Posted by: lifewithapouch | December 20, 2009

Where’s the Bathroom?

This used to be a question I could always answer, with complete details. Wherever I was at, from a sports arena to a department store to any particular intersection in the general area of where I lived, I could tell you where the nearest restroom was, and the next nearest, and the one after that. I could tell you each restroom’s attributes – did it usually have toilet paper? Was it clean? Was it private? Did it have a sink with running water or did it have a Purell dispenser?

But clearly I’ve lost my touch. Yesterday, I was at a Bed, Bath, and Beyond with my mother-in-law, and she asked me the question, and I couldn’t answer it. Where was the bathroom? How could I not know?! I’ve experienced this several times in the last six months, and as I get ever closer to my two-year anniversary of surgery, I guess it makes sense. Don’t get me wrong – bathrooms are definitely still important to me, but I rarely seek them out with such frequency or urgency. I recently realized that, three months into taking piano lessons at a music school, I had never used the restroom there. it really struck me – I’m usually there for an hour at a time, and in my previous life I would have used the restroom immediately upon arrival, as soon as I finished my lesson, and occasionally I would have had to use it midway through my lesson. But in my new life, it took three months of going there before I ever figured out where the restroom was.

It’s liberating. I guess, to be crude, I sort of have my little portable restroom attached to my body. It’s hardly romantic. But it’s a life. It’s a life I can live, with joy.

Posted by: lifewithapouch | December 13, 2009

Ostomy As Afterthought?

As I approach my two-year mark since surgery, I find that I am so used to my ostomy that, at times, I forget about it. Yesterday, I experienced such a moment. It was a beautiful Saturday after a long cold spell, and plans to accomplish particular weekend objectives – e.g., cleaning the house, working on my writing sample for grad school applications – were quickly fading as more enjoyable prospects presented themselves. After a leisurely morning at my favorite coffee shop, my husband and I took a long walk in the open parkland near our house. Both of us have experienced a busy autumn, and neither of us have been moving our bodies enough, or getting outside enough. We delighted in the clouds, and the sun on our faces, and the pleasant smell of the dried grasses bending in the gentle breeze. We laughed like children as we encountered slick mud patches and sullied our jeans. We returned home with the elated feeling of stagnant blood having circulated once again. And we were starving.

So, phase two of the glorious Saturday. We decided it was time to get our Christmas tree, and why not make it a special, celebratory time, and pick up lot of goodies and treats to enjoy through the evening? We were off to Whole Foods. We bought wine, avocados, smoked salmon, flatbread crackers, a couple of different cheeses, fresh smoked mozzarella ravioli, and a few other things. At the last minute, my husband threw in some Silk nog, his favorite. And, at the last minute, I threw in some peach cranberry juice. I hadn’t purchased this kind of juice in a long time – I generally don’t drink a lot of fruit juice – but I remembered how particularly fantastic the peach cranberry was and thought, Why not? A special evening…

We found a fantastic tree, and once home, I began to arrange the various treats, while he set up the tree. I poured myself a glass of wine, but I realized I was awfully thirsty, so I also poured myself a large glass of that peach cranberry juice. Man! I forgot how tasty that juice is. I gulped down the whole glass, and refilled it. About an hour later, my husband poured me another half glass. Just as I finished it, I remembered why I hadn’t bought any kind of cranberry juice in a long time. I felt my pouch. Full of liquid! Oh yeah, vitamin C. Doh! After surgery, I had realized that consuming large amounts of concentrated vitamin C – as in cranberry juice – had such a dramatic effect on my output, that it wasn’t worth it. But all day I had been enjoying myself so much, and my ostomy was the last thing on my mind. It didn’t even occur to me once until I had not only bought the juice, but had consumed two and a half glasses of it!

I took two Immodium, but was still having to empty my pouch every 30-45 minutes. Before I went to bed, I took a third Immodium. I got through it, and honestly, it wasn’t a very big deal. I was at home, after all. The bathroom was quite convenient. But it’s rather shocking to realize that I have become so used to my ostomy, that I could forget something as basic as the fact that I need to avoid lots of fruit juice. I mean, I could have enjoyed a half glass of it without incident. But two and a half glasses? Sometimes I feel so normal, that it takes an “incident” to remind me that I do, in fact, have some boundaries worth respecting.

