My New Job: End Stage Renal Disease

My new job is in renal dietetics and I will be working as a dietitian in dialysis facilities caring for those with End Stage Renal (Kidney) Disease (ESRD). Chronic Kidney Disease (CKD) is the declining function of the kidneys and affects more than 26 million Americans, or 1 out of ever 9 adults. As kidney function declines, CKD progresses and when the kidneys perform at about 10% capacity, a patients is considered to have ESRD, which requires transplantation or dialysis to stay alive.

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What is dialysis?

There are two types of dialysis: hemodialysis and peritoneal dialysis. I will be working in hemodialysis and will expand on that type, but you can read all about peritoneal dialysis. Hemodialysis is traditionally performed in a dialysis clinic where patients come 3x a week (either Monday, Wednesday, Friday or Tuesday, Thursday, Saturday) and are dialyzied (blood filtered) for 3-4 hours through an access site, typically on their arm.

What do the kidneys do?

The kidneys perform a lot of vital functions of the body including filtering the blood to remove waste (e.g. urine) and the release of hormones which regulate blood pressure and bone health. When the kidneys lose filtering capacity, vitamins and minerals build-up in the blood at toxic levels. Micronutrients such as potassium, sodium, phosphorous, and calcium can cause fatalities in renal patients if not controlled in the diet. The diet is hugely important to follow for renal patients.

Why do the kidneys fail?

Chronic uncontrolled blood pressure, chronic uncontrolled diabetes, glomerular disease, and other complications such as polycystic kidney disease, drug abuse (prescription and illicit), poisons, and trauma. The rate of ESRD is increasing due to the increase of obesity and associated co-morbidities such as diabetes and hypertension.

What diet do dialysis patients have to follow?

Foods that are commonly omitted or limited from the renal diet include: beans, peanut butter, nuts, many cereals and grains, all dairy products, colas, processed meats, orange juice, oranges, bananas, tomatoes, tomato products, kiwi, pears, melon, dried fruits, potatoes, squash, avocado, mushrooms, pumpkin, chocolate, and WATER and all other fluids.

However, the renal diet is highly personalized to a patient’s needs based on their labs and may be changed on a frequent basis.

Renal diets need to be very high in protein — about 95 grams (for a 150 pound adult) or 140 grams (for a 220 pound adult). And because processed meats, beans, and nuts are discouraged in the renal population, fresh meat and eggs are the only sources of high biological value protein (HBV). A renal patient requires significant amounts of protein due to protein loss during dialysis, as well as a decline in the body’s ability to make amino acids (protein in the body) due to CKD.

What if a patient doesn’t eat enough protein?

Albumin is a protein made by the liver. This lab value has the strongest correlation to morbidity (illness) and mortality (death) in the renal population. In addition to drug therapies, the diet is the best way to elevate albumin levels.

This is a perfect example of why I support all food groups. A vegetarian/vegan would not fare well on dialysis based on their food preferences. Simply, there are NO methods available to achieve neither adequate intake, nor intake from high biological value proteins.

I hope this gives an idea of what my new job entails. Today I meet the entire patient care team: nephrologist, charge nurse, social worker, and me, the dietitian. We have rounds starting…soon! Better jet! 😀

But first a quick Lily picture. On our way to the dog park yesterday…

Question: Knowing what a renal diet aims to limit or eliminate, what would you have the most trouble omitting?

I think limiting fluids, tomato products, and bananas would be the hardest for me!

P.S. I am a writer for the Examiner in Columbus! I cover cooking! It’s been a slow start simply because I haven’t had time or Internet, but I look to put out a lot more articles soon! 😀

Happy Monday,

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7 foods in question

Happy Friday! 😀 Bring on the weekend, right?!

I left for work at 6:30am yesterday and didn’t walk in the door til 8pm! Loong day! Last evening was the Bariatric Surgery Support Group I lead and the turn out was excellent! My group continues to grow and I have learned SO much! While I think there’s a “right” and a “wrong” candidate for bariatric surgery, the bottom line is that people are going to get weight loss surgery somehow…some way. As a dietitian, it is my duty and my job to help these individuals make the right surgical or non-surgical decision for THEM and to help them adopt lasting lifestyle changes in their eating and exercise habits. It has been very rewarding once I was able to put personal biases aside.

