Friday, August 15, 2014

Low-Carb: Getting through Luncheons and Other Group Meals

The first rule for following a low-carb diet when going to luncheons and other group outings is to assume there will be nothing there that you can eat. You'll usually be right and you'll come prepared. If it's a breakfast, eat before you go. If it's a luncheon, eat afterwards. Check the menu first if it's at a restaurant.

Most restaurants can offer something low-carb, but my carb-loving coworkers have a way of picking places and selecting buffets where there's absolutely nothing I can eat. (I'm carb intolerant and allergic to wheat.) Salad doesn't count as a meal. If I were more of a smart-aleck, I'd ask people who suggest salad if that's what they normally have for lunch and if so, whether they don't get hungry until dinner.

It's a problem when the meal is the entire point of the gathering or it comes in the middle of an event. This came up today--the buffet at the staff meeting had pasta, meatballs and salad. And here I thought the nineties were over. I went to McDonald's because a 20-calorie salad doesn't get me through the day no matter how much dressing I add. Some people find that socially awkward, but where are your acquaintances going to be when you're having an allergic reaction to something you ate? They won't be holding your hair back over the toilet or giving you Sudafed or regretting that nobody warned you, they'll be clucking that you should have had the salad.

The second rule is to prepare: eat breakfast before, eat lunch after, plan to fast, take some food you can eat, or find out where you can go nearby. Don't leave the house hungry--unless you know for a fact there will be food you can eat, assume there won't be. 

Wednesday, August 13, 2014

Controlling TMJ Pain; Fixing a Wheelchair Controller

The roaming pain should have been my first clue that my mouth wasn't hurting from newly replaced fillings. As soon as I realized it was TMJ pain, I followed advice from old TV ads for pain pills: "Take at the first sign of pain." They were right--nip it in the bud and tension can't turn into spasms, which turn into pain, which turns into more tension. All I've taken is aspirin and ibuprofin. I've also avoided long practice sessions playing the recorder. (I could say I'm a purist about playing baroque music, but truth to tell, a clarinet is really hard to play. I've tried.) I also avoid coffee when it bothers me, which is as intermittent as my TMJ pain.

My parents are still roped in red tape and I have nothing but nail clippers and a screwdriver. Since their credit union wouldn't accept their power of attorney, I whipped up a new one and brought a notary public to their nursing home.

Even with some practice, my mother couldn't drive her new wheelchair: the joystick has right and left reversed and she can't get used to it. Tonight I had the idea to flip it over so that the joystick is facing downward and right and left aren't flipped. We'll see how Mom does with it. 

Thursday, August 7, 2014

Eldercare: Almost It's Over!

How did things go so far downhill so fast?

A month ago, I wasn't thinking about my parents going to a nursing home and selling almost all their belongings. But kidney failure put my mother in the hospital and an accident put my father there, too, a few weeks ago. They've since improved and now they're both at a rehab center. Their dog has moved in with me.

Mom and Dad were in the same room, but they had to move my father because he called out for my mother all night and she couldn't get any sleep. Now he calls out to her from the room across the hall. He stops if I'm there--he calls out for me instead. At least my mother has the room to herself so she can learn to drive her new wheelchair, the one I found on Craigslist and bought from a guy at a storage unit way out in Longmont. When Mom said she found it hard to control, I bought a new joystick for it off Ebay.

Ebay wouldn't take my credit card--it said it had expired. It hadn't. The seller's website wouldn't take my address, even though I live in the US. I finally gave the seller my credit card number over the phone and got the joystick. I put the new joystick on her wheelchair the day after I got it, but Mom still can't drive it. This, from a woman who used to get around in a wheelchair that drove like a bumper car. I advised her to practice for a few hours.

Monday, I met with a man who does estate sales. He looked around my parents' house (after I'd taken out about 50 bags of papers and old toiletries) and said it would take him and his crew of six to eight people two weeks to set up. Most houses, he said, took a week to set up. Yes, I grew up in a (borderline) hoarder house. I've watched episodes of Clean House lately and wished the messy houses they show were all I had to deal with.

Among the papers I sorted were several unpaid bills. I take care of my parents' bills, but I can't take care of them if I don't see them. They're paid now, and now that my mother doesn't have to spend so much time taking care of Dad, she has time to deal with credit card companies and her credit union. The way her lawyer set up her power of attorney (with two co-successors) renders it useless with her credit union. She's putting me on her account and I've whipped up a new power of attorney form.

