Me No Pause, Journal of the Journey to Wise Woman's Garden

By the time I went to the doctor and was diagnosed with severe anemia (my hemoglobin was half of what it should have been), I had the following symptoms:

• Extreme fatigue
• Intermittent chest wall pain
• Extreme irritability
• Heart racing while resting (enough that I could hear it in my ears, and it would wake me out of a sound sleep)
• Depression
• Lack of ability to concentrate effectively
• Feeling cold, particularly in the evening
• Headaches with any kind of exertion, or nagging headaches that occurred later in the day or first thing in the morning

The interesting thing to me is, before I was diagnosed, I soldiered through all of my symptomology, blaming it on other things. When the doctor examined me and found that my heart was racing even when I was lying down, she asked me if I was having chest pain. I said no. I did have intermittent pain that I attributed to reflux, which I do suffer from and take daily medication for. I didn't think to mention it. I did mention my fairly nonstop menstrual flow, but I still had to ask the doctor specifically to test me for anemia. She checked the box on her paperwork only after I asked.

The strangest thing happened when the nurse called to tell me I was anemic and should start treatment with iron pills (along with vitamin C, which helps the body to absorb the iron). I physically crashed and began to notice all my symptoms. I was so shaky and weak at breakfast the next morning that I could barely hold my coffee cup. My gynecologist told me several days later that if my anemic condition had happened all at once instead of over months, I would have been hospitalized flat on my back, but my body had adjusted over time until my symptoms became this severe.

The racing heart and the chest pain went away completely within a few days of starting treatment, as did the nagging headaches, but the other symptoms took awhile to resolve. I was not able to leave home for about two months due to the extreme fatigue, which made me feel unsteady any time I exerted myself. It was shocking how sick I had become without realizing it.

Having said all this, it is important to get medical confirmation of anemia before starting to take iron supplements on a regular basis. A simple blood test will confirm it, and a doctor's exam will rule out other possible conditions. Iron overdose is highly toxic, can cause grave illness, and can kill a small child. If you do take iron supplements, store them safely out of children's reach.

I think that the reason women under 50 are twice as likely as men to die of heart attacks is largely because we tend not to notice our symptoms for what they are. We are so used to functioning through discomfort that we learn to effectively deny to ourselves that we don't feel well:  it was something I ate, I'm just over-tired, or I'm getting my period. We women are particularly good at talking ourselves out of our symptoms. We are often just too busy to be sick until it takes us down so hard that we're in trouble.

I didn't have a period for four months after my crisis. An ultrasound showed that my uterine lining had thinned sixty percent from what it had been the year before. A biopsy came back cancer-free. I sailed along happily for quite a long time thinking that perhaps I had reached the land of the free, when all of a sudden, it started again—the flooding flow. I became immediately depressed and anxious. I felt that all my well-being was flowing out of my body, too. This time I picked up the phone.

In my mother's day, a hysterectomy was the only solution for abnormally heavy menstrual bleeding. I still remember my father taking my little brother and me to the hospital to wave at my mother in her room on the second floor because she was hospitalized for ten days, which was routine then. We missed each other terribly. Now, thankfully, there are a few options that are not so radical.

I have chosen to have an endometrial ablation. This is a procedure that destroys the shedding layer, or endometrium, of the uterus by use of a laser or radio waves. It can be done as an office procedure and is very low risk. The downside is that it doesn't work for everyone—the younger you are, the higher the likelihood that you will need a second treatment—and depending on the shape and condition of the uterus, it is not as effective for some as for others. Fifty percent of women will stop having periods entirely. My gynecologist told me, and these are her words, "It is unrealistic to expect never to see another drop of blood come out of your vagina again because some of the cells that shed are in your fallopian tubes or other places, but you should see a dramatic drop in the amount of bleeding you're having, even if it doesn't stop entirely."

That's good enough for me. And I did choose to have my procedure done in the hospital OR because of my particular circumstances, but even at that I will only be unconscious for a few minutes. It seems a small price to pay.

The message of my story today is pay attention to what your body is trying to tell you. Even chronic fatigue or extreme irritability should be evaluated for an organic cause. I don't know why we always feel that we should put up with things and not complain, Ladies. This is pretty last century behavior. And spouses (and I know there are some of you reading this—good for you), if you notice changes in your beloved, it is loving sometimes to say, "Hey, maybe you can stand it Honey, but I can't stand it anymore," as my spouse said to me. She actually picked up the phone, put it in my hand, and said, "You want to stay married?" Yes I was angry for a little while, but I love her all the more now for caring that much and running the gauntlet of my extreme irritability to help me to take care of myself.