Today I wanted to discuss an article called “The 7 Foods Experts Won’t Eat” [1]. Seven different medical and nutrition experts each listed a different food they strictly forbid in their diet. I thought the list was not only interesting, but controversial and I was curious to hear some feedback from you all! So here it goes…

1. Canned tomatoes shunned by Fredrick vom Saal, PhD, an endocrinologist at the University of Missouri who studies bisphenol-A.

The issue: The resin linings of tin cans contain bisphenol-A, a synthetic estrogen that has been linked to ailments ranging from reproductive problems to heart disease, diabetes, and obesity. Unfortunately, acidity (a prominent characteristic of tomatoes) causes BPA to leach into your food. Studies show that the BPA in most people’s body exceeds the amount that suppresses sperm production or causes chromosomal damage to the eggs of animals [1].

The solution: Choose tomatoes in glass bottles.

2. Corn-fed beef shunned by Joel Salatin, co-owner of Polyface Farms and author of half a dozen books on sustainable farming.

The issue: Cattle evolved to eat grass, not grains [1]. Grain-fed beef have less nutritional value and are higher in saturated fat than grass-fed beef.

The solution: Purchase and consume grass-fed beef.

3. Microwave popcorn shunned by Olga Naidenko, PhD, a senior scientist for the Environmental Working Group.

The issue: Chemicals, including perfluorooctanoic acid (PFOA), in the lining of the bag, are part of a class of compounds that may be linked to infertility in humans, according to a recent study from UCLA. In animal testing, the chemicals cause liver, testicular, and pancreatic cancer [1].

The solution: Pop popcorn in a skillet.

4. Nonorganic potatoes shunned by Jeffrey Moyer, chair of the National Organic Standards Board.

The issue: Root vegetables absorb herbicides, pesticides, and fungicides that wind up in soil [1].

The solution: Buy organic.

5. Farmed salmon shunned by David Carpenter, MD, director of the Institute for Health and the Environment at the University at Albany and publisher of a major study in the journal Science on contamination in fish.

The issue: Nature didn’t intend for salmon to be crammed into pens and fed soy, poultry litter, and hydrolyzed chicken feathers. As a result, farmed salmon is lower in vitamin D and higher in contaminants, including carcinogens, PCBs, brominated flame retardants, and pesticides such as dioxin and DDT [1].

The solution: Switch to wild-caught Alaska salmon. If the package says fresh Atlantic, it’s farmed [1].

6. Milk Produced with Artificial Hormones shunned by Rick North, project director of the Campaign for Safe Food at the Oregon Physicians for Social Responsibility and former CEO of the Oregon division of the American Cancer Society [1].

The issue: Milk producers treat their dairy cattle with recombinant bovine growth hormone (rBGH or rBST, as it is also known) to boost milk production [1].

The solution: Check labels for rBGH-free, rBST-free, produced without artificial hormones, or organic milk. These phrases indicate rBGH-free products [1].

7. Conventional apples shunned by Mark Kastel, former executive for agribusiness and codirector of the Cornucopia Institute, a farm-policy research group that supports organic foods [1].

The issue: Apples are heavily sprayed with pesticides.

The solution: Buy organic. Otherwise, wash and peel apples before eating.

Question: Do you avoid any of these 7 foods, too? Are there any you disagree with? Any changes you may make in your grocery purchases?

I think I will make apples and potatoes 2 produce items I purchase organic. I buy wild-caught fish and grass-fed beef, and I never eat popcorn. Canned tomatoes are a tough one, but if jarred tomatoes are safe…I can do that! And I always buy milk that does not contain rBGH-free.

Any fun weekend plans?

I can’t wait to relax!

Happy weekend!