You'd think a nursing home would take care of all needs. Not so. I do my parents' laundry since nursing homes lose patients' clothes left and right; the last time, they sent Dad home with random clothes that weren't even his size and ended up writing me a check for clothing that I had bought for Dad a week earlier. Since both parents have lost weight, I bought them some new threads from Goodwill and ARC.

My mother's blood sugars have been running over 200 since she can't take metformin anymore. She can't control her blood sugar with food alone--I think the kidney failure scared her into being more strict about carbs than she had been. (The doctors said her kidney failure might have been caused by an antibiotic she reacted to.) So along with clean laundry, I brought her some Atkins bars and made sure she had enough coconut oil.

My next project is to scan her photos and letters onto her laptop and send the originals to her sister, who has volunteered to act as curator. (I bought a laptop cable so the laptop doesn't go the way of my Dad's clothes.) If Mom ends up with one more thing that needs to be taken to the post office, she's on her own.

Helping my parents isn't all I've been doing: I got three fillings replaced a few days ago. Between that and having revived my habit of grinding my teeth at night, my teeth have hurt for the past few days to the point that it's hard to eat. But I feel well enough to go to and have a good laugh without hurting myself. And now that things are becoming more stable, I tell myself, "almost it's over."

Monday, July 28, 2014

Freakin' Fabulous Pâté

I'll admit it: even though my dietary requirements include organ meat, it was a chore to eat it...and you know what happens when that's the case. I ended up eating Atkins bars instead of liver. Partly, I've been too busy the past few weeks to eat many home-cooked meals, but mostly, there are a lot of things--even on Atkins induction--that I'd rather eat than liver.

Last Saturday, needing some wind in my sails after a few weeks of family emergencies, uncluttering my parents' house with a room temperature of 85 degrees, and being too wound up to get much sleep, I checked out a book called Freakin' Fabulous by Clinton Kelly from What Not to Wear and The Chew.

Just looking at the pictures at red lights on the drive home inspired me to stop at the store--the grocery store. I knew Kelly was a stylist, but didn't know he could cook, too. He's quite the meat eater--his good looks attest to that. That, and it sounds like he eats little or no junk food. I don't suppose the Fabulous munch on Fritos. Even though he thinks fat is bad, he's no ascetic--in fact, almost all the recipes are low-carb if you forget about the crostini. The Freakin' Fabulous Four recipes (hollandaise, roasted chicken, french omelette, and nice vinaigrette) are all fat and protein.

I set to work in the kitchen over the weekend. The little pancetta/lettuce/goat cheese rolls were one of the tastiest, easiest snacks I've made. For the first time, I roasted a tender, juicy chicken with a crispy skin. Tonight, I made the best pâté I've ever eaten, anywhere. And it was the fastest, easiest I've ever made! I did add two tablespoons of butter and skip the anchovies because I don't like them. I accidentally burned the onions because I'm not used to frying with olive oil. Even so, the burned onions smelled good, so I proceeded. It turned out beautifully. Clinton's recipe is now THE recipe for pâté in this house.

I'm planning to try the recipe for salmon mousse. Since it calls for a packet of gelatin, an ingredient some readers here have a surprisingly wide and deep knowledge of, I'll provide details on how it turns out.

Friday, July 25, 2014

It Hurts When I Eat This!

Newbies in the low-carb and paleo community often say, "the diet is great, but I still have problems eating (fill in the blank). What should I do?"

Maybe they're too young to remember a certain old joke. A man goes to see his doctor and says, "Doctor, it hurts when I do this." (Picture the patient holding his arm in odd way.) "What should I do?" The doctor says, "Stop holding your arm that way."

This old joke now represents a radical idea. If you have trouble eating something, then stop eating it. Or eat smaller amounts of it if the smaller amount doesn't give you problems and you can stop yourself at a little bit.

I have FODMAPs problems--polyols in particular. I can't eat more than a strawberry a day or a few spoonfuls of lemon juice without getting an upset stomach and acid reflux. Too much alcohol sugar gives me gas. I could try probiotics, resistant starch, fermented foods and the other latest things that purportedly heal your gut. Having taken antibiotics like candy since childhood for sinus problems and acne and taking a couple of massive courses of them to kill Staphylococcus aureus and Helicobacter pylori later on, my gut bacteria population is probably down to a few isolated tribes.

For myself, though, I don't see a point in eating more starch (carbohydrate) so that I more carbohydrate. My digestion works perfectly if I don't eat fruit or more than a little sugar alcohol or large meals. And I had some serious upper GI problems--acid reflux and an esophageal ulcer.

