Sunday, March 27, 2011

A gift

On March 27, 2006 I checked into Shady Grove Adventist Hospital for a week of I-131 treatment for thyroid cancer. Days of complete isolation, having my radioactivity measured daily with a Gieger counter, worrying that I would permanently lose my sense of taste (it's a possible side effect), and wondering whether I was elevating my kids' risk of cancer from the residual radiation took a huge psychological toll. I finally worked through enough of the pain and worry to write my cancer story last year, and I am republishing it again for my 5th anniversary.

Four years ago this week, I walked out of hospital after 4 days of isolation, with puffy painful salivary glands and intermittent nausea from the lifesaving -- I hoped -- I-131 (radioactive iodine) treatment for Stage III papillary thyroid cancer. My cancer diagnosis was  a complete surprise, since multiple doctors had for years been telling me that my thyroid was fine, my "levels" were within normal limits, and that there was no need to worry about the growing nodules as the two biopsies were negative. Only after I started having trouble swallowing did I find an endocrinologist that would send me for a surgery consultation, and it was during the complete thyroidectomy that the surgeon recognized the autoimmune disease Hashimoto's Thyroiditis, and cancer that had spread to most of the lymph nodes in my neck. It was very aggressive, and required a higher dose of 1-131 than is usually prescribed.

Hearing the C-word out of a doctor's mouth is one of the worst experiences imaginable. I wasn't even 40 years old. My kids were 6 and 3 years old. I was simultaneously completely numb, and as frightened as I have ever been in my life. Once I got over the fright and the ensuing months of chaos, tests, scans, more tests, treatment, and more tests, I got angry. Angry that my physical symptoms had been dismissed for years as all in my head. Angry that because I was a mother of young children excessive fatigue was "normal." Angry that my inability to lose weight was dismissed as eating too much or not counting calories. Angry that I had to push, to be a bitch, really, to be taken seriously and get the treatment I needed. And furious that there might be other women out there who were treated like shit by the medical establishment just like I was.

Had we waited and watched the nodules, as more than one doctor advised, the cancer would have further metastisized, and my chances of surviving would have plummeted. Had I listened to the doctor that gently suggested that maybe it was postpartum depression (my youngest was 3!) causing my symptoms, it might have required chemotherapy and radiation instead of the less-risky radioactive iodine treatment to kill the tumors. If I had taken the advice of the doctor that told me that my weight gain was because I needed to diet, and to just make an appointment with a nutritionist, I would most likely be a box of ashes right now instead of typing this post. By trusting my instincts and being dissatisfied with the advice and treatment offered, I saved my own life.

There's no moral to this tale. Having these experiences does not make me a better person or any stronger than those who were treated compassionately and received the care they needed promptly. I did learn a few things, though, that I'm more than happy to share:

Trust your instincts. Your body knows when something is wrong. Listen to it. Do your research. Ask the uncomfortable questions. Don't be afraid to fire your doctor; I switched doctors four times in 2 years. Get a second opinion. Demand to be taken seriously. It sucks, but sometimes it's on you to get what you need. Doctors are human beings and they make mistakes all the time. Make it a point to encourage others to fight hard, just like you did.

If you are diagnosed with cancer, get as much information as you can. Cancer.net is an invaluable resource for looking up various types of cancer and getting specific information about stages, treatments, and aftereffects. It has links to advocacy and patient support groups, and should you need it, advice about end-of-life care. Make sure you have a will and a living will, that someone has power of attorney if you're incapacitated, and that you've made your burial or cremation wishes known should it come to that. It's hard to think about those things -- we all want to be survivors -- but you have to, especially if you have children.

And if you survive, appreciate what you've been given. Take steps to live your life the way you want. Slow down. Take some risks. Jump in with your eyes closed once in a while. Things aren't always going to go your way, but hey, at least you're not in a box. I don't go for the "cancer is a gift" bullshit that has been peddled by people like Deepak Chopra, among others, but if you make it through alive it does give you a unique perspective on life's trials. Your life is the gift, and you have every right to stop and savor it. Musician and brain cancer victim Warren Zevon said it exactly right: "Enjoy every sandwich." I plan to enjoy every sandwich for a long time.