Goitrogenic Foods

Hypothyroidism is one of those whispered-about diagnoses out there that people commonly misunderstand. If a person is struggling with their weight, you’ll commonly hear, “Maybe I have a thyroid problem”. Sure, maybe so. But trust me, hypothyroidism is much more complex than that.

A recent email from a reader, Liz (Hi Liz!) spurred this topic today. When she put in the blog topic request I had a “Doh!” moment. What a great topic to blog about…thank you, Liz!

Hypothyroidism is an very common endocrine disorder which results from underactive thyroid hormone. This thyroid hormone deficiency can be the result of several happenings. But I’m not a physician, so I won’t even go there 🙂 However, you can read all about the pathophysiology. While hypothyroidism is common, mortality rates are incredibly rare. The highest rates of hypothyroidism are found among Caucasian, elderly females.

Symptoms of hypothyroidism include: fatigues, loss of energy, lethargy, weight gain, decreased appetite, sensitivity to cold, dry skin, hair loss, muscle and joint pain, depression, forgetfulness, menstrual irregularities, decreased perspiration, blurred vision, auditory loss, hoarseness, neck and throat pain, thyroid enlargement, fever, goiter, jaundice, bradycardia, and pitting edema. Other biometric symptoms of hypothyroidism include: anemia, dilutional hyponatremia, hyperlipidemia, and elevated creatinine. Phew.

The primary causes of hypothyroidism include iodine deficiency and in developed countries, autoimmune disorder.

As for the diet, there are several recommendations those with hypothyroidism should consider, including:

• Limiting goitrogenic foods (i.e. brussel’s sprouts, kohlrabi, turnips, rutabaga, radishes, cabbage, kale, and cauliflower). If you choose to consume these foods, do so in moderation and preferably after being cooked.
• Taking a multivitamin supplement
• Take vitamins, minerals (e.g. iron, calcium, and vitamin D) 4 hours before or after thyroid medication
• Consider adopting a low-residue (low-fiber) diet if your medical provider feels your medication is not being properly absorbed
• Find an endocrinologist you love. A good endocrinologist is worth their weight in gold. Endocrine disorders, such as hypothyroidism, should be treated by an endocrinologist.
• Limit or avoid soy as it can act as a hormone mnemic.

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And one last recipe tribute to PAPRIKA, Blogger Secret Ingredient for the week!

Grilled Halibut Cod with Peach and Pepper Salsa adapted from Cooking Light June 2010

Salsa:
2 1/2  cups  coarsely chopped peeled yellow peaches (about 1 1/4 pounds)
1 1/3  cups  chopped red bell pepper (about 1 large)
1/2  cup  thinly sliced green onions
1/2  cup  chopped fresh arugula
1/3  cup  fresh lemon juice (about 2 lemons)
2  tablespoons  chopped fresh oregano
1/4  teaspoon  salt
1  habanero pepper, seeded and minced
1  garlic clove, minced

Fish:
2  tablespoons  fresh lemon juice
2  tablespoons olive oil
1  teaspoon smoked paprika
2  garlic cloves, minced
6  (6-ounce) skinless halibut cod fillets
1/2  teaspoon  salt
1/2  teaspoon  freshly ground black pepper
Cooking spray

Directions:

To prepare salsa, combine first 9 ingredients; toss gently. Let stand 30 minutes before serving.
Prepare grill to medium-high heat.

To prepare fish, combine 2 tablespoons juice, oil, paprika, and 2 garlic cloves in a large, shallow glass baking dish, stirring with a whisk. Add fish to juice mixture; turn to coat. Cover and let stand 15 minutes.

Remove fish from marinade; discard marinade. Sprinkle fish evenly with 1/2 teaspoon salt and black pepper. Place fish on a grill rack coated with cooking spray; grill 3 minutes on each side or until desired degree of doneness. Serve fish with salsa. Serves 6 (1 fish filet and 2/3 cup salsa per serving).