When I was young I used to think that being an old lady and going through menopause was the worst fate in the world. Cranky, ugly old ladies! Billboards, magazines, media in general is filled images of sexy, young women. Childbearing and child rearing are industries unto themselves. It is no wonder I felt that way.

You know you are more than your childbearing capabilities (whether or not you actually bore children). You deserve to be well as you enter the Wise Woman's garden. It's okay, and even essential to listen to that voice within and be well.

Homemade Irish Corned Beef and Vegetables

This recipe was published in our local paper, The Oregonian, last year. We made it and fell in love. It takes eight days to brine, so requires some planning but it is absolutely worth the trouble. It bears no resemblance to the weird colored store bought stuff. We've never used the insta-cure they talk about. I think it's entirely unecessary.

The broth (not the brine) that the brisket simmers in is salty, but really flavorful. I couldn't stand to waste it.I added a good deal more water to it and made a barley soup with it last year.


The uncooked corned beef freezes really well. This year we had a bigger brisket than we needed so we cut it in half after it was corned but before it was cooked, and froze it. All we had to do for a nice weekend dinner was to defrost it and cook it according to the cooking directions above. I do take short cuts from the recipe above when cooking. I put the brisket in Guinness, and water or broth to almost cover, and add about two tablespoons pickling spice--and that's all. I let it simmer that way for two and a half hours in a pot with a tight fitting lid,  and serve it with whatever suits my fancy at the time.

Homemade Irish Corned Beef and Vegetables

Published March 9, 2010

Makes 6 to 8 servings

Ingredients

For the brine:

·         6 cups water

·         2 cups lager beer

·         1 1/2 cups coarse kosher salt

·         1 cup firmly packed golden brown sugar

·         1 1/2 tablespoons Insta Cure No. 1 (optional; see note)

·         1/4 cup pickling spices

·         1 6- to 8-pound flat-cut beef brisket, trimmed, but with some fat remaining

Corned beef and vegetables:

·         1 12-ounce bottle Guinness stout or other stout or porter

·         4 bay leaves

·         1 tablespoon coriander seeds

·         2 whole allspice

·         1 dried chile de arbol, broken in half (see note)

·         12 baby turnips, trimmed, or 3 medium turnips or rutabagas, peeled and quartered

·         8 unpeeled medium-size white or red waxy potatoes (about 3 pounds)

·         6 medium carrots, peeled

·         4 medium onions, peeled, halved through root ends

·         2 medium parsnips, peeled, cut into 2-inch lengths

·         1 2-pound head cabbage, quartered

·         Horseradish, for serving (optional)

·         Mustard for serving (optional)

Instructions:

To make brine: Pour the water and beer into a large, deep roasting pan. Add coarse salt; stir until dissolved. Add sugar; stir until dissolved. If desired, stir in Insta Cure. Mix in pickling spices. Pierce brisket all over with tip of small, sharp knife. Submerge brisket in liquid, then top with a heavy platter to weigh meat down. Cover and refrigerate 4 days.

Remove brisket from brine. Stir liquid to blend. Return brisket to brine; top with heavy platter. Cover; refrigerate 4 days. Remove brisket from brine. Rinse with cold running water.

To make corned beef and vegetables: Place corned beef in a very large, wide pot. Add stout and enough water to cover by 1 inch. Wrap bay leaves, coriander seeds, allspice and chile in cheesecloth and tie with kitchen string to secure. Add spice bag to pot with beef and bring to a boil. Reduce heat to medium-low, cover and simmer until beef is tender, about 2 1/4 hours. Transfer beef to a large baking sheet.

Add turnips and all remaining vegetables to liquid in pot; bring to a boil. Reduce heat to medium and boil gently until all vegetables are tender, about 25 minutes. Using slotted spoon, transfer vegetables to baking sheet with beef. Return beef to pot and rewarm 5 minutes. Discard spice bag.

Cut beef against grain into 1/4-inch-thick slices. Arrange beef and vegetables on platter. Serve with horseradish and mustard.

Note: Insta Cure No. 1 is a mixture of sodium nitrate and salt that is used in cured and smoked sausages to prevent botulism. In this brine, its only purpose is to prevent the meat from turning gray, so it is optional. You'll find Insta Cure No. 1 at sausagemaker.com, and at stores that sell sporting goods or meat-preserving equipment.