Posted by: lifewithapouch | December 6, 2009

Cyborg

I am a cyborg. But that is really nothing new, nor is it predicated on my having a pouch hanging from my abdomen that collects my waste and provides a mechanism for me to dispose of it. I agree with those who argue that we are all cyborgs to some extent, and I tend to buy into Andy Clark’s argument that we are “natural-born cyborgs,” that we are wired to “exploit deep neural plasticity in order to become one with our best and most reliable tools. Minds like ours were made for mergers,” (Clark, Natural-Born Cyborgs). Besides wearing clothes and eye glasses and relying on a pen and paper to work out a long multiplication problem, I will even admit to feeling pained at being without my iPhone. I do feel like the web is an extension of my knowledge, that I know things that may not be in my brain currently yet are imminently accessible to me (if you are married, you might have the experience that you “know” things that are actually stored in your partner’s brain), and that social networks like Facebook create for me an “ambient awareness” of my friends’ lives.

But it wasn’t until I had ileostomy surgery that I really thought about what it means to be a cyborg. To question cyborgism is to question what it means to be human. On one level, having an ostomy challenges assumptions of humanness no more than having a prosthetic limb, or having a pacemaker. To the extent that we conceive of ourselves as being somewhere inside the head, one could imagine that a sense of selfhood and humanness could survive even in the case of prosthetic arms and legs and artificial organs, so long as the brain was intact. When considering a future of biotechnological implants, I think many of us feel most alarmed at the notion of implanting anything into our brains as opposed to other parts of our bodies – an implant into our brains might threaten our selfhood and change who we are.

Years ago, people with Crohn’s disease were treated with lobotomies. There was an idea that the disease was all in the brain, and that by removing some parts, the patient would be cured. It sounds horrendous, yet more recently our guts have been termed “the second brain,” a term coined by Dr. Michael D. Gershon, because it operates with considerable independence from our “primary” brain. The gut has its own nervous system, called the enteric nervous system. “The role of the enteric nervous system is to manage every aspect of digestion, from the esophagus to the stomach, small intestine and colon. The second brain, or little brain, accomplishes all that with the same tools as the big brain, a sophisticated nearly self-contained network of neural circuitry, neurotransmitters and proteins. The independence is a function of the enteric nervous system’s complexity,” (“The Other Brain Also Deals With Many Woes”, New York Times, 8/23/2005). In having an ileostomy, did I actually have a sort of lobotomy?

What fascinates me is how one or both of my brains – I still have a substantial portion of my enteric nervous system, i.e., esophagus, small intestine – did exhibit neural plasticity in incorporating my new technological device into my biological process. Following surgery, my output thickened, and within months my total awareness became sensitized to when to empty my pouch, even waking me up in the night when my pouch is full. I feel my stoma expand and contract, and at some level, I feel my pouch. It is a part of me, and my brain(s) had no trouble incorporating it.

Yet, as I have written in a previous post, for months following surgery, I had strange dreams in which I was a half-human, half-reptilian creature with a stoma like a large scaly hose, and a long dragon-like tail. The dreams were all very much in line with Kafka’s Metamorphosis, full of anxiety, self-loathing, and existential crisis. Even as my consciousness was expanding to incorporate my ostomy into my sense of self, my subconscious was was shouting not-me not-me not-me.

I wonder if this is the tension and struggle that accompanies each new merging between the biological and nonbiological. My ostomy is not the first technology to render me a cyborg, and it won’t be the last. As I become more cyborg, does the process of merging become less problematic? Andy Clark argues that to be human is to be cyborg, that humanity is inherently cyborg. Perhaps cyborg and human are insufficient terms for thinking about the ways we will imagine identity as our bodies continue to incorporate technologies that defy categorizations like man-made and natural, or biological and nonbiological.

But for now, if I think about degrees of humanness, there is no doubt for me that I feel more human with my cyborg ostomy technology than I did as the sickly, starving wraith I was before surgery.

Posted by: lifewithapouch | November 29, 2009

Thanksgiving

At Thanksgiving dinner, my mom poured a little champagne into each of our glasses and began the toasts. Among the many toasts, was one for me, “And we’re so thankful for Emily’s first Thanksgiving as a healthy person.” I had to correct her. Actually, it’s my second Thanksgiving already. Hard to believe! Whereupon she recalled how amazing it was last year to watch me eat my entire plate of food, and then some. And I prepared everyone to watch me accomplish that feat again!

