Hospital with a view.  Seen from across the Hillsborough River on the Riverwalk.

Hospital with a view. Seen from across the Hillsborough River on the Riverwalk.

Rowers on a windy day.

Rowers on a windy day.

Geometric skyline

Geometric skyline

Our hotel and and an incredibly azure sky.

Our hotel and an incredibly azure sky.

View of the atrium from the eighth floor.  It almost gives me vertigo.

View of the atrium from the eighth floor. It almost gives me vertigo.

Walking back late at night I almost said hello.

Walking back late at night I almost said hello.

It was a quick trip across the state to Tampa. The Embassy Suites never fails to satisfy and we had beautiful weather, but the best part of the trip was that RA stayed home!

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“What’s Your Donkey?”

A few months ago, I attended a business conference and one of the presenters, a videographer, told a story about filming in a small village whose name I can’t pronounce nor remember. She asked the women what would make life easier for them in that remote village and they said, “A donkey.”

At first she was surprised at such a simple request, but they explained how a donkey would help them till the soil and then carry their produce to market. There were other reasons as to why a donkey would make such a difference in their day-to-day existence so they organized a means to get the village women their donkey.

That talk, in reference to setting up a business and figuring out our needs, made quite an impression on me and it got me to thinking. What’s my donkey?

In my stand-off with RA, there are several inflammation markers I keep track of. As far as I remember, my sed rate has been normal or close to normal. (I am now the proud owner of my medical history for the last nine years. I asked and I received a CD of my chart. I will peruse later.)

The other marker, the one that more closely reflects how I feel physically, is my CRP. That has spiked more often than not over the years. Last fall I was feeling a little crappy and sure enough my CRP was 16. At last month’s visit it was nine. When it’s close to normal (4.9 or less) I feel terrific. Nine is good, awful good.

When my CRP is normal or near normal, I feel 20 years younger and just as spry. A while back we had to replace the water filter on our fridge and without even thinking, I went into a full squat, my tush almost raking the floor by my feet. My husband stood by my side, confident that I could not dislodge the filter from the bottom of the fridge without his muscles.

This is a man who road and mountain bikes, surfs (when there’s a swell, he once got kicked out of a surf spot because he was catching all the good waves. He’s used to Pacific Ocean swells; the Atlantic doesn’t quite cut it) and is younger than me. Since he was annoying me, I ignored him until he cried out, “I can’t do that! Squat like you’re doing now.”

I pressed on the end of the filter and it popped into my hand. I stood up, coolly handed it to him, then left him there, transfixed, with his mouth hanging open. This is also a man who had seen me at my worst, when I thought the fight with RA was lost or would be.

But, I said no, not yet.

And so, that is my RA donkey: a low, or normal, CRP.

And the continued flexibility to do full squats whenever I darn well feel like it.

 

 

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The Pain of Thawing

Snow in New York City Photo credit: Emilia Navarro

Snow in New York City
Photo credit: Emilia Navarro

I remember. The crisp clean air, cutting through you like a knife, the painful jolt of it as it burns through and hits the lungs. The brittle blue sky dome stretching tautly overhead. The bare tree branches wrapped in brilliant crystal, nature’s luminescent ornaments. The quiet of the icy day, for though there are other’s sounds, the cold has blocked your ears.

I remember the slush on the roads, the slipping and sliding away, sideways, along the street hoping no one crashes into you while you work to concentrate, turn the wheel into the skid, yes, into the skid, pump the brakes ever so lightly. Think, think, think, in slow motion, yet it all takes no more than several seconds.

Then back on the road again, like nothing happened, until it does once more. Boots crunching on the piled snow along the sidewalks. Boots slipping on the ice, oops, bottom hitting the cold, glassy surface with a sudden sting. Bounce right back up like an Olympic gymnast. No one notices; all too busy keeping their own feet safely on the treacherous ground.

Covered from head to toe, parka snapped and zippered shut. Crocheted scarf wound tightly around neck and mouth and nose. Eyes alone braving the frigid air.

Step by step, you stealthily make your way to the warm enclosure.

And then once inside, the pain of thawing.

***For my daughter, a dear friend and all who are currently braving this brutal winter.

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Ride

What does it mean when I don’t even feel hot until the 28th minute of my 30-minute workout?

Does it mean I should pedal faster, or pedal longer to get the cardio I need, and to lose the dreaded extra pounds? My short-lived goal of ten miles in 30 minutes has been, oh, so met.

I had decided that for the sake of consistency, I would limit the time on my stationary bike to 30 minutes and do it at least three days a week. Once I’m on the bike I revel in it, but it’s the getting on it that sometimes gets lost in the course of the day. There are so many other things to do! So I told myself: It’s only 30 minutes!

But the deal was that I couldn’t just meander through my bike ride enjoying the blue skies and puffy white clouds seen through my patio’s screen enclosure. I had to make it count. I had to make it comparable to my Tai Chi exercise, if not in length, then in sweat equity.

Tai Chi class is an hour and a half long; granted we do break for tea and cookies, and live chatting. And we spend almost half of the rest of the time watching the instructor go through the moves, which we then try to copy. She is poetry in motion; we are discordant verses.

Tai Chi is a real workout even though it’s slo-mo martial arts. By the end of class I’m usually sweating and my legs are crying out for a chair. Any chair. I used to get the same workout reward from my bike. The endorphins would fly as the sweat would pour. It was awesome.

But apparently, the three-minute mile is not good enough to even get a bead unless I do a whole lot more of them. Lately, I’d been having fun just increasing my speed, beating my personal best, 18, 19, 20, 21, 22, 23 miles per hour. Whooeee! That was fun; now it’s time to get to work.

I’m feeling good and as usually happens, when I feel good I tend to work out more, or should I say, harder. Which then makes me feel even better, a win/win. For I see exercise as money in the bank. If I put in a little bit each day, or almost every day, I will accumulate a mighty reservoir of health to dip into now and then as I ride this roller coaster called RA.

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The Change

Over the years my fingers have gone through what I call “The Change.”

It would start with a stabbing pain, like a needle being repeatedly inserted into a specific joint. I’d be working and go to do something and the pain would make me suck in my breath and wince internally. I would not let on how much it hurt. I didn’t like letting others know of my pain (something I plan to write about later, my misplaced stoicism).

In those moments, I would squeeze the offending knuckle with my other hand to make the pain stop. The pain didn’t prevent me from doing what I had to do, accomplishing all the fine motor functions required of me. But it did make me angry that I had to deal with it.

And the worst thing was that I had to deal with it over and over again. One sad knuckle at a time.

I knew what it was before a doctor confirmed it. It was Father Time knocking. It was the life-clock ticking. It was Osteoarthritis setting in.

Once the change is complete, the knuckle looks swollen, has less mobility and it doesn’t hurt. But while the change is happening, the pain is oh, so exquisite. I don’t know why OA  picked my hands to strike first, but it did, it has. And still is.

This time it’s attacking my poor little pinkie. For the second time. Can’t remember when it got the first knuckle, but it now is engaged once more. photo (78)

The pinkie ring I used to wear can no longer traverse the length of the finger to settle where it once belonged.

The knuckle is tender all the time and filing my fingernail was a study in stoicism. But I will do my nails, dammit! RA or OA, or RA and OA, will not restrict what I want to do.

Ouch!

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