Note: Chile de arbol is a thin, red, very hot, 3-inch-long dried chile. It is sold at some supermarkets, and at specialty foods stores and Latino markets.

From Bruce Aidells, Bon Appétit, March 2008

An E-Filer's Cautionary Tale

Don't hate me because I'm dutiful. It's not even the last day of January and my 2010 tax returns are filed with refunds on the way straight to my bank account. We have an agreement in our house. The person with the most income pays the CPA takes all the deductions. This leaves me still filing a 1040EZ. I used to be an April  14th filer. I think, one year, long ago in the days of paper forms one had to file out on one's own, I even filed for an extension because I blew the chore off too long. The IRS has made it easier and easier for average Americans with W-2s and 1099s to file our taxes. At first, the forms were simplified. Then you could use your push button telephone to file a return. Now of course, there's e-filing. I like e-filing. I enter my numbers, the software does the work. I get my refund or know how much I have to pay. I can leave it there until April `14th, or file it right away.

The IRS has one official website: http://www.irs.gov/. Do not go there through an internet search. Type the address directly into your browser. Doing this eliminates any possibility that you have been directed to any other site. In the past there have been IRS look alike sites that were phishing for information. They don't seem as prevalent now, but it never hurts to be cautious.

The official IRS site has  pretty much every form the average filer could want. Some of them, like the 1040EZ are 'fillable', meaning you can type your information into them, save your work and print it out when you are ready to file. E-filing is a slightly different process, in that the information you give the software is transmitted directly to the IRS electronically when you decide to file. You print out paper copies only for your own files after the return has been accepted. On the IRS website you will find options to e-file for free, or 'freefile'. If you click the link to free file you will be taken to a portion of the IRS website that tells you how to file your return for free electronically. This is verbage copied directly from  the http://www.irs.gov/ website:

• Free File companies have their own eligibility criteria, but none offer Free File to taxpayers with an adjusted gross income of more than $58,000.
• Other eligibility criteria may include your: age, state, eligibility for the Earned Income Tax Credit, and military status.
• Check the company's website for details because the companies' offers may differ. For example, some companies charge a fee for state tax returns and some may not support a particular form you need to file.
• Remember to begin your Free File return on IRS.gov or you may be charged a fee or asked to buy additional products and services.

There's a nifty little screening tool, if you're still not sure you're eligible to free file, but if you are eligible, as I am,  all you have to do is choose your site from an IRS provided list and you're good to go. But, herein lies my cautionary tale:

Last year I free filed, following a link to a provider's site directly from the IRS website. The software interviewed me and guided me entirely through the process. I still had a question for which I phoned the IRS directly and spoke to a person who answered immediately and was extremely helpful, but for the most part I completed my return without a hitch. I must have hit a wrong button and navigated past the piece of the interview that asked how much I paid in State taxes. I reviewed my work but trusted the software that I owed the State $900.00, even as this little voice inside me was screaming, "You made a mistake!" I submitted my return without listening to it. The software is almost too easy. It can lull you into submission. Literally. It was the stupidest mistake I ever made on my taxes. I had to hand file an amended return with the State. It took six months before I got my money back, and I had a threatening letter before that happened. I filed my State taxes through the same site I filed my free filed Federal return. There was a fee for filing my State taxes. It was nonrefundable. I paid a fee to make my mistake. I vowed be more careful in the future.

I liked the website where I free filed enough that I saved the URL in my favorites for this year. When I got my W-2, I hopped right back there efficiently. They had my information from last year. It was even easier to complete a return, although I was a little gun shy, so I did check it over pretty thoroughly. I noticed that the draft form 1040EZ I was looking at on the provider site did not match the form on the IRS website. The provider's form did not have the important added line for this year, "Making Work Pay". I wrote to customer service about that. They wrote back quickly to tell me where to find the credit on their form--that had been automatically given to me--and to explain that information is electronically submitted to the IRS, not the forms. The way their forms look don't actually matter, as long as all the information's there. It was still confusing, but at least they were prompt with their explanation. The explanation worked for me and I was finally ready to file. I entered all the information to get my return ready to file and hit the button, only to find that they wanted money for both my Federal and State return--to the tune of nearly forty dollars! WHAT?! I went back to the IRS website to double check that this provider was still on their free file list. They were. I wrote to customer service again to ask them why their software was trying to charge me when I clearly qualified for free filing.