As the holidays come around, I am in danger of many soppy moments as I encounter recurring realizations of how fantastic it feels to gather with family to celebrate these special times while simultaneously feeling well and being able to participate. No more fevers, nausea, or the inevitable negotiations with pity, well-meant but never-the-less insensitive remarks, and overly rich food. As I devoured my mom’s very creamy whipped potatoes, freshly chopped cranberry and citrus salad, sweet potatoes with marshmallow and candied pecans among all the other dishes, not to mention consuming red wine and following it all up with pie and espresso, my stomach happily complied, and I felt fine. Well, as fine as the next person.

On my way home from Thanksgiving dinner, I had to drive to an out-of-the-way 24-hour pharmacy to pick up a prescription (not Crohn’s-related; fortunately I am medicine-free when it comes to that), and only when I got home did I realize that I had called in the wrong prescription. Doh! But as bummed out as I was, I went back out and got the correct prescription. It reminded me of the old days, when I just didn’t have the energy to do such a thing. In the old days, my husband would have brought me home from Thanksgiving dinner, then gone to get the prescription, and if it was the wrong one, he would have driven back out to get the right one. Now, I can take care of it myself. Sweet man that he is, he still accompanied me, but I drove.

I’m grateful for so many things, but now as each year passes I will always reflect on how wonderful it is simply to be healthy. I hope I never take it for granted.

Posted by: lifewithapouch | November 22, 2009

Yet Another Experiment?

The other day a woman from Coloplast called me to inquire if I was still using their products, and if so, how it was going. I told her I that am using Coloplast products, and that it’s going okay. Not great. I have to change it every two to three days. It would be nice if it lasted longer. Friends of mine who use Hollister only have to change it once a week. Furthermore, my baseplate always develops a wrinkle in the same spot, and I don’t understand why. I’m not overweight (at least not terribly overweight!), and I’m afraid that if I didn’t have the barrier ring underneath, the wrinkle would be a channel for leakage.

She asked me if my stoma sticks out. I said that it does, maybe a half an inch. It actually seems to change – sometimes big and floppy, other times all shrunken up and small. She recommended that I try a convex baseplate. She is the second person to recommend this to me, but the first to explain to me why this might make sense. I have always assumed that the convex baseplate was just for people whose stoma is flush to the skin, but she told me that she has talked to a lot of people who use it even though their stoma sticks out. She said that a lot of people who had leakage problems have found that when they use the convex they get much longer wear time. She said their could be a slight dip in my skin around my stoma that is not even really visible to the eye, but that might result in leakages with the regular baseplate. She recommended that I stop using a barrier ring and paste, as I have been doing, and instead use a little of the strip paste to fill in any gaps between the stoma and the inner edge of the baseplate. I told her that I had tried the strip paste twice, and hadn’t even made it 24 hours. Was I doing something wrong? She said she thought it was probably because I needed the convex baseplate.

Another tip – apparently there are five notches in the baseplate, which are places you can cut out a little triangle. This is to make the baseplate more flexible, and she suggested that if I did this I might not incur the wrinkle. I had never even noticed the notches before.

So, she is sending me samples. I haven’t received them yet, but I’m working up the courage to engage in another experiment. It is always psychologically taxing to try something new, but I know that if it worked and I could go four or five days between changes, it would be a huge quality of life improvement. I hope she’s right on this. I will comment on this post once I’ve experimented to let you know how it goes. I’m also curious if any of my readers are using a convex baseplate even though their stoma sticks out?

Posted by: lifewithapouch | November 15, 2009

Explaining the Past

As I apply to graduate school, there is one section of the application that is optional for some, but required for me: the supplemental essay. You get one page to add something, anything, to your application that you feel is necessary for the school to know when considering your application. I’ve got one page to explain my “missing years.” I need to explain it because if I didn’t, I would be a picture with something missing. They might not understand what it was, but they would sense that something didn’t add up. The letters of recommendation are old. The applicant has been working as a software developer for years – why does she want to go to graduate school to study something else now? Why wasn’t she involved in any professional organizations or community groups? What exactly has she been doing since she graduated from college?

And so I must encapsulate it in one page. It needs to explain what I was doing without asking for pity. It needs to say, this is something worth considering as you compare me to other candidates, but it shouldn’t be soppy and woe-is-me. It needs to be somewhere between a single sentence and a treatise. It needs to convey how limited my life was while providing assurance that my life is unlimited now.

I begin, I stop, I cry, I begin again. I compose. I choose my words. I change commas to periods and begin new sentences. I change my font and my margins. Gotta fit it in one page. The diagnosis, the decline, the dark years. I craft my story. I portray myself. I have a plot, a turning point, a denouement. I have a happy ever after. All in one page.