Nutrition Information (per serving): 267 calories; 8.6 g. fat (1.2 g. saturated fat, 4.6 monounsaturated, 1.8 g. polyunsaturated); 35.5 g. protein; 11.8 g. carbohydrate; 2.3 g. fiber; 52 mg. cholesterol; 389 mg. sodium

Result: This was really good! The habanero gives a fun zing to the citrus of the salsa. Very light and again, featured not only paprika, but also the grill. I am LOVING the easy clean-up that accompanies cooking on the grill 😀

And a Lily (or should I say Lily’s tongue?) appearance, per Mari’s request 😉

Off to work 😦 I am typically off on Fridays but since Monday was a holiday…off I go…after stopping by Panera for bagels to appease my co-workers 😉

Question: Had you previously heard of goitrogenic foods? Any fun weekend plans? 😀

P.S. Don’t forget to submit BSI entries by Sunday at 5pm CT!

Brainstorming my happy hour selection,

Not so private push-ups

So I had my medication check-up yesterday. For the past month, I have been taking 500 milligrams of Metformin twice daily to help control my insulin resistance from PCOS. Sadly, I have noted little to no change in my blood glucose or my weight (1 pound down – woot! *eye roll*)…

Quick embarrassing story: While I was waiting for the doc to come into the exam room yesterday, I decided to get my push ups out of the way for Heather’s 100 Push-Up Challenge. Yes, doctor’s offices are germ-laden, but I work in a health clinic…nothing there I’m not already exposed to day-in and day-out. As I was on the floor doing my push-ups, my doc walked in. With a medical student. No knock to warn they were entering.They both had a puzzled look on their face and as I climbed up to my feet, blushing, I explained that I was doing push-ups. They thought I was quite committed to be utilizing my wait time so effectively! 😉

Anyway, my doc doubled my dose and I am now prescribed 1,000 milligrams twice daily. While I’m bummed, I understand that I have to do what it takes…and that also means not giving up on weight loss and giving more attention to my eating habits and exercise regimen. What was a tad VERY depressing was the fact that I will likely be on Metformin for the rest of my life. Did I mention I hate taking pills? 😦

On that note, I have FINALLY started my page on PCOS and Insulin Resistance. Check it out! After reading A Patient’s Guide to PCOS, I feel assured that I’m doing so much right…and that I am NOT alone. There are so many PCOS sufferers out there, and I feel so much better about the situation when I tackle it head-on versus throwing pity parties for myself. So yep, check out the info on PCOS. I put a lot of thought into it and hope that it can help other women and PCOS sufferers find answers and comfort.

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And in honor of my hosting BSI this week…another recipe featuring PAPRIKA! This one, I swear, was a surprise! Cooking Light and I were on the same page with paprika this week, apparently!

Smoky Spanish-Style Pan Roast from Cooking Light June 2010

1  pound small red new potatoes, halved
2  tablespoons  olive oil
3/4  teaspoon  salt, divided
1/2  teaspoon  freshly ground black pepper, divided
3/4  pound  unpeeled large shrimp
1/4  pound  Spanish chorizo, thinly sliced
1  pound  green beans, trimmed
4  garlic cloves, chopped
1/2  cup  pilsner beer
1/2  teaspoon  Spanish smoked paprika
2  red bell peppers, cut into thin strips
1/4  cup  fresh flat-leaf parsley leaves

Directions:Preheat oven to 400° F.

Combine potatoes, oil, 1/2 teaspoon salt, and 1/4 teaspoon black pepper in a large roasting pan, tossing well to coat potatoes. Arrange potatoes in a single layer, cut side down, in pan. Bake at 400° for 15 minutes or until potatoes are lightly browned.

While potatoes cook, peel shrimp, leaving tails intact. Devein shrimp, if desired. Set shrimp aside.

Stir chorizo, green beans, garlic, remaining 1/4 teaspoon salt, and remaining 1/4 teaspoon black pepper into pan. Bake at 400° for 10 minutes. Add beer, paprika, and bell pepper, scraping pan to loosen browned bits. Nestle shrimp into vegetable mixture. Bake at 400° for 10 minutes or until potatoes and green beans are tender and shrimp are done. Sprinkle with fresh parsley leaves. Serves 4 (approx. 1 1/2 cups per serving).