The explanation was surprising. The provider site offers free filing as per the IRS, but they also run a commercial site for people who want to file electronically but don't qualify to file for free. If you come to their site somewhere other than through the IRS website--as I did when I saved the URL from the previous year--the software sees you as a commercial customer and there's no way to change it. The customer service rep did apologize for the misunderstanding and gave me an electronic coupon code to file both returns for less that my State return would have cost. They did make good, and I did file my returns, but hey people what about a link to your free site if someone eligible comes to your commercial site? Would that be so hard?

I'm a big proponent of e-filing. I'm sure it's easier on everyone and processing is cheaper, but you do have to be cautious and aware. Any mistakes you make are still ultimately your responsibility.

I know most people cringe at the mere mention of IRS. I once didn't open a letter from the IRS for a month because I was so terrified that I had done something wrong, only to find that someone at the IRS had refigured my taxes for me because I had forgotten to take the Earned Income Credit, and sent me a refund of nearly three hundred dollars. If e-filing is too much for you, you need help filing your taxes or you have issues around taxes from previous years, the IRS does offer help on all fronts. You can find information on the IRS website for anything from taxpayer advocacy services to IRS offices with extended Saturday services to assist you in filing your taxes.

I don't work for the IRS, I just have a die-hard helpful nature and I was thinking that someone might be helped by the story of my mishaps. I'm glad my refund's on the way. We can finally replace the carpeting downstairs. That's a big yay!

Be well. If you can't ignore the inevitability of paying your taxes, at least you can bash about in the world and enjoy yourself with the time you save because paying them is a lot easier these days. That's what I'm off to do.

What's for lunch? Ahnna's No-Mayo Tuna Salad

Before we worked Weight Watchers a couple years ago--which is a great program on which I lost thirty pounds sitting on my butt all day as I must--I would sometimes get a hankering for one of my grandma's tuna salad sandwiches on white bread, with mayo, chopped up olives and onions, and always served with greasy Wise potato chips on the side. Not very waistline friendly, but I certainly wasn't worried about that at six. Asha craved Subway tuna subs when she was pregnant with Wren. One six inch tuna sub has a whopping 30 grams of fat--most of which comes from mayo and other condiments. I was determined to create a healthier recipe.

We spent the better part of two years actually 'counting points' as per the Weight Watcher's regimen. During this time I lost what I actually believe was a craving for fat. I don't like mayonnaise anymore. I really can't even stand the sight of it. The sight of Jon Stewart attempting to down Baconnaise on The Daily Show (this is hilarious, don't miss it: http://www.thedailyshow.com/watch/wed-june-17-2009/heal-or-no-heal ) makes me confused about whether to laugh hysterically or run and lose my dinner.

Here it is. I declare this better than the mayo made version.

Ahnna's No Mayo Tuna Salad
Serves 2

1 7-oz can of tuna
1/2 cup of fat free sour cream (more or less depending on taste)
2 tablespoons capers
1 tablespoon prepared mustard
1 shredded carrot (optional)
2 tablespoons finely chopped onion (optional)

Put everything into a bowl and mix with a fork until well blended.

You can certainly serve this on bread as sandwiches, although I prefer really crunchy crackers, like Wasa whole grain crisp bread.

I don't even know if they still make Wise potato chips anymore--although I think they're better left to memories in my case.

Enjoy in good health.

I Still Think We Sould Call It Stopnowalldoneforgetaboutit...

As the new year dawns, I have been diagnosed with anemia from many, many months of menstrual flow--sometimes extremely heavy, sometimes what I would call normal, sometimes very light--but it seems, always with me these last several months. I should have called the doctor sooner, and not necessarily for the reason you're thinking. Within one day of calling to make an appointment with my gynecologist to run screaming that I've had enough, my flow completely stopped and has stayed that way as of this writing. I should have known it's like taking a car to the mechanic for a sound that's driving you crazy, but stops as soon as you drive into the shop.

But seriously, I should have called the doctor sooner, but I was too tired and cranky. It's sometimes a challenge to take care of one's health when one is feeling unhealthy. By the time I did get in for my physical I was feeling exhausted all the time, short tempered and had some episodes of chest soreness that I now believe were related to anemia since it went away immediately when I started the prescribed treatment. I also managed to burn myself cooking on New Year's Eve, which could be blamed on symptoms of anemia because I've felt like I'm in a fog half the time lately.