It’s strange to explain the past, especially when it is in the context of what is essentially a job interview. The old my-weakness-is-my-strength twist, the look-how-I’ve-overcome-adversity meme. But it’s necessary. Otherwise, there are just missing years, a puzzle without a piece, a story without a middle.

Posted by: lifewithapouch | November 8, 2009

The Primitive Side

I think one of the biggest surprises of ileostomy surgery for me is how primitive the whole system is. In an age of heart transplants, and smart prosthetics, and face transplants, they want us to stick a bag onto our abdomens with paste or some other adhesive. It may stick well, it may not. You might be lucky enough to only change it once a week, or you might need to change it every other day. Most of the time your supplies will be in good shape, but sometimes they will be defective.

And if you take a look around the web at various how-to guides, you’ll come across some pretty funny ideas! I found some Hollister literature somewhere that suggested that when you empty your pouch, you should rinse the tail with water. How do they suppose we should do that? Even in your own bathroom, it is questionable how you rinse this thing with water without creating a big mess. But in a public restroom, it is completely out of the question! On another website I found a list of the steps for how to empty your pouch in the toilet, and the first step was to wear a clean pair of medical gloves! No offense to anyone who actually does this, but I really cannot imagine putting on medical gloves every time I go to the bathroom.

On the subject of diarrhea, the general advice is that some foods may cause loose stool. “Some foods” on at least one website included “large meals.” In other words, sometimes you’re going to have loose stool, and good luck finding the specific reason. I guess “large meal” might have been my problem last night! My husband and I had a rather large meal at a restaurant in Boulder, and in the half hour after that I had no activity. We were getting ready to leave Boulder to return to Denver, so I went to the bathroom before we left. But no sooner did we get onto the traffic-clogged highway back to Denver, than I had a “loose stool” reaction to that large meal. My pouch was filling up fast, and we were stuck in traffic! I took two Immodium, but it was too late. We managed to pull off at Westminster, and my husband dropped me off at Panera. I had to walk the entire length of Panera with my hand practically on my crotch, because I was afraid that if I didn’t hold my pouch closed it would burst open. It was so full of liquid I had less than an inch of space at the very top of the pouch. Luckily, I made it. Only then did the Immodium kick in.

And what about emptying your pouch when your stoma is active? All of the sites recommend that you empty your pouch when your stoma is quiet. Good idea, but sometimes you just don’t have a choice. Either you had a leakage and you have to change it even though you just ate dinner, or you’re changing it first thing in the morning before you’ve eaten anything like you always do, only this particular morning your stoma decides to be active. That was my morning this morning. 8 AM is generally a good time, but don’t count on it! A half an hour and two barrier rings later, I finally had a new pouch on and I was ready to punch a hole in the wall! At one point, with a paper towel over my stoma, I was scuttling over to my linen closet to get a second barrier ring, when my husband passed by. “What’s wrong?” he asked. I glared at him. Don’t ask me what’s wrong! You see that I’m naked with a towel over my stoma! Things are not good! Don’t look at me! Don’t be nice! Sorry, hubby. Nice of you to ask me what’s wrong. I’m just in a really bad mood.

So, I googled a little to see if I could find any tips about changing your pouch when your stoma is active. No, not really. Everyone just says to change it when it’s quiet. As if it is all very sophisticated. This whole system is ridiculous! As I rinsed my hands off for the fifth time and stuffed another dirty paper towel into my Ziploc bag, and tried to dry my skin and get a new barrier ring on, I was thinking, Somebody has got to come up with something better than this. I really hope that the three main suppliers don’t stop innovating just because they have captive consumers. I want to believe that in ten years there will be some options that are a little less primitive. Yes, having an ileostomy is manageable. Yes, it’s a hell of a lot better than being sick. But I’m sure I’m not the only one who wants more – I imagine some kind of flexible metal grafted onto my skin so that the pouch just clicks on and there is no adhesive or contact between stomal output and skin. I imagine an internal pouching system that has no major risk of infection, with a collapsible funnel that you open and extend down to empty into the toilet. I imagine a new colon and rectum grown for me from my own stem cells.

I get that the products they have now are a lot better than what they had twenty or thirty years ago. But the concept is basically the same. I hope there will be a new paradigm for how to do this. I hope that somewhere, there is an ostomate who is also some kind of science/bioengineering genius who turns her attention to this problem and comes up with an amazing solution.