(Originally posted in April, 2010)

Sunday, January 9, 2011

Noodles and assumptions

I am not a Johnny-Come-Lately to food. I've gone to culinary school; I'm an excellent home cook; I'm well-versed in world cuisine; and I'm a historian, preservationist, and curator of our culinary past. I have been featured in a national newspaper for championing the resurgence of canning, and have long extolled the virtues of old-fashioned home cooking from simpler times, dishes like Chicken a la King and American Chop Suey. I am secure in my belief that we educated foodies of the 21st century should hold on to these relics of a less-sophisticated era.

I unearthed one of those relics this week while getting ready for a comfort food project with Twitter bud Matt at A Good Time With Wine. A recipe sift turned up pot roast, casseroles and Christmas cookies - and a handwritten recipe for something called Javanese Bami. It's a simple stir fry of noodles, pork and cabbage that I recall my mom making from time to time when I was growing up in the 1960's & 70's. Mom got the recipe from my late maternal grandmother, and the age of the recipe combined with its probable provenance from a 1960's women's magazine made me sure that this must be a Ladies Home Journal bowdlerization of an Indonesian recipe, dumbed down for American tastes and renamed so as not to sound too "foreign." Curiosity piqued, I decided to do a bit of research and recreate this childhood memory as something authentic.

I typed "Javanese Bami recipe" into Google, hit send, and got a reminder from the universe not to be such a know-it-all.

A dozen recipes for Bami Goreng popped up, most noting that contrary to what I assumed, "bami" is not a made-up word. The vegetables included varied from recipe to recipe, some called for sambaal oelek, or Indonesian chili paste, and a few called for kecap manis, a sweetish soy condiment. That said, more than one page noted that there are as many variations of Bami Goreng as there are cooks. The version I grew up eating was pretty close to "real."

I made a couple of changes to the recipe and served it for dinner last night. As with many Asian recipes, it looks more complicated than it is. Get everything clean, chopped and ready to go and this will come together in minutes.

Bami Goreng

1/2 lb. Chinese egg noodles, cooked and drained
4-5 thin pork chops, cut into strips
4 small onions, chopped
4 cloves garlic, minced
1 bunch scallions, sliced on the diagonal
1 small head of Bok Choy, washed, trimmed and sliced diagonally
1/2 bunch of celery, washed, trimmed, and sliced diagonally
1/2 lb. of fresh mushrooms, sliced
1/4 fresh bean sprouts
1/2 lb. small fresh shrimp, peeled and de-veined
1/4 c. soy sauce
2 t. Palm sugar, or light brown sugar
1 bunch of cilantro, washed and chopped
Vegetable oil for cooking

Cook noodles according to package directions. Drain, rinse, and set aside.

Dissolve sugar in soy sauce, set aside. Grab a small handful of cilantro & set it aside for garnish.

Heat a large non-stick skillet over medium-high heat. Add a couple of teaspoons of vegetable oil, swirl to coat the pan, then add pork. Stir-fry until pork starts to brown. Remove to a plate.

Heat a very large lidded saute pan over medium-high heat. I have a 14" straight-sided saute pan that is perfect for this, but a large electric skillet would work too. When pan is hot, add about 1 Tb. of vegetable oil. Swirl to coat the bottom, then add onions. Stir-fry until onions start to brown a little at the edges. Add garlic and cook until it becomes fragrant. Add cabbage and celery, turn down the heat to medium, cover and cook for about 5 minutes. Remove cover, turn the heat back up to medium-high and add scallions, mushrooms bean sprouts, soy sauce mixture, and shrimp. Keep stirring. When shrimp turns pink add the noodles. Give it a couple of turns to heat them through, taste and add more soy sauce if needed. Add cilantro and toss.

Serves 6 people generously. Heap into a large soup dish, sprinkle with a little of the reserved cilantro, and add a generous dollop of sambal oelek, Chinese chili-garlic paste, or Sriracha.