What if I could eat all the beans, potatoes, fruit and sugar alcohol I wanted, though? If I did, I'd probably weigh 200 pounds. I'd also have roller-coaster blood sugars and I'd start getting cavities and sore teeth again. As for large meals, I have zero need to be able to knock back a five-course dinner.

For me, taking things to "heal" my gut would be a solution looking for a problem.

Saturday, July 19, 2014

Adventures in Eldercare

This week has found me at a beautiful assisted living home, at the emergency room, and then at a shady-looking storage unit on the outskirts of Longmont to meet a stranger.

First, though, the week started with my doing some housecleaning at my parents' place. I cleaned out magazines, catalogs, junk mail, and other old papers--some 15 trash bags full. I found a vacuum cleaner, a printer, a tub of cassettes, family photos, old hunting and fishing licenses, a letter of condolence from my grandparents on the death of my brother Marvin, a letter from someone telling my parents to "kiss the baby" (me), and a bunch of unpaid bills. My parents' assistant and I organized and boxed up a lot of the stuff to get it ready for an estate sale. The room we worked in is beginning to look like a room. Yes--this was all in one room. It's the worst room, but there are several more to go.

Monday, a woman who runs several assisted living homes came by, interviewed Dad, and took me to a lovely place in my parents' neighborhood. It's a regular house with half a dozen residents (mostly women), clean, spacious, and easy to get around in with a large deck out back and an orchard in the back yard. Heck, I'd go live there. I'm told it's not easy to find a place for a man if he wants to bunk with someone since it's mostly women who go to nursing homes. Nevertheless, they accepted my father and I put a down payment on a room and gave them their 30-page application.

Even though I disagree with my parents about their living situation, I've respected their wishes up until now. My father doesn't want to move (he doesn't want to go to an unfamiliar place), but his living in his home puts him in danger of falling (which he's done many times) and causes a hardship for me and my mother, who have to care for him. Monday and Tuesday, I was with him for 12 hours a day since my nephew works full time and has a long commute. Wednesday morning, my nephew called at 5AM asking how to stop the bleeding from a gash in Dad's arm, which he got from his second fall of the night. I told him to apply pressure and help Dad elevate his arm over his head, thinking he'd have taken him to the emergency room if it were serious. When I got there midday, he said, "I think Grandpa should go to the doctor." He added that he overslept, hadn't done anything on the list I'd given him the night before (including giving Dad his medications), didn't clean up the mess in the bathroom, didn't do the dishes, and had to leave for work right away. He supposed he should have set his alarm.

I spent the rest of the day first at Dad's primary physician, who cleaned up his wound and gave me a list of Dad's medications. I wrestled Dad's pills away from him the night before when he said it didn't matter which pills he took--and the visiting nurse didn't fill his pill boxes and I had no idea what to put in them. The doctor recommended Dad go to a nursing home and told me to take him to the emergency room for the bump on his head.

It was a busy day at the emergency room I'd taken Mom to a few days before: a construction worker hurt his arm, a stoic young guy had, as far as I could tell, hurt his knee, a young woman came in with a neck brace and a wheelchair, another woman was having an anxiety attack, an old man lay down on the chairs, and a couple of young women with a bunch of kids were there for reasons I couldn't discern. There were several more people I didn't pay any attention to. After some hours, a doctor and an assistant came to discuss Dad's reason for being there. I later told the doctor I had plans to move Dad to assisted living, but it would take a few days. Dad's head injury and cut on his arm weren't serious, but the doctor admitted him as an inpatient for an infection Dad had been treated for at home--god bless him.

At 6PM, after a day without a proper meal, the elephant took over. The elephant is the part of your brain that just wants to be warm, dry, fed, comfortable and happy. I got the nurse at the front desk to keep an eye on Dad, walked out in front of a moving car, drove to McDonald's, and ordered two burgers that the counter clerk suggested. I ate one, asked for a coffee and a bag for the other burger, left the coffee there, went home and changed into warmer clothes because it was cold and rainy, came back, grabbed the coffee and ate the other burger. Then I went to my mother's hospital room.

I think it was that day that my mother had dialysis. Despite treatment, her kidney function went downhill from the time she was admitted. As a result, she was so confused and incoherent that the doctor asked my permission to do dialysis to prevent permanent complications from the toxins in her body. I knew dialysis was a painful thing to go through, but said yes since I thought it might help her. After two rounds, she has improved so much that she's back to her old self and the hospital is making sure she's going to be ready for discharge.