Posted by: lifewithapouch | November 1, 2009

A Place to Rant

Before I had ileostomy surgery, I met with an ostomy nurse, and she told me, “This is totally manageable. You will have bad days, there’s no question about that. But everyone I have worked with has been very happy about their decision to have surgery. Most days will be good days.” Based on my experience over the last twenty months since I had surgery, I would say that this statement is a fair one.

I mostly write about how wonderful life has been since surgery, and it takes little effort to do that. This is how I feel most of the time, and knowing that there is so much fear out there around having surgery, I think it is important to communicate that. I was recently reading my new issue of The Phoenix magazine, the quarterly magazine put out by the United Ostomy Association of America (see link on my blog), and it occurred to me that it too is primarily filled with a combination of inspiring, positive stories, and technical information. The technical information is generally in the form of Ask The Nurse sections and articles about things like how to handle skin infections. I flipped through the magazine, and I realized that what I’d really like to see is a Rant section. Maybe just one page – I wouldn’t want there to be so much ranting that we inadvertently communicate that surgery is the most terrible thing that can happen to you, because I really believe it is just about the best thing that has happened to me since I got sick – but a little place where I could read humorous accounts of other people’s bad days would actually make me laugh and feel better. Because some days are challenging.

A lot of ostomates don’t personally know other ostomates, and some percentage of us keep the whole thing a secret from just about everybody in our lives. I am obviously not one of those people, but I respect that decision. So when you’re having a bad day because
-you woke up at 3 AM with a pile of poo on your tummy
-you’re having an inexplicable spate of leakages and you’re having to change your pouch every single day
-you were at the public restroom at fill-in-the-blank and somehow you pulled off your whole pouch when you went to the bathroom
-your stoma made the most obnoxious sound ever when you were having sex
-you got diarrhea and you accidentally sprayed the whole bathroom wall
-you’ve managed to get poo on your hands several times in the same day when emptying your pouch
-[your bad day story here]

wouldn’t it be fun to go somewhere and read other people’s rants?

Fortunately for me, my best friend is an ostomate, so when I need to rant I can call her up. And she, likewise, can call me up. Every ostomate should have an ostomate friend. But whether you have an ostomate friend or not, I think it would be be nice to have a place where we could all share our rants and feel a little camaraderie around the fact that we all share this peculiar situation that frankly some days is gross, inconvenient, and frustrating.

Posted by: lifewithapouch | October 25, 2009

The Possibility of Success

Everyone defines success differently, but broadly speaking, I would say that it is meeting your goals. When I was sick with Crohn’s colitis, I almost never met my goals. Sometimes my goals were relatively big, like working a full day or writing a couple thousand words on my novel. Other times, they were small, like emptying the dishwasher, or taking a shower and getting dressed. The scale from small to big was a sick person’s scale. My big, challenging goals were things I could have easily accomplished as a healthy person. But even so, I never quite made it. And one day I stopped making goals. I would wake up, and it might be nine, ten, even noon already. I’d shuffle around my home, maybe do a few dishes or straighten up a little before I was tired again. I would read a little, then become disengaged. Somehow evening would arrive, and my husband would come home and I was still in my pajamas. It sounds like the life of a depressed person, but I felt relatively cheerful most of the time. I had just forgotten what normal was, so I had no perspective on how bad things had gotten. And since I’d stopped making goals, I didn’t feel like I was failing day after day.

As an ostomate, I am a healthy person, and for the first time in years I can make goals and reach them. At first, I was afraid to set goals for myself. I started small. I was going to work six hours a day for a while, and see if I could do it. I was going to write a little every day, and see if I managed that. I would try to keep the house clean and make dinner and shower and get dressed and brush my teeth. But before long, I found that all of this was easy! So I decided to work eight hours a day. Eventually I started this blog. I decided that I wanted to go to graduate school, and for this I would have to take my GREs. I decided I wanted to travel again. I wanted to take up piano lessons. And I wanted to try to get my first published credit.

The higher I set the goal, the more nervous I get. The anxiety is not a central part of my character; rather, it is a learned response from the cycle of failure I experienced as a sick person. I have a rational layer that informs me that success is in trying, rejection is part of the process, that nobody experiences unqualified success with every single goal they set. And then there’s an emotional layer underneath, that results in trembling as I send a query letter off to a magazine, or telling myself that I shouldn’t try to pursue a PhD program after all.