Nutrition Information (per serving): 392 calories; 15.5 g. fat (3.8 g. saturated, 8.5 g. monounsaturated, 2.4 g. polyunsaturated);
28 g. protein; 36.6 g. carbohydrate; 7.7 g. fiber; 129 mg. cholesterol; 590 mg. sodium

Result: Again, easy and delicious! I planned this recipe to use the leftover chorizo from last night’s Grilled Salmon with Chorizo and Fingerlings. I will definitely be making it again. The dish was light with a huge punch of beer and paprika flavor…right up my alley!

Don’t Forget!!

I’ve already received several paprika recipes for the Blogger Secret Ingredient Contest! You have until Sunday at 5PM Central Time to submit yours!

Random questoin: What’s something you know a lot about, or would consider yourself an “expert” in? What topic do you wish you knew more about? Doesn’t have to be nutrition, fitness, or health-related at all…just curious!

Have a wonderful day!

One savvvory breakfast

Good morning! 😀

If it weren’t so GLORIOUS, I’d be ashamed to admit that Mr. Prevention and I crawled into bed at 10pm last night. WILD and CRAZY kids, I’m tellin’ ya! 😉 9 hours of sleep…ahhhh. 🙂

Anyways, if you’re a Cooking Light lover like myself, you probably started drooling at page 28 in the most recent May issue. On page 28 there was a recipe for Open-Faced Sandwiches with Ricotta, Arugula, and Fried Egg. While Cooking Light didn’t specify whether this was a morning or evening dish, I made it a morning dish of my own with a few modifications.

Nicole’s Open-Faced Sandwich with Hummus, Arugula, and Fried Egg

1 slice bakery bread (I used an Asiago cheese bread)
cooking spray
1 large handful of arugula
1 tsp extra-virgin olive oil
1 tsp lemon juice
ground pepper and salt, to taste
1 large egg
1 Tbsp hummus (I used pesto hummus)

Directions:

Toss arugula, olive oil, lemon juice, salt, and pepper gently. Set aside.

Lightly spray bread with cooking spray. Broil or toast until browned.

Heat a small skillet. Coat with cooking spray. Cook 3/4’s of the way through and toss.

Spread hummus over toast. Layer on fried egg. Top with arugula and serve. Serves 1.

Nutrition Information: 301 calories; 16 g. fat; 225 mg. cholesterol; 470 mg. cholesterol; 27 g. carbohydrate; 2 g. fiber; 14 g. protein

Result: This is delicious! I think it would be great with ricotta, too…just didn’t have any on hand! This would work as a savory breakfast, or quick, light supper! Mmmm mmm! I served it with OJ + POM – additional Mmmm mmm!

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The farmer’s market yesterday was wonderful! Mostly radishes and greens are out thus far. I was most excited to see free-range, organic, local eggs and grass-fed, organic, hormone-free, local meat! 😀

I got:

1 bag arugula ($2!!)
pesto hummus ($4)
Asiago Cheese Loaf ($6)
1# grass-fed ground beef ($4)
sesame seeds ($1.50!!)
dried rosemary ($2!!)
ground mustard ($1.50!!)
bones for Lily ($4)

The spices were so fresh and wonderful! And cheap! It was hard to only get what I needed! And the bones for Lily…impulse buy. 🙂

I’ve got 2 hockey games today and grocery shopping to do! And of course, getting ready for the busy work week ahead!

Question: Do you prefer a sweet breakfast…or a savory breakfast? What did you have (or will you have) for breakfast this morning?

Enjoy Sunday…tomorrow is Monday,

Cooking: chore or pleasure?

Good morning, Wednesday! I couldn’t be happier to have you here! 😀

Monday and Tuesday were busy, stressful work days…but followed up by delicious dinner delights! As I chatted with my mom on my way home from work on Monday, I distinctly remember her saying, “Take it easy tonight, Sugar…get you guys some Subways and relax.”