The main concern was safety--her ability to get around. Friday night last week, Mom called me because her wheelchair was stalled. A burner on the stove was on and she couldn't get to it to shut it off. I came over, got her into her other wheelchair, and saw that she couldn't get through the room with the papers, cassettes, printer, vacuum cleaner, and other treasures. That's when I started cleaning it up.

This morning, a wheelchair repairman quoted me $125 to come out and diagnose the problem. Repairs would cost parts plus $85 per hour in labor. This, for a chair that's been through several repairs and that Mom complains hurts her back. I called a number on Craigslist for a chair that looked promising: never used, fairly small, and with a foot rest that wouldn't require Mom to lift her legs over a divider to transfer to a bed or chair. Great price, too. The guy sounded like a Frenchman, couldn't tell me the address of the place to meet him, but said it was at a storage place on Whatever Road in Longmont. I couldn't find any Whatever Road in Longmont on Google maps. He named a different storage place on another street at the end of the road. I was to call him from there.

Resources being limited, I bit. I drove north to oil well country to the outskirts of Longmont, past an abandoned factory to the storage place at the end of the road past some guys parked in the street. It was them. I followed them to another storage unit on Weaver Road (way-a-ver, with my brain supplying the T). The unit was neat and clean, the chair was just as described, and the guy let me use his phone to find a credit union branch nearby, since I wouldn't need someone with a truck to haul it--it would come apart and fit in my car. Nevertheless, I had to drive all the way to north Denver to make a withdrawal and come back. Even though the guy seemed pleasant enough, I drove back thinking, "I'm taking a wad of cash by myself to meet a stranger from Craigslist at a storage unit." Even so, I wasn't really worried: the guy didn't give me the creeps, and I'm easily creeped out by people.

The legwork, housework and paperwork has been a full-time job this week, but things are falling into place: Dad will have a place to go where he'll be taken care of, Mom has a new wheelchair at a great price, and the house will be ready to sell if we keep after the cleanup. I'm still doing Atkins, and so have little desire to snack--and great thing given how much I've had to do without time to stop for little meals every few hours.

Sunday, July 13, 2014

Want Something? The Universe Doesn't Care

Wouldn't it be great to think, picture and believe your way to a wonderful life? Being a science geek, it's easy to forget how popular that belief is, even among educated people. Call it The Secret, the law of attraction, positive thinking, or affirmations. I call it wishing for a no-effort solution; Richard Rumelt describes it aptly in Good Strategy, Bad Strategy:

But I do know that believing that rays come out of your head and change the physical world, and that by thinking only of success you can become a success, are forms of psychosis and cannot be recommended as approaches to management or strategy....Nevertheless, the doctrine that one can impose one's visions and desires on the world by the force of thought alone retains a powerful appeal to many people. 

This hit home lately because my mother is in the hospital and I have to take time off from work to be with my father since my nephew works afternoons and nights. My parents have an assistant and she's done a yeoman's work, but she has other clients besides them. I'm trying to get Dad into a nursing home, but given his needs, it's not easy to find a place. Since my parents' Medicaid application hasn't gone through yet, we're "Medicaid pending," meaning somebody has to pay full freight (around $3,000 per month) until the application is approved. Once it's approved, you get reimbursed.

No amount of positive thinking will make this go away. The buck stops here with me because it has to--there's no one else's lap to dump it in. Wishful thinking won't get Dad into a nursing home and the law of attraction hasn't turned up many people who want to deal with this.

Fantasize all you want, the universe doesn't care. Is someone supposed to jump at the chance to take on your responsibilities for bathing and cooking for Grandma just because you'd rather be backpacking in Thailand?

Affirmations aren't substitutes for difficult decisions. My parents could have taken action to make this easier for me: signing the application for Medicaid months ago when it looked like Dad might need to go to a nursing home, moving to a smaller place near my home (they'd have had more resources to deal with this), getting rid of things instead of accumulating more and fantasizing about needing rototillers and a garage full of power tools at the age of 80. The things could have been organized instead of thrown into piles. I used to have nightmares about dealing with all my parents' stuff. For whatever reason, a LC diet makes me sleep like the dead. I rarely have dreams anymore--a blessing.

To take such action, though, you have to answer unpleasant questions: what if neither of us could drive anymore? What if we can't take care of ourselves? What if somebody else has to deal with this?