I finally took my GREs, and I aced them. As I sat there in front of the computer looking at my score, I couldn’t believe what I was seeing. I kept blinking and reading every single word on the screen. Why is it showing these numbers? Is it really saying that these numbers are my score? I was shaking. As I walked out of the test center into the beautiful Colorado sunshine, I started crying. Why didn’t I believe in myself? Sometimes it feels like I recovered from Crohn’s disease over night, but fully recovering from chronic illness actually takes a long time. I have to learn to believe in myself again.

And then I received a positive response to my query letter, and again I was stunned. The phenomenon of reaching a goal is still so new. In my head, I keep hearing myself saying “Really?” As my life opens up before me, and I begin to realize that I might actually achieve what I set out to do, there’s a new kind of fear. You mean if I apply to a graduate program in Ithaca, NY, I might actually get in? What then? We would have to make a decision about whether to uproot our lives and move someplace with really cold wet winters, or stay here and forego that opportunity. What if my piano teacher, who is in the movie industry, reads my screenplay and he actually likes it and passes it on to a studio and they too are interested? What if my first published credit leads to my second leads to my third, and some day I can quit my job as a software developer and just consider myself a writer?

Don’t get me wrong, I want all of these things to happen. I want every opportunity to come my way. But perhaps more importantly, I want the internal strength to be able to shrug off the rejections as they come and keep moving forward. I guess right now I am just somewhat dazed as I try to come to terms with the possibility of success. Even though it’s been nineteen months since surgery, I’m still getting used to allowing myself to hope and dream. I’m still getting used to making goals, and only finally getting a glimmer of how thrilling it is to reach one.

Posted by: lifewithapouch | October 18, 2009

An Alkaline Meal

I invited a friend over to dinner today, and at first she hesitated to accept. She explained to me that she was on an alkaline diet right now to combat some acid reflux. And boy, was she tired of eating millet. Ah, millet. This brought back memories. Over my eleven years with Crohn’s disease, I went on my share of alkaline diets, and I’ve eaten a lot of millet. I actually love millet, but nevertheless have probably only eaten it a couple of times in the year and a half since surgery. But this was no reason not to come to my house for a meal! If anyone should be able to pull off an alkaline meal, it’s me. So I urged her and her husband to come anyway. I just warned her tongue-in-cheek that if the meal was bland, we would blame her.

So I poured over my cookbooks, picking up a few heavily-used ones that I hadn’t looked at since my sick days. First, The Cleanse Cookbook, by Christine Dreher. This one, with the acid-forming and alkaline-forming lists that I had once photocopied so that I could have the lists taped up on the refrigerator and folded in my wallet. This one, with the recipes that would be really good if only you added a little of this and a little of that. Then I opened my Paul Pitchford’s Healing With Whole Foods. This book had really been through it. The pages are curled, dog-eared and food-bespattered. I went to the index, and shuddered as I recalled how I’d poured over the index so many times, desperate to find the information that was going to cure me. The book is great for understanding the properties of individual foods and for good, wholesome recipes, but try using the information there to form a Chinese understanding of the cause of your disease. Given all of the symptoms I had, there were all kinds of explanations, many of them directly contradicting each other. I used to go in circles in this book, at my wit’s end, trying to find some new insight. Maybe if I eliminated this, or added that, I would get my Crohn’s under control.

It was strange to dip back into this world. Just looking through these pages brought me back to a very dark time, a time when I still had enough hope that I was searching for a way that I could control my disease, but becoming aware that nothing I did seemed to make any difference. There were days when I found some tidbit that inspired optimism, days when invariably I had to run to Whole Foods right away to get this or that thing that was going to make a big difference. Then nothing. It’s a cycle that often led to despair.

But that’s not where I’m at anymore. Cooking an alkaline meal now would be an opportunity to create something pleasing for my friend; my own life didn’t hang in the balance. And another big difference is that as a healthy person, I have the energy to be creative in the kitchen. Having refreshed my mind on what is acid versus alkaline-forming, I could go to some of my fun cookbooks and with a few creative substitutions I could create a meal that would delight us all and relieve my dear friend from the monotony of millet.

The proposed menu:

Toasted buckwheat and tempeh stuffed cabbage with roasted red pepper sauce and a basil garlic cashew sour cream (the latter sauce is for the rest of us; cashews are acid-forming)
Bitter greens, figs, and butternut squash with a curried almond dressing (dressing on the side in case my friend can’t have it)

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