What are the symptoms of anemia, you may ask. There are many kinds of anemia and many symptoms, some of which are so mild that you might attribute them to other causes such as work stress or fatigue, but here are some pretty common ones: Pale skin color, fatigue, irritability, dizziness, weakness, shortness of breath, sore tongue, brittle nails, decreased appetite, frontal headache, chest pain or soreness, rapid or skipping heartbeats, depression and loss of interest in sex.

The longer anemia is allowed to go on, the harder it is to treat and there is more likelyhood of longer lasting effects. Here I am blogging about it when I should have paid better attention. I had many of these symptoms and was all too willing to write it off as life stress until it started to knock me down around the holidays this year.

I'm writing about it in case any of you reading this might be feeling symptoms you're avoiding too. It's not that hard to get a blood test.

I think the worst part of all this is that my body actually adjusted to feeling bad. Tired just started to feel normal. I actually felt quite relieved to have a physical diagnosis for my symptoms. It's not always that easy to expain. A good friend of mine, who is post-menopausal, said to me: "It's a hard time of life because you sort of fall apart in so many ways and you have to figure out how the pieces go back together because they never go back together the same way again." How true that is. Many people, doctors included, can be quite dismissive about the emotional effects of perimenopause. Sometimes I think there should be hangouts for women going through perimenopause, just like there are places for other people who have similar interests or issues. You know, someplace there's a bouncer at the door if a non-sympathetic person tries to get in. I know I'd go some days.

Take good care of yourselves.

Ahnna's Chicken and Dumplings or, Proof That You Can Teach an Old Yankee New Tricks

My spouse remembers her gentle southern Mamaw's cooking with such tender longing sometimes that one day I went looking for a recipe for Chicken and Dumplings. There were all sorts of recipes. Some were complex with vegetables in them. Some were so simple that cut up flour tortillas were substituted for the dumplings. I was told quite firmly that authentic Southern Chicken and Dumplings does not have vegetables in it, and as for the tortillas, just ew.

The first time we made this using a recipe I found on this wonderful blog: http://eatathomecooks.com/2009/07/homemade-chicken-and-dumplings-its-easy-really.html

We rolled the dough out and cut it, just as it shows in the illustration. The recipe is delicious, although for Asha, was still not satisfying her memory of her childhood. Her Mamaw undoubtedly dropped her dough from a spoon rather than rolling it and cutting it, and her broth was thicker and milkier.

This is the version I concocted, with a nod of thanks to the blog above for the dumpling recipe. Asha declared that this recipe is probably more flavorful than her Mamaw's--based on what her Mamaw had on hand to feed 11 children on a daily basis--but our family ate this recipe quite happily. I know Mamaw's smiling on us for passing on her comfort food as best we can.

We like to make this dish a couple days after we've had roasted chicken for dinner. We have homemade stock and leftover chicken for our recipe, but this would work equally well with store bought stock and a cooked, cut-up chicken breast. It makes a surprisingly easy and satisfying dinner.

Ahnna's Chicken and Dumplings
Serves 4-6

For the broth base:
6-8 cups chicken stock
3 cups of cooked chicken cut or shredded into bite size pieces
Salt and pepper to taste

For the dumplings:
2 cups flour
2 Tbs. butter
1/2 tsp. baking powder
salt to taste
1cup milk (a little more if you like the drop batter thinner)

For the milk slurry (to thicken):
3-4 tablespoons of flour
About a half a cup milk

To make the dumpling dough:
Combine the flour, baking powder and salt.  Cut the butter into the dry ingredients with a fork or pastry blender.  Stir in the milk, mixing with a fork  until the dough forms a ball.

Bring the broth to a hard simmer in a wide, deep pot. Season with salt and pepper to taste. Use two teaspoons (one to scoop and one to scrape)  to drop the dumpling dough into the broth. The dumplings should be fairly small, about the size of shooter marbles, but they don't have to be perfect, or even terribly uniform. Stir them as the pot becomes full so they stay seperate.

When you have finished dropping the dumplings into the pot, mix approximately four tablespoons of flour with approximately half a cup of milk in a measuring cup to make a slurry. Mix it well enough to get out most of the lumps. Drop this mixture in to the simmering broth by spoonfuls, stirring the pot between additions. This will keep the gravy smooth. If you've added all your slurry and let it simmer in the pot for a minute or so and it's still not thick enough for your taste, make more slurry with another tablespoon of flour and a little more milk.

Add the cooked chicken, allow everything to simmer together for a few minutes more, and serve.

If you have any leftovers, you might need to thin them with some extra broth as the dumplings soak up the broth overnight, but we are quite happy to eat it home-y and lumpy the second day.