Oops. Sorry mom! 😉

Shrimp Scampi adapted from She Cooks and Bakes

2 1 ½ lbs pounds (12 to 15 per pound) shrimp in the shell
3 2 tablespoons olive oil
2 tablespoons dry white wine (I used white balsamic vinegar)
Kosher salt (approx. ½ tsp)
Fresh ground black pepper
5 Tbsp 12 tablespoons (1 1/2 sticks) unsalted butter 50/50 Smart Balance Butter Blend
4 teaspoons minced garlic
1/4 cup minced shallots (I omitted this because I didn’t have any that day)
3 tablespoons minced fresh parsley leaves
1 teaspoon minced fresh rosemary leaves
1/4 teaspoon crushed red pepper flakes
1 teaspoon grated lemon zest
2 tablespoons freshly squeezed lemon juice
1 extra-large egg yolk
2/3 cup panko bread crumbs
Lemon wedges, for serving

Directions:

Preheat the oven to 425º F.

Peel shrimp leaving the tails on, and devein the shrimp.

Place the shrimp in a mixing bowl and toss with the olive oil, wine, 2 teaspoons salt, and 1 teaspoon pepper. Allow to sit at room temperature while you make the butter and garlic mixture.

In a small bowl, mash the softened butter with the garlic, parsley, rosemary, red pepper flakes, lemon zest, lemon juice, egg yolk, panko, 1/2 teaspoon salt, and 1/4 teaspoon of pepper until combined.

Starting from the outer edge of a 14-inch dish, arrange the shrimp in a single layer cut side down with the tails curling up and towards the center of the dish.

Pour the remaining marinade over the shrimp. Spread the butter mixture evenly over the shrimp. Bake for 10 to 12 minutes. Serve with lemon wedges. Serves 4.

Nutrition Information (per serving): 427 calories; 24 g. fat; 297 mg. cholesterol; 768 mg. sodium; 12 g. carbohydrate; 0 g. fiber; 37 g. protein

Result: Mr. Prevention LOVED it! He’s a sucker for all things shrimp & buttery, so this was certainly right up his alley. I was puzzled over the nutrition facts as there was lots of butter left in the bottom…and I do mean lots. So the nutrition facts aren’t as bad as they look, but I have no way of knowing exactly…so they’re correct if you get out every last drip of butter 😉 …which you shouldn’t, Smart Balance blend or not! 😀

Cauliflower Mac and Cheese slightly adapted from Waisting Duxie

12 oz whole wheat macaroni
1 head of cauliflower, coarsely chopped
3/4 (whole wheat) breadcrumbs (I used panko)
1/2 cup parsley, chopped
1 Tbsp olive oil
1 tsp salt
3/4 tsp pepper
1 1/2 cups 8 ounces shredded low fat sharp cheddar (I used 1.5% Cabot)
1/2 cup non-fat milk
cayenne (optional)
1 medium onion, finely diced
1 1/2 cups reduced fat sour cream
1 Tbsp tsp mustard powder

Directions:

Preheat the oven to 400º F. Coat a 9 by 13-inch baking pan with cooking spray.

Bring a large pot of water to a boil. Add the macaroni and cook until tender but firm, about 5 to 8 minutes. Steam cauliflower on top or add to the pasta for the last 3 minutes. Drain and transfer to a large bowl.

In a skillet heat the olive oil, add the bread crumbs, 1/4 tsp salt, and pepper stir to coat all the crumbs with the oil (this will give a super crisp top) add the parsley, stir to mix well.

Return the pasta pot to medium heat and coat with cooking spray. Add the onion, 3/4 tsp salt, and 1/2 tsp pepper and cook, stirring occasionally until soft about 5 minutes. Add the milk, sour cream, cheese, mustard power, and cayenne (if using) to the pot and stir until the cheese melts. Mix in the pasta and cauliflower. Transfer to the prepared baking dish

Sprinkle the crumbs over the top of the macaroni and cheese. Bake for 15 minutes. Then broil for 3 minutes so the top is crisp and nicely browned. Let stand and cool for 5 minutes before serving. Yield: 8 large servings.

Nutrition Information (per serving): 320 calories; 10.1 g. fat; 18 mg. cholesterol; 521 mg. sodium; 47 g. carbohydrate; 6.4 g. fiber; 16.6 g. protein (54% carbohydrate; 19% protein; 26% fat — the recipe stats basically represent a well-balanced caloric intake).

Result: I really enjoyed this recipe! And the portion really is HUGE! I knocked the mustard down a bit, I think it fired back a bit taste-wise, but that’s the only thing! Mr. Prevention is a harder nut to crack, but he even appreciated the nutrition stats! Definitely looking forward to leftovers for lunch today!

Served with a salad:

Mmmmmmm! 😀

Health Update: My insulin levels and HbA1c (average blood sugar) checked out (phew!). But there’s still some unanswered questions (like, why do I have diabetic-high blood sugars after running?). The “diagnosis” of PCOS has not been negated just yet (:( ). Just keeping you all posted! Thank you again for all of your support through this roller coaster. Your warmth has been so much appreciated and I could’ve never expected such caring, amazing readers. ❤

So, have you jumped on the coconut oil and water train? What’s all the fuss about? Check in tomorrow to find out!

Question: Is cooking a core or a pleasure to you?

Random Question: What was your favorite subject in high school?

I loved math…hated science. But ended up in a science-based career!

P.S. Lily says “THANK YOU, EVERYONE!” for all the birthday wishes and compliments on her cuteness (she has a bigger head now!)!! She enjoyed her bone cake thoroughly! 😉

Happy Hump Day!

manic monday

I was on the red eye back to Tulsa last night (yuck!). I have a feeling after a mere 4 hours in the office last week due to the conference in San Jose and my doctor’s appointment, this week is going to be brutal! I was silly and checked my schedule for this week and next before leaving for the weekend and I have 16 patients on my schedule every day for the next 2 weeks. As in, no open slots! ::downing coffee::

Before I left Chicago, I knew I needed a game plan. I’ve had a few days to process my “diagnosis” (to be confirmed on Friday with an ultrasound), and I’m ready to do what it takes. Home was hard…restaurants, friends, etc. I mean, do you know how hard it is to say to Ron Pope and flan for this girl? But that’s reality and I made it work with my carbohydrate-controlled diet (you won’t hear me call it “low-carb” because it’s not).

I meal planned for the week and made a grocery list so that I can head to the grocery store after work today. It has been at least a week since I’ve been in the kitchen and that makes me sad!! 😦

But home was just what I needed after having my world rocked with this health scare. My 9-miler was a breeze — I did the 8 minutes of running (5.3-6.0 mph increasing 0.1 every minute) with 2 minutes of walking at 4.0 mph. I finished in 1:42:30 (11:23 min/mi). However, my blood sugar was NOT okay after my run and after some research, running and I may have to call it quits. It appears intense exercise raises my blood sugars not only DURING exercise, but for SEVERAL hours after exercise (thanks to hormones like glucagon and epinepherine for any nerds or curious minds out there). So frustrating! Just when you think you’re doing something right… Again, I can’t help but feel like this is a bad joke considering my DO What You DON’T Challenge goals were to increase my yoga/Pilates and weight lifting! Thank goodness this month has taught me to tolerate those activities 😉

Pictures from home:

Family dinner…salad included 🙂 Mmmm!

+ Gorgonzola 😀

I poached eggs for the first time!

My brother modeling his breakfast sandwich – hash brown, egg, and turkey bacon (loco!)

Celebrating Grannie’s 87th and Dad’s 65th birthdays!

Mom and lil brother at dad’s birthday dinner

Question: Have you ever poached an egg before?

Random Questions: How often do you get to see your family? How far do you live from your parents? How many brothers and sisters do you have?

Thank you again for all of your support with this PCOS business. I have received so many emails from readers, family, family friends, and complete strangers who have made this news so much easier to bear. Thank you, thank you. 😀

Hope everyone had an excellent weekend! Have a wonderful week! 🙂

Be well,